Home⇛The PCMC Journal⇛vol. 15 no. 2 (2019)

Comparison of the Anxiety Levels in Children with Acute LymphoblasticLeukemia and their Well Siblings Using the Child Drawing :Hospital Manual

Efraim Culminas | Angie Sievert-Fernandez | Michael M. Resurreccion

 

Abstract:

OBJECTIVES: The study aims to determine and compare the anxiety of children with acute lymphoblastic leukemia (ALL) and their well siblings based on Child drawing: Hospital manual and to identify factors associated with the level of anxiety. METHODS: A prospective cross-sectional study was done in tertiary pediatric hospitals which included children aged five to eleven years old diagnosed with ALL and their well siblings. RESULTS: A total of forty dyads of participants were studied. ALL patients presented higher anxiety scores than their siblings, but this was not statistically significant. There is a weak direct correlation between overall anxiety scores of ALL patients and their siblings (p = 0.017). There is insufficient evidence for an association between select clinical factors with anxiety scores. The linear regression model explained 49.77% in the variation of the anxiety scores but was not statistically significant. CONCLUSIONS: There is a direct correlation between overall anxiety scores of ALL patients and their siblings. There is also a positive association with larger family size and child‘s response to sibling‘s illness. Larger families are likelier to have a healthier environment. The study also showed low to average anxiety levels among participants which may be related to quality of care and support given by the institution and inherent resiliency of the family. RECOMMENDATIONS: Future research should aim to develop programs in partnership with families and other social support groups and explore the effectiveness of these interventions. Further studies should examine other possible cultural and psychodynamic factors prevalent in Filipino Family.



References:

