Family Management Intervention Study On Children With Leukemia In Chongqing

Background:Leukemia is the most common malignant tumor in children.With the continuous improvement of diagnosis and treatment technology,the 5-year overall survival rate of children with acute lymphoblastic leukemia in China reaches 70.8%.Leukemia has become a chronic disease requiring long-term care.Domestic and abroad studies have shown that families with leukemia patients face a heavy economic burden and long-term care pressure,which therefore leads to family conflicts and affects family function.Whether the family as a whole can integrate disease management into daily life greatly affects the treatment and rehabilitation of the child.At present,the status quo and influencing factors of family management of children with leukemia in China are still unclear,and there is also a lack of intervention strategies for family management of leukemia children.Objectives:1.Understand the current situation of and explore the influencing factors of family management of families with children with leukemia.2.Carry out family management intervention for the parents of children with leukemia,and evaluate the changes after the intervention.Explore the effect of applying family management intervention,with the ecosystem theory as the framework,in the family management of families with children with leukemia.Methods:1.Cross-sectional investigation and study: Using the method of convenient sampling to select parents of children with leukemia who were hospitalized in the children's hospital in Chongqing from August 2017 to March 2018 and using the general information questionnaire,FaMM,FFFS,and SSRS to investigate and understand the current situation of and the influencing factors of their family management.2.Quasi-experiment study: Constructing family management intervention strategy based on social ecosystem theory.Using the method of convenient sampling to select parents of children with leukemia who were hospitalized in the children's hospital in Chongqing from April 2018 to December 2018 as the study object.Among them,data from the control group were collected from April 2018 to July 2018,data from the treatment group were collected from August 2018 to December 2018.The control group received routine treatment and nursing,and the treatment group,on the basis of the control group,was provided,by the intervention team,with family management intervention including family task adjustment,disease care guidance,peer communication,social support and so on.The FaMM,FACES?,PANAS and SSRS were used before the intervention,4 weeks after intervention and 8 weeks after intervention,and the intervention effect was evaluated.Results:1.Status of family management:(1)From the scale of scores,family management scores of families with children with leukemia show that the scores of Children's Daily Life are significantly lower than the intermediate scores(P<0.01),the Disease Management Ability and the Parental Relationship scores are at an intermediate level,and the Disease-related Concerns,the Family Life Difficulties,and the Disease Management Burden scores are significantly higher than the intermediate scores(P<0.01).(2)Multivariate linear regression analysis showed that factors such as the type of disease in children,the level of parents' education,the monthly income of families,changes in parents' work and family types were related to family management results(P<0.05).(3)Structural equation model shows that family function,economic status,educational level,and residence directly affect family management,among which family function has the greatest negative effect on family management(direct effect value is 0.533),social support indirectly affects negative results of family management by affecting family function(indirect effect value is 0.141),work changes can either directly or indirectly affect the positive results of family management by affecting family function(direct effect value is-0.273,indirect effect value is-0.114,total effect value is-0.387).2.Family management intervention:(1)There was no statistically significant difference between the two groups before the intervention(P>0.05);(2)The total scores of the treatment group,during the 4th and the 8th week of intervention,of disease management ability,positive negative emotion,objective support,subjective support,and social support were better than the scores before intervention and those of the control group,and the difference was statistically significant(P<0.05).(3)The support utilization score improved with time(P<0.01);(4)The difference of family intimacy and adaptability scores between the two groups had no statistical significance(P>0.05)after the intervention.Conclusion:1.The family management level of children with leukemia is relatively low.Parents think that their children's daily life,after the child's illness,became different from the daily lives of healthy children at the same age,that the future of their children and families needed more concern,that the care disease consumes more energy and family life also became difficult.Family function,family financial situation,parents' educational level,social contextual and psychological status should be concerned to develop interventions in order to promote family management.2.Family management interventions that adjust family tasks,guide disease care,conduct peer communication,provide psychological and social support,introduce welfare systems,and correct misconceptions can effectively improve the condition management ability of parents of children with leukemia and positively adjust parental emotions,improve the social support for families and help families cope with the condition in a better way,but it has no obvious effect on improving family intimacy and adaptability.