Trajectories of illness uncertainty among parents of children with atypical genital appearance due to differences of sex development.

IF 2.7 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Journal of Pediatric Psychology Pub Date : 2024-08-01 DOI:10.1093/jpepsy/jsae043
Katherine A Traino, Lucia M Ciciolla, Megan N Perez, John M Chaney, Ginger Welch, Laurence S Baskin, Cindy L Buchanan, Yee-Ming Chan, Earl Y Cheng, Douglas E Coplen, Amy B Wisniewski, Larry L Mullins
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Abstract

Objective: The present study aimed to identify distinct trajectories of parental illness uncertainty among parents of children born with atypical genital appearance due to a difference of sex development over the first year following diagnosis. It was hypothesized that four trajectory classes would emerge, including "low stable," "high stable," "decreasing," and "increasing" classes, and that select demographic, familial, and medical factors would predict these classes.

Methods: Participants included 56 mothers and 43 fathers of 57 children born with moderate to severe genital atypia. Participants were recruited from eleven specialty clinics across the U.S. Growth mixture modeling (GMM) approaches, controlling for parent dyad clustering, were conducted to examine classes of parental illness uncertainty ratings over time.

Results: A three-class GMM was identified as the best-fitting model. The three classes were interpreted as "moderate stable" (56.8%), "low stable" (33.0%), and "declining" (10.3%). Findings suggest possible diagnostic differences across trajectories.

Conclusions: Findings highlight the nature of parents' perceptions of ambiguity and uncertainty about their child's diagnosis and treatment the year following their child's birth/diagnosis. Future research is needed to better understand how these trajectories might shift over the course of the child's development. Results support the development of tailored, evidence-based interventions to address coping with uncertainty among families raising a child with chronic health needs.

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因性别发育差异导致生殖器外观不典型儿童的父母对疾病不确定性的轨迹。
研究目的本研究旨在确定因性别发育差异而导致先天性生殖器外观不典型的儿童的父母在确诊后第一年内的疾病不确定性的不同轨迹。假设会出现四个轨迹等级,包括 "低稳定"、"高稳定"、"递减 "和 "递增 "等级,并且人口、家庭和医疗因素会预测这些等级:参与者包括 57 名先天性中度至重度生殖器不典型儿童的 56 名母亲和 43 名父亲。在控制父母双方聚类的情况下,采用增长混合模型(GMM)方法研究了父母疾病不确定性评级随时间变化的等级:结果:三类 GMM 被确定为最佳拟合模型。这三个等级被解释为 "中度稳定"(56.8%)、"低度稳定"(33.0%)和 "下降"(10.3%)。研究结果表明,不同轨迹之间可能存在诊断差异:研究结果凸显了父母在孩子出生/诊断后一年内对孩子诊断和治疗的模糊性和不确定性的看法。未来的研究需要更好地了解这些轨迹在儿童成长过程中可能发生的变化。研究结果支持开发有针对性的循证干预措施,以解决抚养有慢性健康需求儿童的家庭在应对不确定性方面的问题。
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来源期刊
Journal of Pediatric Psychology
Journal of Pediatric Psychology PSYCHOLOGY, DEVELOPMENTAL-
CiteScore
6.00
自引率
11.10%
发文量
89
期刊介绍: The Journal of Pediatric Psychology is the official journal of the Society of Pediatric Psychology, Division 54 of the American Psychological Association. The Journal of Pediatric Psychology publishes articles related to theory, research, and professional practice in pediatric psychology. Pediatric psychology is an integrated field of science and practice in which the principles of psychology are applied within the context of pediatric health. The field aims to promote the health and development of children, adolescents, and their families through use of evidence-based methods.
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