Evaluating depression in a sample of children and adolescents with cancer in Greece

Psychosocial adaptation of families with children newly diagnosed with cancer in the Greek population amidst the socioeconomic crisis

OBJECTIVE

To present the initial assessment of psychosocial adaptation among Greek parents whose children were newly diagnosed with cancer amidst the turmoil of an ongoing financial crisis.

STUDY DESIGN

This prospective observational study used a quantitative approach.

PARTICIPANTS

Sixty-one parents of children with cancer treated at a large urban tertiary-care children's hospital were prospectively recruited to participate in our study during the first week of their child's diagnosis (2013-2016).

METHODS

The parents were asked to complete the psychosocial assessment tool (PAT 2.0), Zung Depression Scale, State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale, and World Health Organization Quality of Life-Bref Instrument; Moreover, three female healthcare providers (the physician oncologist, the head nurse and a senior nurse) completed the relevant PAT 2.0 -Staff Perceptions questionnaire the results of which were then compared to those of the child's parent.

FINDINGS

The majority of parents had PAT 2.0 scores indicative of increased psychosocial risk :54% were stratified into the "Targeted" (moderate risk) and 15% into the "Clinical" (highest risk) categories, whereas healthcare providers underestimated psychosocial risk in 57%-59% of the cases. The subscales that most contributed to the increased scores were Parental Stress Reaction, Family Structure and Resources, and Family Social Support. The PAT 2.0 had statistically significant correlations with most of the anxiety and depression scales, with Zung having the strongest correlation (r-value: +0.5, p-value <0.01). Our cohort presented more anxiety and depression compared to the general Greek population (14% for depression versus 2,9% for the general population and 46% for anxiety compared to 4,1%) in the years of financial recession in Greece.

CONCLUSIONS

The parents of children newly diagnosed with cancer in Greece are at increased risk for developing anxiety and depression in the years of financial recession in Greece compared to general population.

IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS

Parental stress reaction to diagnosis as well as lack of family resources and social support may contribute to this difference. Screening for psychosocial risk factors is essential for the early identification of these families and for the optimal utilization of the limited available resources in times of economic hardship.

Light Therapy for QoL/Depression in AYA With Cancer: A Randomized Trial

OBJECTIVE

Secondary outcomes from a published feasibility and acceptability trial were examined to explore the effect of bright white light (BWL) on quality of life (QoL) and depressive symptoms compared to dim red light (DRL) control in adolescents and young adults (AYAs) receiving cancer-directed therapy.

METHODS

Fifty-one AYAs (12-22 years, 51% male) newly diagnosed with cancer were randomized to receive 8 weeks of BWL (n = 26) or DRL (n = 25). The CDI-2 (total score, negative mood/physical symptoms, interpersonal problems, ineffectiveness, and negative self-esteem) and parent- and self-report PedsQL (total score and subscales of physical, emotional, social, and school QoL) were completed at multiple timepoints.

RESULTS

BWL produced improvements in self-reported total depression (d = -.64; 95% confidence interval [CI] = -1.26, -0.01), negative self-esteem (d = -.80; 95% CI = -1.43, -.14), negative mood/physical symptoms (d = -.73; 95% CI = -1.36, -0.08), ineffectiveness (d = -.43; 95% CI = -1.04, .19), total self-reported QoL (d = .41; 95% CI = -.16, .96), emotional (d = .78; 95% CI = .19, 1.37), school functioning (d = .48; 95% CI = -.09, 1.04), and parent-reported school functioning (d = .66; 95% CI = 0.02, 1.33). BWL reported a greater rate of improvement than DRL for total depression (β = .49, p < .05) and self-esteem (β = .44, p < .05), and parent-reported school functioning (β = -1.68, p < .05).

CONCLUSIONS

BWL improved QoL and depressive symptoms for AYAs with cancer. These findings will inform larger randomized controlled trials.

The Effect of Painting on Depression in Children with Cancer Undergoing Chemotherapy

Background:

Psychological and social health of children with cancer may be severely affected by the disease and its treatment. Successive drawing by children can help them over time in terms of psychological and social adaptation. This study aimed to investigate the effects of drawing on depression in children with cancer undergoing chemotherapy.

Materials and Methods:

This quasi-experimental study was conducted on 7–12-year-old children with cancer undergoing chemotherapy. After completing Maria Kovacs' Children's Depression Inventory (CDI), 65 children who had obtained scores higher than 12 were chosen as study participants and were randomly divided into two experimental and control groups. The children in the experimental group were engaged in open painting sessions for 6 weeks. After the intervention, the CDI was completed again in both the groups. The obtained data were analyzed using descriptive and inferential statistical methods, such as independent t-test, paired t-test, and Chi-square and Mann–Whitney tests.

Results:

There was a significant difference between the children's depression scores before and after the intervention in both the two groups (P < 0.001).

Conclusions:

The results showed that painting was effective in reducing depression in children with cancer undergoing chemotherapy. Therefore, painting can be used as an easy, cheap, and effective intervention by nurses to help children with cancer undergoing chemotherapy.

Assessment of quality of life in adolescent patients with cancer and adolescent survivors of childhood cancer

PURPOSE

The aim of the study was to assess the quality of life (QoL) of adolescents with cancer and survivors of childhood cancer as well as the effect of various demographic factors upon it.

DESIGN AND METHODS

The sample of the study included 82 adolescents aged 13-20 years who had been diagnosed with any type of cancer. Twenty-six of them received treatment and 56 survivors of childhood cancer had successfully completed their treatment. Data collection lasted from July 2010 to December 2012 in Children's Hematology-Oncology Unit in Athens. For data collection, Minneapolis-Manchester Quality Questionnaire of Life Instrument was used. The assessment of the QoL of adolescents undergoing treatment was performed with three measurements and that of the survivors with one.

