Volume 18, Issue 9 (December 2020)
Nursing and Midwifery Journal 2020, 18(9): 715-721 |
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Valizadeh S, Tizfahm T, Kiyani A. Behavioral-Emotional Disorders in Children with Leukemia Undergoing Chemotherapy: a Cross-Sectional Study. Nursing and Midwifery Journal 2020; 18 (9) :715-721
URL: http://unmf.umsu.ac.ir/article-1-4197-en.html
URL: http://unmf.umsu.ac.ir/article-1-4197-en.html
1- MSc Student in Internal Surgical Nursing, Faculty of Nursing and Midwifery, Islamic Azad University of Urmia, Urmia, Iran
2- Master of Internal Surgery Nursing, Faculty of Nursing and Midwifery, Islamic Azad University of Urmia, Urmia, Iran. (Corresponding Author) , Tizfahmturan386@gmail.com
3- Urmia University of Medical sciences, Urmia, Iran
2- Master of Internal Surgery Nursing, Faculty of Nursing and Midwifery, Islamic Azad University of Urmia, Urmia, Iran. (Corresponding Author) , Tizfahmturan386@gmail.com
3- Urmia University of Medical sciences, Urmia, Iran
Abstract: (1805 Views)
Background & Aims: Leukemia is the most common childhood tumor, accounting for approximately one-third of all cancers of this age. Children with leukemia often receive multimodal treatments, which can cause acute and long-term side effects. Painful procedures, long hospital stays, and unclear prognosis are common stressors that can affect these children's emotional and behavioral systems. This cross-sectional study was performed to determine the extent of behavioral-emotional problems in children with leukemia undergoing chemotherapy at Shahid Motahari Educational Center in Urmia, 2019.
Materials & Methods: In this cross-sectional study, 163 children with leukemia (mean age 9.27 ± 2.82 years) who were referred to the oncology clinic of Shahid Motahari Hospital were selected using available sampling method. The demographic information questionnaire and the Child Behavior Checklist (CBCL) were used to collect data. After getting acquainted with the children and their parents, the purpose of the study was explained to them. After obtaining informed consent from the parents of all patients, the questionnaires were completed by the parents. The collected data were analyzed using descriptive and inferential statistical methods (independent t-test and one-way analysis of variance).
Results: In this study, the mean and standard deviation of total, internalized, and externalized behavioral problems were 97.92 ± 28.24, 61.9 ± 16.51, and 25.11 ± 11.34, respectively Based on the normalized average, the highest score was related to the withdrawn/depression component (57.81 out of 100). Statistical analysis of the data showed that the mean score of total behavioral problems (p = 0.000) and all the subscales were significantly different among the participants with different levels of education (p0.05). In addition, the Pearson correlation coefficient showed that there was a statistically significant positive relationship between the mean score of total problems and quantitative variables of child's age, age of diagnosis, father's age and mother's age (p>0.05).
Conclusion: Based on results of this study, the scores of anxiety / depression, isolation / depression, attention problems and internalized behavioral problems were above average. The mean scores of total behavioral problems and their components in school children (the first year of high school) is much higher than the children of lower grades. Therefore, it is important to identify and prevent such cases in high school children with leukemia.
