Effects of Caregivers on the Mental State of Children Receiving Inpatient Treatment in the Oncology Service
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Original Article
P: 133-140
July 2024

Effects of Caregivers on the Mental State of Children Receiving Inpatient Treatment in the Oncology Service

Turk J Child Adolesc Ment Health 2024;31(2):133-140
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No information available
Received Date: 23.01.2023
Accepted Date: 16.05.2023
Online Date: 31.07.2024
Publish Date: 31.07.2024
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ABSTRACT

Objectives:

Economic and social burdens lead caregivers to psychopathologies that affect their childrens’ undergoing cancer treatment. In this study, we aimed to evaluate the effect of caregivers on the mental health of children and adolescents receiving inpatient treatment for cancer.

Materials and Methods:

In this study, 44 patients who received inpatient treatment at Ege University Tülay Aktaş Oncology Hospital between March 2019 and March 2020 and who accepted participation were included. The diagnoses of the patients were made according to the Affective Disorders and Schizophrenia Interview Schedule for School-Age Children-current and lifelong version which is a semi-structured interview and according to the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders. Symptom Checklist-90-Revised (SCL), Parental Attitude Research Instrument (PARI), and Hospital Anxiety-Depression Scale (HADS) were applied to the caregivers.

Results:

A total of 44 patients, [24 (54.5%) girls and 20 (45.5%) boys] between the ages of 2-18 years were included in the study. The mean age of the girls was 9.2 (±5.7), and that of the boys was 10.0 (±5.2) years. The most common diagnosis in 26 (59.1%) patients with psychiatric diagnosis was depressive disorder (n=14, 31.8%). As the education level of mothers decreased, there was a significant increase in the frequency of psychiatric diagnoses among patients (p=0.02). As the number of hospitalization days increased, the frequency of psychiatric diagnoses in children increased (p=0.01). Scale scores of those with and without psychopathology were similar (p>0.05). The average number of hospitalization days was 93. According to HADS cut-offs twenty-eight (63.6%) of the parents had elevated anxiety scores while 21 (47.7%) had elevated depression scores. PARI attitude of hostility and rejection [p=0.01, mean ± standard deviation (SD): 30.70±7.50], husband and wife incompatibility subscale scores (p=0.04, mean ± SD: 17.00±4.93), anxiety subscale of HADS scores (p=0.07, mean ± SD: 12.11±4.18), were higher in the caregivers of patients who were hospitalized for more than 93 days.

Conclusion:

It has been observed that children of caregivers with rigid and protective attitudes who have low education levels are at risk of psychiatric disorders. A multidisciplinary approach is important for developing psychosocial support strategies for caregivers of patients in oncology. Prolonged hospitalization time is an important factor that negatively affects the psychiatric status of both caregivers and patients. The treatment team should notice the need for psychiatric support in such cases.