  1. American Cancer Society. Cancer facts and figures 2017.
  2. Laudico AV, Esteban DB, Tabafunda TM. Philippines, Manila and Rizal Cancer Registry, 1983–1992. In: Parkin DM, Kramarova E, Draper GJ, et al., editors. International incidence of childhood cancer. Vol II. IARC Sci Publ No. 144. Lyon: IARC Press; 1998. p. 211–215.
  3. Laudico AV, Esteban DB, Reyes L, Liquido L. Philippine cancer facts and estimates. Manila: Philippine Cancer Society, Inc.; 1998.
  4. Whitlock FA. Suicide and physical illness. In: Roy A, editor. Suicide. Baltimore: Williams and Wilkins; 1986. p. 151–170.
  5. McGrant P. Findings of the impact of treatment for childhood acute lymphoblastic leukemia on family relationships. Child Fam Soc Work. 2001;6:229–37.
  6. Alderfer MA, Kazar AE. Family issues when a child is on treatment for cancer. In: Brown RT, editor. Comprehensive handbook of childhood cancer and sickle cell disease: a biopsychosocial approach. Oxford: Oxford University Press; 2006. p. 53–74.
  7. Alderfer MA, Long K, Lown EA, Marsland A, Ostrowski N, Hock J, et al. Psychosocial adjustment of siblings of children with cancer: a systematic review. Psychooncology. 2011.
  8. Clatworthy S, Simon K, Tiedeman ME. Child drawing: hospital—an instrument designed to measure the emotional status of hospitalized school-aged children. J Pediatr Nurs. 1999;14:2–9.
  9. Pao SM, Bosk A. Anxiety in medically ill children and adolescents. Depress Anxiety. 2010;28:40–9.
  10. Newman BM, Newman PR, Griffen S, O’Connor K, Spas J. The relationship of social support to depressive symptoms during the transition to high school. Adolescence. 2007;42:441–59.
  11. DuBois DL, Felner RD, Meares H, Krier M. Prospective investigation of the effects of socioeconomic disadvantage, life stress, and social support on early adolescent adjustment. J Abnorm Psychol. 1994;103:511–22.
  12. Enskar K, Carlsson M, Golsater M, Hamrin E, Kreuger A. Parental reports of changes and challenges that result from parenting a child with cancer. J Pediatr Oncol Nurs. 1997;14:156–63.
  13. Rocha-Garcia A, Del Río A, Alvarez H, Hernández-Peña P, Martinez-Garcia MC, Marin-Palomares T, et al. The emotional response of families to children with leukemia at the lower socioeconomic level in central Mexico. Psychooncology. 2003;12:78–90.
  14. Sidhu R, Passmore A, Baker D. An investigation into parent perceptions of the needs of siblings of children with cancer. J Pediatr Oncol Nurs. 2005;22:276–87.
  15. Carpenter PJ, Sahler OJZ. Sibling perception and adaptation to childhood cancer: conceptual and methodological considerations. In: Johnson JH, Johnson SB, editors. Advances in child health psychology. Gainesville (FL): University of Florida Press; 1991. p. 193–205.
  16. Sloper P, While D. Risk factors in the adjustment of siblings of children with cancer. J Child Psychol Psychiatry. 1996;37:597–607.
  17. Barrera M, Fleming CF, Khan FS. The role of emotional social support in the psychological adjustment of siblings of children with cancer. Child Care Health Dev. 2004;30:103–11.
  18. Woodgate RL. Siblings’ experiences with childhood cancer. Cancer Nurs. 2006;29:406–14.
  19. Alderfer MA, Labay LE, Kazak AE. Brief report: does posttraumatic stress apply to siblings of childhood cancer survivors? J Pediatr Psychol. 2003;28:281–6.
  20. Packman WL, Crittenden MR, Schaeffer E, Bongar B, Fischer JB, Cowan MJ. Psychosocial consequences of bone marrow transplantation in donor and nondonor siblings. J Dev Behav Pediatr. 1997;18:244–53.
  21. Packman WL, Fine J, Chesterman B, Van Zutphen K, Golan R, Amylon M. Camp Okizu: preliminary investigation of a psychological intervention for siblings of pediatric cancer patients. Child Health Care. 2004;33:201–15.
  22. Packman WL, Gong K, van Zutphen K, Shaffer T, Crittenden M. Psychosocial adjustment of adolescent siblings of hematopoietic stem cell transplant patients. J Pediatr Oncol Nurs. 2004;21:233–48.
  23. Demaray MK, Malecki CK. Critical levels of perceived social support associated with student adjustment. Sch Psychol Q. 2002;17:213–41.
  24. Myers R, et al. A prospective study of anxiety, depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia. Cancer. 2014;120. Available from: http://onlinelibrary.wiley.com/doi/10.1002/cncr.28578/epdf
  25. Julious SA, Campbell MJ, Walker SJ, George SL, Machin D. Sample sizes for cancer trials where health related quality of life is the primary outcome. Br J Cancer. 2000;83:83. Available from: http://www.nature.com/bjc/journal/v83/n7/abs/6691383a.html
  26. Burns R, Kaufman S. Draw-a-person techniques. New York: Harper & Row; 1970–1972.
  27. McKeever P. Siblings of chronically ill children: a literature review with implication for research and practice. Am J Orthopsychiat. 1983;53:240–9.
  28. Bank S, Kahn M. Sisterhood-brotherhood is powerful: sibling-subsystems in family therapy. Fam Process. 1975;14:311–39.
  29. Cohen MS. Families coping with childhood chronic illness: a research review. Fam Syst Health. 1999;17:149–64.
  30. Sharpe D, Rossiter L. Siblings of children with a chronic illness: a meta-analysis. J Pediatr Psychol. 2002;27:699–710.
  31. Coddington R. The significance of life events as etiologic factors in the disease of children: I and II. J Psychosom Res. 1972;16:205–15.
  32. Hannah ME, Midlarsky E. Siblings of the handicapped: a literature review for school psychologists. Sch Psychol Rev. 1985;14:510–20.
  33. Howe GW. Siblings of children with physical disabilities and chronic illnesses: studies of risk and social ecology. In: Stoneman Z, Berman PW, editors. The effects of mental retardation, disability, and illness on sibling relationships: research issues and challenges. Baltimore (MD): Paul H. Brookes; 1993. p. 185–213.
  34. Minuchin S, et al. Families of the slums. New York: Basic Books; 1967.
  35. Spinetta J, Deasy-Spinetta P, editors. Living with childhood cancer. St. Louis: C. V. Mosby; 1981.
  36. Birenbaum A. On managing a courtesy stigma. J Health Soc Behav. 1970;2:196–206.
  37. Gath A. Sibling reactions to mental handicap: a comparison of the brothers and sisters of mongol children. J Child Psychol Psychiatry. 1974;15:187–98.
  38. Farber B. Effects of a severely retarded child on the family. In: Trapp E, Himelstein P, editors. Readings on the exceptional child. New York: Appleton-Century-Croft; 1972.
  39. Cairns N, et al. Adaptation of siblings to childhood malignancy. J Pediatr. 1979;95:484–7.
  40. Allan J, Townley R, Phelan P. Family response to cystic fibrosis. Aust Pediatr J. 1974;10:136–46.
  41. Alderfer M, Hodges J. Supporting siblings of children with cancer: a need for family-school partnerships. Sch Ment Health. 2010;2:72–81. doi:10.1007/s12310-010-0927-
  42. Birenbaum A. On managing a courtesy stigma. J Health Soc Behav. 1970;2:196–206.

Tools


Copyright © 2025  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic