Qiong Wang1, Shimin Zhang2, Yi Wang3, Zhengyue Jing4, Yanxin Zhou5, Kaili Qi6, Xiyuan Wang7, Chengchao Zhou8. 1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China. Electronic address: wq995323@163.com. 2. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China. Electronic address: 1758217072@qq.com. 3. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China. Electronic address: wangyi031104@163.com. 4. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China. Electronic address: 2680929012@qq.com. 5. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China. Electronic address: 1248257972@qq.com. 6. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China. Electronic address: virtuekey@163.com. 7. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China. Electronic address: 17865193515@163.com. 8. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, China. Electronic address: zhouchengchao@sdu.edu.cn.
Abstract
BACKGROUND: Losing the only child is an extremely distressful life event for parents. Previous studies indicated that shidu parents were more vulnerable to develop posttraumatic stress disorder (PTSD). This study aims to calculate the pooled prevalence of PTSD and identify its risk factors. METHOD: We conducted a systematic literature search in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang databases, Vip databases. We performed a meta-analysis using random effects models to calculate the pooled PTSD in shidu parents. Associated factors for PTSD was evaluated by determining standardized mean difference (SMD) with 95% CIs. All analyses were performed using the Stata 16.0. RESULTS: Eight articles (covering 2,722 shidu parents) were included in this study. The pooled prevalence of PTSD was 46.8% (95%CI: 33.2%-60.3%) among Chinese shidu parents. Female (SMD[95%CI]: 0.41[0.20, 0.62]), higher education level (SMD[95%CI]: 0.15[0.03, 0.28]), lower income (SMD[95%CI]: 0.33[0.13, 0.53]), losing a daughter (SMD[95%CI]: 0.16[0.03, 0.28]) and shorter time since loss (SMD[95%CI]: 0.24[0.07, 0.40]) were significantly associated with a higher PTSD prevalence. Registered residence, cause of death, age of the child, and having a grandchild were not associated with PTSD. LIMITATIONS: Some variables included in this meta-analysis were only measured twice, which limited the conclusions to some extent. CONCLUSION: This meta-analysis indicated that nearly half of shidu parents experienced PTSD and provided evidence of risk factors for PTSD in shidu parents. Further research is suggested to determine how these factors interact. Effective interventions should be conducted to shidu parents with PTSD.
BACKGROUND: Losing the only child is an extremely distressful life event for parents. Previous studies indicated that shidu parents were more vulnerable to develop posttraumatic stress disorder (PTSD). This study aims to calculate the pooled prevalence of PTSD and identify its risk factors. METHOD: We conducted a systematic literature search in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang databases, Vip databases. We performed a meta-analysis using random effects models to calculate the pooled PTSD in shidu parents. Associated factors for PTSD was evaluated by determining standardized mean difference (SMD) with 95% CIs. All analyses were performed using the Stata 16.0. RESULTS: Eight articles (covering 2,722 shidu parents) were included in this study. The pooled prevalence of PTSD was 46.8% (95%CI: 33.2%-60.3%) among Chinese shidu parents. Female (SMD[95%CI]: 0.41[0.20, 0.62]), higher education level (SMD[95%CI]: 0.15[0.03, 0.28]), lower income (SMD[95%CI]: 0.33[0.13, 0.53]), losing a daughter (SMD[95%CI]: 0.16[0.03, 0.28]) and shorter time since loss (SMD[95%CI]: 0.24[0.07, 0.40]) were significantly associated with a higher PTSD prevalence. Registered residence, cause of death, age of the child, and having a grandchild were not associated with PTSD. LIMITATIONS: Some variables included in this meta-analysis were only measured twice, which limited the conclusions to some extent. CONCLUSION: This meta-analysis indicated that nearly half of shidu parents experienced PTSD and provided evidence of risk factors for PTSD in shidu parents. Further research is suggested to determine how these factors interact. Effective interventions should be conducted to shidu parents with PTSD.