References

1
Cancer today. [Accessed May 17, 2021.http://gco.iarc.fr/today/home]
2
Definition of survivorship - NCI Dictionary of Cancer Terms - National Cancer Institute. Published February 2, 2011. [Accessed May 17, 2021.https://www.cancer.gov/publications/dictionaries/cancer-terms/def/survivorship]
3
Mitchell AJ, Vaze A, Rao S. Clinical diagnosis of depression in primary care: a meta-analysis. Lancet. 2009;374:609-619.
4
Durualp E, Kara FN, Yılmaz V, Alabeyoğlu K. Kronik Hastalığı Olan ve Olmayan Çocukların ve Ebeveynlerinin Görüşlerine Göre Yaşam Kalitelerinin Karşılaştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2010;63:55-63.
5
Edwards B, Clarke V. The psychological impact of a cancer diagnosis on families: the influence of family functioning and patients’ illness characteristics on depression and anxiety. Psychooncology. 2004;13:562-576.
6
Cop E, Dinc GS, Kultur SEC. Coping Styles of Mothers of Children with Chronic Diseases and Their Relationship with Psychiatric Symptoms: A Preliminary Report. Turk J Pediatr Dis. 2016;10:170-176.
7
Norberg AL, Lindblad F, Boman KK. Parental traumatic stress during and after pediatriccancer treatment. Acta Oncol. 2005;44:382-388.
8
Salem H, Andersen EW, Dalton SO, Schmiegelow K, Winther JF, Lichtenthal WG, Johansen C, Bidstrup PE. Psychotropic Medication Use in Parents of Children Diagnosed With Cancer. Pediatrics. 2019;143:e20182605.
9
Grootenhuis MA, Last BF. Predictors of parental emotional adjustment to childhood cancer. Psychooncology. 1997;6:115-128.
10
Barlow JH, Ellard DR. The psychosocial well-being of children with chronic disease, their parents and siblings: an overview of the research evidence base. Child Care Health Dev. 2006;32:19-31.
11
Gokler B, Unal F, Pehlivanturk F, Kultur EC¸ Akdemir D, Taner Y. Reliability and validity of schedule for affective disorders and schizophrenia for school-age children-present and lifetime version-Turkish version (K-SADS-PL-T). Turk J Child Adolesc Ment Health. 2004;11:109-116.
12
Aydemir O. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Turkish J Psychiatry. 1997;8:280-287.
13
Le Compte G, Le Compte A, Özer S. (1978). Üç sosyoekonomik düzeyde Ankaralı annelerin çocuk yetiştirme tutumları: Bir ölçek uyarlaması. Psikoloji Dergisi. 1978;1:5-8.
14
Derogatis LR, Cleary PA. Confirmation of the dimensional structure of the SCL‐90: A study in construct validation. J Clin Psychol. 1977;33:981-989.
15
Dağ İ. Belirti tarama listesi (SCL-90-R)’nin üniversite öğrencileri için güvenirliği ve geçerliği. Türk Psikiyatri Derg. 1991;2:5-12.
16
Majeed MH, Khokhar MA, Abid M, Raza A, Qaisar MN, Ali AA, Wagas A. Frequency and correlates of symptoms of anxiety and depression among young caregivers of cancer patients: a pilot study. BMC Res Notes. 2018;11:631.
17
Budak MA, Geçkil E. Kronik Hastalığı Olan Çocukların Annelerinin Bakım Verme Yükü ile Anksiyete-Depresyon Düzeyinin Belirlenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2020;3:391-399.
18
Tuna MK, Aydoğan Ü, Sarı O, Kılıç S, Cöngöloğlu MA, Atay AA, Kürekçi AE, Köseoğlu V, Sağlam K. GATF Pediatrik hematoloji ve Onkoloji kliniklerinde herhangi bir malignite veya kronik hastalık nedeniyle takip edilen çocukların ebeveynlerindeki depresyon, anksiyete, umutsuzluk durumlarının belirlenmesi. TSK Koruyucu Hekimlik Bülteni. 2012;11:577-582.
19
Eiser C, Eiser JR, Stride CB. Quality of life in children newly diagnosed with cancer and their mothers. Health Qual Life Outcomes. 2005;3:29.
20
Boman KK, Viksten J, Kogner P, Samuelsson U. Serious illness in childhood: the different threats of cancer and diabetes from a parent perspective. J Pediatr. 2004;145:373-379.
21
Iqbal A, Siddiqui KS. Depression among parents of children with acute lymphoblastic leukemia. J Ayub Med Coll Abbottabad. 2002;14:6-9.
22
Wikman A, Mattsson E, von Essen L, Hovén E. Prevalence and predictors of symptoms of anxiety and depression, and comorbid symptoms of distress in parents of childhood cancer survivors and bereaved parents five years after the end of treatment or a child’s death. Acta Oncol. 2018;57:950-957.
