Baseline Characteristics Associated with Posttraumatic Stress in Caregivers of Pediatric Transplant Recipients: A Multi-Site, Multi-Regional Study
The objective of this study was to identify demographic, medical, psychosocial, and behavioral factors associated with parental post-traumatic stress (PTSS) within the pediatric transplant setting. Identification of these factors can aid in the ongoing development of the Integrative Trajectory Model (ITM), which provides a framework in which to understand posttraumatic stress within the medical setting. Participants included 386 parents who were enrolled in the Medication Adherence in Children who had a Liver Transplant (MALT) study, a longitudinal study that recruited from five transplant clinics across the U.S. The majority of participants were non-Hispanic, Caucasian, married, privately insured, and female. Most had school-aged children and completed, at minimum, some years of college or completed vocational school. Time since transplant ranged from 1 to 17 years, with the majority of transplants coming from deceased donors. Both mothers and fathers reported, on average, elevated levels of PTSS, and a minority of parents reported clinically indicated levels of depressive symptoms. Results from the primary analyses revealed that overall PTSS, avoidance symptoms, and intrusion symptoms were not significantly associated with parental gender or donor type. Overall PTSS, avoidance, and intrusion were positively associated with depressive symptoms and barriers to medication adherence. Results from post-hoc analyses show that intrusive symptoms were negatively associated with time since transplant and avoidance scores were positively associated with non-married status and lower education level. Results of this study indicate potential correlates of PTSS to include within the Integrative Trajectory Model (i.e., depressive symptoms, perceived barriers to treatment adherence, and time since transplant). Other factors that are in need of further exploration are education level and non-married status, which have been shown to be associated with PTSS avoidance. These findings indicate the clinical need to assess for and address PTSS and its potential correlates, such as depression and perceived barriers to medication adherence, within the transplant setting. Additionally, the results suggest a need to assess for PTSS in both mothers and fathers and to monitor whether intrusive symptoms are decreasing over time and, if not, to assess further as to what may be contributing to their maintenance.
Supelana, Christina J, "Baseline Characteristics Associated with Posttraumatic Stress in Caregivers of Pediatric Transplant Recipients: A Multi-Site, Multi-Regional Study" (2019). ETD Collection for Fordham University. AAI13425444.