在传统社会中养育性发育障碍儿童：心理影响

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2024-11-17 DOI:10.1016/j.jpedsurg.2024.162067

Afef Toumi , Sami Sfar , Hajer Ounissi , Amjed Ben Haouala , Wafa Dhouib , Amine Ksia , Mongi Mekki , Mohsen Belghith , Lassaad Sahnoun

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引用次数: 0

摘要

背景性发育障碍会给父母带来巨大的心理压力，尤其是在传统社会中，这类疾病被视为耻辱。本研究旨在调查先天性肾上腺皮质增生症导致的性发育障碍对染色体核型为46, XX的儿童的心理情感影响，从而确定父母焦虑和抑郁发生的预测因素，以及父母为适应孩子的病情而采取的应对策略。材料与方法这是一项回顾性、横断面、描述性和分析性研究，研究对象是在 2005 年 1 月 1 日至 2021 年 12 月 31 日期间接受女性化基因整形手术、因先天性肾上腺皮质增生症导致性发育障碍而接受治疗的 46 XX 核型儿童的家长。研究使用贝克抑郁量表、汉密尔顿焦虑量表和简易 COPE（阿拉伯语版本）分别评估抑郁、焦虑和应对能力。其中，57.4%的家长表现出抑郁症状，37%的家长表现出焦虑症状。家长最常采用的应对策略是接受（88.9%）、依赖宗教（66.7%）、计划（63%）和积极应对（63%）。抑郁的预测因素包括患儿目前的年龄（OR=1,280）、女性化基因整形手术时的年龄（OR=1,273）以及未向患儿透露基因整形手术的情况（OR=331,522）。焦虑的预测因素包括父母的性别为女性（OR=7,756）、孩子目前的年龄（OR=1,499）、进行女性化基因整形手术时孩子的年龄（OR=1,150）以及未向孩子透露基因整形手术的情况（OR=115,278）。结论尽管与先天性肾上腺皮质增生症有关的性发育障碍患儿的父母采取了各种应对策略，但焦虑和抑郁的发生对这些父母中的许多人来说仍然是不可避免的，这取决于几个明确的预测因素。因此，当务之急是提供适当的心理支持，帮助这些父母有效地适应这种复杂的情况。研究类型病例对照研究证据等级III

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Parenting a child with disorder of sexual development in traditional society: Psychological impact

Background

Disorders of Sexual Development can cause significant psychological distress for parents, particularly in traditional societies where such conditions are stigmatized.

Aim

This study aims to investigate the psychoaffective impact of sexual development disorders caused by congenital adrenal hyperplasia in children with 46, XX karyotype, in order to determine the predictive factors for the onset of anxiety and depression among parents and the coping strategies employed by parents to adapt to their child’s condition.

Materials and Methods

This is a retrospective, cross-sectional, descriptive, and analytical study involving parents of children treated for sexual development disorders related to congenital adrenal hyperplasia, with a 46, XX karyotype, who underwent feminizing genitoplasty during the period from January 1, 2005 and December 31, 2021. The Beck Depression Inventory, the Hamilton Anxiety Scale, and the Brief COPE, in their Arabic versions, were used to assess depression, anxiety and coping respectively.

Results

This study included 54 parents. Among them 57,4% exhibited depressive symptomatology, while 37% reported anxiety symptoms. The most frequently adopted coping strategies among parents were acceptance (88,9%), reliance on religion (66,7%), planning (63%), and active coping (63%). Predictive factors of depression included the child’s current age (OR=1,280), the age of the child at the time of feminizing genitoplasty (OR=1,273), and the non-disclosure of the genitoplasty to the child (OR=331,522). Predictive factors of anxiety included the parent’s female gender (OR=7,756), the child’s current age (OR=1,499), the age of the child at the time of feminizing genitoplasty (OR=1,150), and the nondisclosure of the genitoplasty to the child (OR=115,278).

Conclusion

Despite the various coping strategies adopted by parents of children with disorder of sexual development related to congenital adrenal hyperplasia, the occurrence of anxiety and depression remains inevitable for many of these parents, depending on several well-defined predictive factors. It is therefore imperative to implement appropriate psychological support to help these parents effectively adapt to this complex situation.

Type of Study

Case-Control Study

Level of Evidence

III

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.