The Relationship Between Psychological Stress Response And Perseverative Cognition In Caregivers Of Children With Vascular Malformation

Objectives:1.To investigate the current situation of psychological stress response(anxiety symptoms,depression symptoms,post-traumatic stress disorder symptoms and insomnia symptoms)of caregivers of children with vascular malformation during perioperative intervention;2.Explore the possible mediating role of cognitive fixation(rumination and worry)in the relationship between perioperative stress and psychological stress response of caregivers of children with vascular malformations.Methods:Using the method of convenient sampling,277 caregivers of children with vascular malformation were selected in the ward of Hemangioma and interventional vascular surgery of a top three hospital in Shandong Province.The self-designed general information questionnaire for children and caregivers,generalized anxiety disorder(GAD-7),depression module of patient health questionnaire(PHQ-9),the perceived stress Scale-10 item version(PSS-10),and The 5th edition of post-traumatic stress disorder checklist for dsm-5(PCL-5),insomnia severity index(ISI),ruminative responses scale(RRS)and Penn State Worry Questionnaire(PSWQ)were used to understand the general information of children and caregivers respectively,The anxiety symptoms,depression symptoms,overall stress level,post-traumatic stress disorder symptoms,insomnia symptoms,rumination and worry levels of caregivers were evaluated respectively.The research object of this paper refers to the caregivers of children with vascular malformation,except for special instructions.Adopt spss26.0 statistical analysis of the data,mainly including descriptive statistical analysis,Harman one-way test,independent t-test,chi-square test,ANOVA,Pearson correlation analysis,etc.The mediating effect was analyzed by the PROCESS 2.16 plugin for SPSS,using bias-corrected nonparametric bootstrap method.The mediating effect is significant when the 95%confidence interval of the indirect effect does not include 0.Using bilateral test,P<0.05 was statistically significant.Results:1.The average score of anxiety symptoms was 5.61±5.21,and the average score of depression symptoms was 4.99 ± 5.34.With 10 points as the dividing point,the positive rate of anxiety symptom score was 17.0%,and the positive rate of depression symptom score was 14.4%.With 28 points as the dividing point,the positive rate of PTSD was 7.9%.The average score of insomnia symptoms was 4.82 ± 4.73,with 10 points as the dividing point.The positive rate of insomnia symptoms was 25.3%.The average score of stress(perceived stress)was 16.75 ± 5.75,the average score of rumination was 34.61 ± 13.62,and the average score of worry was 46.76 ± 12.54.2.The results of univariate analysis showed that there was significant difference in the scores of anxiety and depression symptoms in children’s age(P<0.05),there was significant difference in the scores of marital status in post-traumatic stress disorder(P<0.05),and the PTSD scores of caregivers with partners were lower than those without partners.There were significant differences in the scores of anxiety symptoms and post-traumatic stress disorder among caregivers with different family economic status(P<0.05).There was significant difference in the scores of anxiety and depression symptoms in the time of caring for children(P<0.05).The scores of anxiety and depression of caregivers who cared for children for less than 8 hours were lower.3.Pearson correlation analysis showed that perceived stress(stress),worry and rumination were positively correlated with anxiety symptoms,depression symptoms,post-traumatic stress disorder symptoms and insomnia symptoms(P<0.05).4.Rumination is the mediating factor of the relationship between stress and anxiety symptoms(b=0.43,95%confidence interval[0.384,0.578]),and the mediating effect is 0.253(95%confidence interval[0.177,0.341]).Rumination was the mediating factor of the relationship between stress and depressive symptoms(b=0.50,95%confidence interval[0.329,0.545]),and the mediating effect was 0.283(95%confidence interval[0.184,0.401]).Cognitive fixation(rumination and worry)is the mediating factor of the relationship between stress and PTSD symptoms.The mediating effect of rumination is 0.298(95%confidence interval[0.198,0.418]),and the mediating effect of worry is 0.070(95%confidence interval[0.017,0.136]);Rumination and worry are mediating factors in the relationship between stress and insomnia symptoms.The mediating effect of rumination is 0.228(95%confidence interval[0.139,0.327]),and the mediating effect of worry is 0.069(95%confidence interval[0.006,0.134]).Conclusion:1.The psychological stress reaction of caregivers of children with vascular malformation(anxiety symptoms,depression symptoms,post-traumatic stress disorder symptoms,insomnia symptoms)is relatively serious,which should attract the attention of clinical workers and researchers.2.Cognitive fixation(rumination and worry)plays an intermediary role in the relationship between caregiver stress and psychological stress response in children with vascular malformation,rumination plays an intermediary role in the relationship between caregiver stress and psychological stress response(anxiety symptoms,depression symptoms,post-traumatic stress disorder symptoms,insomnia symptoms)in children with vascular malformation,and worry plays an intermediary role in caregiver stress,post-traumatic stress disorder symptoms and insomnia symptoms in children with vascular malformation,Worry does not play a mediating role in stress,anxiety and depression.It can be seen that cognitive fixation(rumination and worry)is one of the important mechanisms of psychological stress response caused by stressors in this group.