A Longitudinal Study On Mental Health And Psychological Intervention In School-age Children With Leukaemia And Their Parents

Objective: (1) To evaluate the mental health conditions of the children with leukaemia or their parents, and the factors associated with mental health conditions. (2) To explore the psychological intervention for children with leukaemia and their parents in order to improve their quality life.Methods: There were 60 children with leukaemia (30 cases with newly-diagnosed and 30 cases received consolidation therap) in leukaemia group,39 children with chronic non- malignant blood diseases in case control group and 52 healthy children in normal control group.The mental health conditions of the children were evaluated by the Screen for Child Anxiety Related Emotional Disorders(SCARED), the Depression Self-rating Scale for Children(DSRSC) and Illness Behavior Questionnaire, And the parents'mental health conditions were rated by Symptom Checklist-90(SCL-90), Medical Coping Modes Questionnaire (MCMQ) and Coping Style Questionnaire wwere used for evaluating children or parents coping styles separately. The influencing factors were retrospective analysised by collecting related information. We used the card imprinted with facial expression to evaluate the emotion in children with leukeamia during the first month hospitalization with psychological intervention and non- psychological intervention,.Results: (1)â‘ The total scores of SCARED, DSRSC and SCL-90 in the four groups showed that the children in the newly-diagnosed-leukaemia group > in the consolidation theray group > in the case control group > in the normal control group (F=10.317, P<0.001; F=11.674, P<0.001; F=11.025, P<0.001).â‘¡The children in the newly-diagnosed- leukaemia group had the highest the scores in somatizationl/panic disorder, generalized anxiety,separation anxiety (P<0.05). The children with leukaemia in consolidation theray stage had higer scores than the normal control group in separation anxiety, social phobia (P<0.05).â‘¢The leukaemia group(the newly-diagnosed-leukaemia group and the consolidation theray group) had higher scores than control groups in DC, P/S, AI, AD, I, AS, DA and WI subscales of the Illness Behavior Questionnaire (P<0.05).â‘£The newly-diagnosed-leukaemia children showed highest scores in obsessive-compulsive, depression and anxiety (P<0.05). The parents having a child with leukaemia in intensive theray stage had showed higher scores than case control group in somatization, depression and anxiety subscales (P<0.05). (2)â‘ On the MCMQ, the confrontation scores in the consolidation theray stage group were higher than the other groups (P<0.05). The leukaemia children used more the avoidance coping style(P<0.05) and the acceptance-resignation coping style than case control group (P<0.001).â‘¡On the coping modes, the parents having a child with leukaemia had higher scores than case control group in self-accusation, help and fantasy subscale (P<0.05).(3)â‘ The correlation analysis between children MCMQ with SCARED, DSRSC and Illness Behavior showed that negative correlation between confronation and negative emotion. The avoidance and acceptance-resignation coping styles had positive correlated with the children poor mental health (P<0.05). As the same, the parents'negative coping styles affected their mental health. The less positive style the parents used, the more psychological problems (P<0.05).â‘¡The children with long hospital stay and poor peer relationship had more anxiety problems. Treatment cost constraints, parents'lack of confidence in treating disease and poor employment would have more problems of poor social adaptation for parents and children'depressive symptoms.(4)As time goes by, the emotion of children in both of the two leukaemia groups were gradually improved, especially the children after the psychological intervention who can confront the disease better, The result showed that the mental health of children and their parents were remarkably improved after the psychological intervention. Conclusions: (1) The children with leukaemia and their parents are in poor mental state, especially for those children with leukaemia at the newly-diagnosed stage. (2) The negative coping modes and poor family economic condition may affect the children and their parents'mental health. (3)Positive psychological and social intervention will be conducive to improve their quality of life.