| Objective:To study the social life ability,emotional status of children after hematopoietic stem cell transplantation,and the relationship between coping style and emotional status of children,provide information for medical staff and parents,and basis for clinical intervention.Method:A questionnaire survey was conducted among children undergoing hematopoietic stem cell transplantation in the transplantation ward of the Department of Hematology,Children's Affiliated Hospital of Soochow University from October 2014 to January 2019.A total of 124 children aged 6 months to 14 years old were investigated with the Baby-Junior Middle School Students Social Living Ability Scale.53 children aged 8 to 16 years old were investigated with CODI Self-Rating Coping Style Scale,the Screen for Children Anxiety Related Emotional Disorders(SCARED)and Self-Rating Scale for Depressive Disorder in Childhood(DSRSC).The relationship between anxiety and depression was compared with the domestic norm,and the relationship between the age at the time of transplantation,course of diseases,complications after transplantation and the social life ability and emotional state of the children were observed.We used SPSS 20.0 software to analyze the data Single factor analysis,Spearman correlation analysis and t test.p<0.05 was defined as statistical significance.Result:(1)Social life ability:1.The total score of social life ability of post-transplantational children was positivelycorrelated with the age at diagnosis,the age at the time of transplantation and the age at the time of filling the questionnaire(r=0.732,p<0.001;r=0.853,p<0.001;r=0.861,p<0.001).2.The standard score of social life ability of post-tranplantation children was positively correlated with the age of initial diagnosis,the age at transplantation and the age of testing(r=0.239,p=0.008;r=0.266,p=0.003;r=0.292,p=0.001).3.The standard score of social life ability of children after transplantation was positively correlated with the course of diseases after transplantation(r=0.246,P=0.006).While no correlation was observed between the standard score and the course of diseases before transplantation and the total course of disease.4.There was no correlation between the standard scores of social life ability of children after transplantation and gender,pre-transplantational chemotherapy,donor source,aGVHD,cGVHD,CMV infection,EBV infection,hemorrhagic cystitis,VOD and complications during testing.5.Compared with the average of the norm group,the mean of the total score of the social life ability of the transplanted children differed from the 1 to 1.5-year-old group significantly(transplantation group:15.50±1.38);norm group:15.69±1.69,p=0.012<0.050).However,there was no significant difference between the other age groups and the norm group(p>0.050).(2)Coping style and emotional state:1.The average subscales of coping style were 4.02± 0.74 in acceptance,2.16±0.57 in negative emotional response,3.24±1.05 in separation anxiety,4.56±0.76 in illusion,3.52±0.92 in self-comfort and 3.18±1.17 in avoidance.The most commonly adopted coping style were "illusion",followed by "acceptance","self-comfort" and "negative emotional response".2.Among 53 children,5(9.43%)had anxiety scale scores reached 23 points or more,which was defined as anxiety disorders.The somatization subscale score was positively correlated with the course of diseases after transplantation(r=0.490,p=0.032).The separation anxiety subscale was negatively correlated with the age of initial diagnosis,transplantation and testing(r=-0.365,p=0.007,r=-0.371,p=0.006;r=0.297,p=-0.297;p=0.=0.031).The score of social phobia subscale was positively correlated with the course of diseases and the total course of diseases after transplantation(r=0.307,P=0.025;r=0.293,P=0.033).The total score of anxiety scale was positively correlated with the course of diseases after transplantation(r=0.291,P=0.034).3.Compared with the norm,the scores of social phobia subscale of girls aged 8 to 12 years old had statistical significance(5.14 ± 2.28 in transplantation group,3.57±2.76 in norm group,p=0.023<0.050).Separation anxiety and school phobia subscale of girls aged 13-16 had statistical significance(1.70±2.00 in transplantation group,3.25±2.65 in norm group,p=0.037<0.050;0.30 ± 0.68 in transplantation group,0.85 ± 1.11 in norm group,p=0.030).The scores of school phobia subscales of boys aged 8-12 years were significantly different(1.00 ± 1.21 in transplantation group,0,82 ± 1.06 in norm group,p=0.001).Somatization subscale,social phobia subscale and anxiety scale of boys aged 13-16 years were statistically significant subscale(6.56 ± 3.13 in transplantation group,3.27±3.10 in norm group,p<0.001;6.89 ± 3.10 in transplantation group,3.72 ± 2.94)in norm group,p=0.015;24.00± 8.57 in transplantation group,14.23±2.11 in norm group,p=0.009).4.Of the 53 children,2(3.77%)had a depression scale score of more than 15 points or more,defined as depressive disorders.The total score of depression scale was positively correlated with the age at the time of transplantation,the age at the time of test and the course of diseases before transplantation(r=0.345,p=0.011;r=0.275,p=0.046;r=0.321;p=0.019).The depression scale scores of boys aged 8 to 10 years old,boys aged 11 to 14 years old and girls aged 8 to 11 years old had statistical significance compared with those of the norm 5.89(+3.10 in transplantation group,9.99±4.57 in norm group,p=0.004;6.93 ± 3.96 in transplantation group,9.91 ± 4.99 in norm group,p=0.011;6.50±2.27 in transplantation group,9.72 ± 4.44 in norm group,p=0.002).5.The scores of anxiety scale were positively correlated with the scores of negative emotional response subscale and escape subscale(r=0.343,p=0.012,r=0.314,p=0.022).The scores of depression scale were positively correlated with negative emotional response(r=0.358,p=0.008).Conclusion:1.The social life ability of children in the 1 to 1.5 years old group was significantly affected.The later the age of onset was,the higher the standard score of social life ability would be.While the later the onset was,the less the influence of late onset on the social life ability of children would be.With the passage of time after transplantation,the social life ability of children gradually improved.2.After transplantation,children often adopt relatively positive coping styles such as"illusion" and "acceptance" to cope with their own diseases.3.The longer the time after transplantation,the more obvious the somatization/panic of the children.the younger children.The younger the children,the more obvious of the separation anxiety would become.With the extension of the course of diseases and the total course of diseases,the more obvious the social phobia of the children would tend to.The longer the time interval after the transplantation,the more serious the general anxiety of the children.4.Compared with normal children,children after transplantation had anxiety various in different degree.The 13 to 16-year-old girls had separation anxiety,8 to 12-year-old girls and 13 to 16-year-old boys had social phobia,13 to 16-year-old girls and 8 to 12-year-old boys had school phobia,13 to 16-year-old boys had somatization/panic,and the overall anxiety was the most obvious.5.Compared with normal children,the depressive disorders of transplanted children was significantly less,and the depressive state of 8 to 11 year-old boys and girls and 11 to 14 year-old boys was significantly better than the norm.Depression in children increased with the age of transplantation,the age of testing and the course of diseases before transplantation.6.Anxiety and depression of children who choose negative emotional reaction and escape coping style are relatively serious.7.Medical staff and parents should encourage children to adopt more positive coping styles,which is more conducive to maintaining a good mental state. |
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