23
Shokri M, Tarjoman A, Borji M, Solaimanizadeh L. Investigating psychological problems in caregiver of pediatrics with cancer: A systematic review. J Child Adolesc Psychiatr Nurs. 2020;33:229-238.
24
Geng HM, Chuang DM, Yang F, Yang Y, Liu WM, Liu LH, Tian HM. Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97:e11863.
25
Isokääntä S, Koivula K, Honkalampi K, Kokki H. Resilience in children and their parents enduring pediatric medical traumatic stress. Paediatr Anaesth. 2019;29:218-225.
26
Psychogiou L, Legge K, Parry E, Mann J, Nath S, Ford T, Kuyken W. Self-Compassion and Parenting in Mothers and Fathers with Depression. Mindfulness (N Y). 2016;7:896-908.
27
Ateş E, Canyılmaz E, Çakır NG, Yurtsever C, Yöney A. Kanser Hastalarının ve Onlara Bakım Veren Kişilerin Depresyon ve Anksiyete Durumlarının Değerlendirilmesi. Ankara Medical Journal. 2018;18:61-67.
28
Şahin N, Öztop DB, Yılmaz S, Altun H. Tip 1 Diyabetes Mellitus Tanılı Ergenlerde Psikopatoloji, Yaşam Kalitesi ve Ebeveyn Tutumlarının Değerlendirilmesi. Nöropsikiyatri Arş. 2015;52:133-138.
29
Barber BK, Olsen JE, Shagle SC. Associations between parental psychological and behavioral control and youth internalized and externalized behaviors. Child Dev. 1994;65:1120-1136.
30
Yalçn SS, Durmuşoğlu-Sendoğdu M, Gümrük F, Unal S, Karg E, Tuğrul B. Evaluation of the children with beta-thalassemia in terms of their self-concept, behavioral, and parental attitudes. J Pediatr Hematol Oncol. 2007;29:523-528.
31
Tillery R, Long A, Phipps S. Child perceptions of parental care and overprotection in children with cancer and healthy children. J Clin Psychol Med Settings. 2014;21:165-172.
32
Tütüncü S. Derleme: Köken Aile Tutumlarının Psikopatoloji Üzerine Etkisi. Gelişim ve Psikol Derg. 2020;1:49-56.
33
AÇ Kantarcıoğlu, MESezgin. Bursa’da Pediatrik Talasemi, Hemofili ve Lösemili Olgu Annelerinin Aşırı Koruyucu Ebeveyn Tutumları ve Duygu Durumlarının Değerlendirilmesi. J Curr Pediatr. 2018;16:37-50.
34
Öz PDF, Yilmaz UHEB. Ruh Sağlığının Korunmasında Önemli Bir Kavram: Psikolojik Sağlamlık. Hacettepe Üniversitesi Hemşire Fakültesi Derg. 2009;16:82-89.
35
Pars H, Çavuşoğlu H. Lösemili Adölesanlarda Psikolojik Sağlamlığın İncelenmesi: Karşılaştırmalı Bir Çalışma. Florence Nightingale Hemşirelik Derg. 2019;27:104-118.
36
Er DM. Çocuk, hastalık, anne-babalar ve kardeşler. Çocuk Sağlığı ve Hastalıkları Dergisi. 2006;49:155-168.
37
Arslantaş H, Adana F, Kaya F, Turan D. Yatan Hastalarda Umutsuzluk ve Sosyal Destek Düzeyi ve Bunları Etkileyen Faktörler. Florence Nightingale Hemşirelik Derg. 2010;18:87-97.
38
Demirbağ S, Ergin D. Türkiye’de Hastanede Yatan Çocukların Yaşam Kalitesini Ne Etkiler? Kırşehir Ahi Evran Üniversitesi Sağlık Bilim Derg. 2022;6:130-143.
39
Sarman A, Sarman E. Pediyatrik Onkoloji Hastalarında Ruhsal Hastalıklar ve Bakıma Yönelik Kanıta Dayalı Güncel Uygulamalar. İzmir Katip Çelebi Üniversitesi Sağlık Bilim Fakültesi Derg. 2022;7:105-111.
40
Özkan S. Psikiyatrik tip: konsültasyon-liyazon psikiyatri. Bull Clin Psychopharmacol. 1990;1:10-17.
41
Ateşçi FÇ, Oguzhanoglu N, Baltalarli B, Karadağ F, Ozdel O, Karagöz N. Psychiatric disorders in cancer patients and associated factors. Türk Psikiyatri Derg. 2003;14:145-152.
42
Cousino MK, Hazen RA. Parenting stress among caregivers of children with chronic illness: a systematic review. J Pediatr Psychol. 2013;38:809-828.
43
Majeed MH, Khokhar MA, Abid M, Raza A, Qaisar MN, Ali AA, Waqas A. Frequency and correlates of symptoms of anxiety and depression among young caregivers of cancer patients: a pilot study. BMC Res Notes. 2018;11:631.
44
Woodgate RL. Life is never the same: childhood cancer narratives. Eur J Cancer Care (Engl). 2006;15:8-18.
45
Canning RD, Harris ES, Kelleher KJ. Factors predicting distress among caregivers to children with chronic medical conditions. J Pediatr Psychol. 1996;21:735-749.