References
1. Karen C. Nelson's Pediatric Medicine Basics. Translation by Farshad Moghadam, Pourranandakht Gholamipour Shirazi. Tehran: Artin Teb Publishing:; 2015. [URL]
2. Childhood cancer [Internet]. [cited 2021 Feb 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/cancer-in-children [URL]
3. Esmaily H, Barzanouni S, Farhangi H. Determining factors contributing to the five-year survival of children suffering from acute lymphoblastic leukemia based on tree survival model in the presence of competing risks. Jorjani Biomedicine Journal 2018;6(4):29-39. [DOI:10.29252/jorjanibiomedj.6.4.29]
4. Society TAC. The American Cancer Society's Oncology in Practice: Clinical Management. 1st edition. Hoboken, NJ: Wiley-Blackwell; 2018.P. 776. [URL]
5. Xu J, Murphy SL, Kochanek KD, Bastian B, Arias E. Deaths: final data for 2016. Natl Vital Stat Rep 2018;67(5):1-76. [PMID]
6. Hunger SP, Mullighan CG. Acute lymphoblastic leukemia in children. N Engl J Med;373(16):1541-52. [DOI:10.1056/NEJMra1400972] [PMID]
7. Cherven B, Mertens A, Meacham LR, Williamson R, Boring C, Wasilewski-Masker K. Knowledge and risk perception of late effects among childhood cancer survivors and parents before and after visiting a childhood cancer survivor clinic. J Pediatr Oncol Nurs 2014;31(6):339-49. [DOI:10.1177/1043454214532022] [PMID]
8. Hanson JL, Nacewicz BM, Sutterer MJ, Cayo AA, Schaefer SM, Rudolph KD, et al. Behavioral problems after early life stress: contributions of the hippocampus and amygdala. Biol Psychiatry;77(4):314-23. [DOI:10.1016/j.biopsych.2014.04.020] [PMID] [PMCID]
9. Carr CP, Martins CM, Stingel AM, Lemgruber VB, Juruena MF. The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes. J Nerv Ment Dis 2013;201(12):1007-20. [DOI:10.1097/NMD.0000000000000049] [PMID]
10. Liu W, Cheung YT, Brinkman TM, Banerjee P, Srivastava D, Nolan VG, et al. Behavioral symptoms and psychiatric disorders in child and adolescent long‐term survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only. Psycho‐oncology 2018;27(6):1597-607. [DOI:10.1002/pon.4699] [PMID] [PMCID]
11. Williams LK, Lamb KE, McCarthy MC.Behavioral side effects of pediatric acute lymphoblastic leukemia treatment: the role of parenting strategies. Pediatr Blood Cancer 2014;61(11):2065-70. [DOI:10.1002/pbc.25164] [PMID]
12. Landers AL, Bellamy JL, Danes SM, Hawk SW. Internalizing and externalizing behavioral problems of American Indian children in the child welfare system. Children and Youth Services Review 2017;81:413-21. [DOI:10.1016/j.childyouth.2017.08.014]
13. Hajrasuliha M, Y.F., Oreyzi HR., The Comparison of Behavioral-Emotional Problems and Skills of Childrens 6-12 Years with Parent with Cancer Compared with Control Group.. J Res Behav Sci, 2016. [URL]
14. Fauth RC, Platt L, Parsons S. The development of behavior problems among disabled and non-disabled children in England. Journal of Applied Developmental Psychology 2017;52:46-58. [DOI:10.1016/j.appdev.2017.06.008]
15. Khazaei T, Khazaei MM, Khazaei M. The prevalence of behavioral problems in children in Birjand. J Birjand Univ Med Sci 2005;12(1):2. [URL]
16. Stormont M, Reinke W, Herman K. Teachers' knowledge of evidence-based interventions and available school resources for children with emotional and behavioral problems. Journal of Behavioral Education 2011;20(2):138. [DOI:10.1007/s10864-011-9122-0]
17. Buizer AI, de Sonneville LM, van den Heuvel‐Eibrink MM, Veerman AJ. Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor. Cancer 2006;106(9):2067-75. [DOI:10.1002/cncr.21820] [PMID]
18. Achenbach TM, Ruffle TM. The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatr Rev 2000;21(8):265-71. [DOI:10.1542/pir.21.8.265] [PMID]
19. Kashani, Z.H.G., The Evaluation of Behavioral Disorders Prevalence in Mofid Hospital Childhood Leukemia (ALL), 2009.
20. Minaei A. Factorial Invariance of syndromes' items of Achenbach's Child Behavior Checklist (CBCL). Educational Psychology 2007; 3(7): 93-116. [Google Scholar]
21. Nazari S, Koupaei MT, Shafiee A, Kashani ZH, Bahraminia E, Ansari M, et al. Emotional/behavioral problems in children with acute lymphoblastic leukemia: a case-control study. Int J Hematol Oncol Stem Cell Res 2014;8(2):14. [PMID] [PMCID]
22. Firoozi M, Rouhi S. Psychological Problems in Boys with Acute Myeloid Leukemia (AML) with Central Nervous System (CNS) Involvement; A Descriptive Study. International Journal of Cancer Management 2020; 13(2):e96851. [DOI:10.5812/ijcm.96851]
23. Savege E, Riordan AO, Hughes M. Quality if life in children with acute lymphoblastic leukemia:a systematic review. Eur J Oncol Nurs 2009;13(1):36-48. [DOI:10.1016/j.ejon.2008.09.001] [PMID]
24. Zareifar S, Almasi-Hashiani A, Karimi M, Tabatabaee S H, Ghiasvand R. Five-year survival rate of pediatric leukemia and its determinants. Koomesh 2012; 14 (1):13-9 [Google Scholar]
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