RESULTS

The QoL of adolescent patients did not significantly change during treatment and they showed a satisfactory QoL. Boys scored higher than girls (z = -1.78, p = .04 in psychological function and t = 2.27, p = .02 in body image) as far as QoL in social relations is concerned (z = -2.79, p = .002 in first measurement and z = -2.31, p = .01 in second measurement). Scores on the scale for the QoL of survivors of childhood cancer who completed treatment was 3.91. Survivors showed a higher QoL than the adolescent patients.

CONCLUSIONS

This research has shown that the studied population scored a sufficient QoL, especially survivors of childhood cancer ones. Moreover, their QoL seemed to be influenced by the stage of treatment, the type of cancer, sex, age, family support, and their level of education.

Assessment of quality of life of children and adolescents with cancer during their treatment

OBJECTIVE

The purpose of this study was to evaluate the quality of life of children and adolescents with any type of cancer in all phases of their treatment.

METHODS

Fifty-six newly diagnosed patients diagnosed with malignancy and hospitalized in a Pediatric Hematology-Oncology Unit in Athens were included in the study. Minneapolis-Manchester Quality of Life Instrument was used for data collection from July 2010 to December 2012. The assessment of children and adolescents' quality of life who were under treatment was performed in three different stages of treatment.

RESULTS

The results of the study showed that the quality of life of children and adolescents with cancer did not change notably during their treatment (F = 0.16, P = 0.86 and F = 0.03, P = 0.97). For the first measurement, at the beginning of the therapy, the score on the scale for quality of life for children and adolescents was 3.44 and 3.88, respectively, in the middle of the treatment 3.36 and 3.89, respectively, and 3.43 and 3.89, respectively, when therapy was completed. Children and adolescents diagnosed with hematologic cancer stated higher quality of life scores (z = -1.61, P = 0.05 and t = 2.64, P = 0.007). Moreover, teenage patients (F = 13.22, P = 0.001) and male patients (t = 2.31, P = 0.02 and t = 2.27, P = 0.02) expressed better quality-of-life scores.

CONCLUSION

According to the results, children and adolescents with any kind of cancer have better quality-of-life scores at the end of their treatment, and when they are supported by their family.

Play model for "evaluation of self-concept of children with cancer"

Background:

Childhood cancers are fatal diseases which cause intense stress and traumatic situations for the ones who experience those diseases. This kind of an emotionally hard life may create some hardships for developing self-concept. The aim of the study is to put forth the self-exposure of a school-age child by using plays.

Materials and Methods:

Six play sessions had been carried out in June-August 2011. As a searching pattern, interpretive case study method was used. The research consisted of six children with cancer, aged between 9 and 12 years. The research was conducted in a public hospital in children oncology service.

Results:

The assessment of data was realized in two stages. The first one was examining the data; the other stage was the content analysis that has been constructed after the play sessions as Nursing Intervention: Play Model. In the newly formed model, nine themes had been found: (a) expressing good memories, (b) control, (c) problem-solving ability, (d) relations, (e) aggressive behaviors, (f) regression, (g) good-bad, (h) trauma, and (i) anxiety.

Conclusions:

The self-concept of the school-age child needs to be supported. It has been submitted that the themes can be supportive for the prospective nursing models concerning child's self-exposure. It has been suggested that the themes produced by Nursing Intervention: Play Model can be used while planning, implementation, and assessment of the nursing care.

Determination of School-Related Problems in Children Treated for Cancer

This descriptive and case–control study was carried out in a pediatric oncology outpatient clinic to determine the school-related physical, social, and psychological problems and problems experienced in academic achievement of children treated for cancer. The sample of the study consisted of 56 Turkish patients with cancer, aged 7–18 years, who were in remission and attending school as well as their parents, a control group of patients who did not have cancer, and their teachers. A Child Information Form, a Child Health Questionnaire Parent’s Form of 50 questions, a Behavior Evaluation Scale for Children, and Young People and a Teacher’s Report Form were used as data collection tools in the study. Of the children, 30.3% experienced various physical difficulties stemming from cancer therapy that affected their school life. The number of late enrollments, the number of children repeating a grade, and the rates of school absenteeism were also found to be higher in the survivors than in the controls.

The Prevalence of Depression in Pediatric Oncology Patients Undergoing Chemotherapy Treatment in Jordan

The aim of this study was to investigate the prevalence of depression in pediatric oncology patients in Jordan, comparing them with peers who suffered from chronic conditions or were healthy. The authors investigated 58 children with cancer, 56 with chronic illnesses, and 64 healthy controls using the Arabic version of the Children’s Depression Inventory (CDI). There was no significant difference in CDI scores between children with cancer, children with chronic illnesses, and healthy controls. Using the conventional cutoff point of a score of 20 gives a prevalence of 20.68% for child-reported depression in the cancer group. This is toward the high end of the range for similar studies in other countries. The results suggest that children with cancer undergoing chemotherapy are no more likely to be depressed than children with chronic illnesses or healthy controls, although further research is warranted.

A Comparison of Emotional Indicators and Depressive Symptom Levels of School-Age Children With and Without Cancer

This study aims to compare the emotional indicators and depressive symptom levels of 6- to 12-year-old children with and without cancer. The sample included 20 children with cancer and 20 healthy children of similar ages and gender. Data were collected by using the Child Introduction Form, Children’s Depression Inventory, the Human Figure Drawing test, and children’s drawings. The results showed that the depressive symptom levels of children with cancer were significantly higher than those of healthy children. Impulsivity, mistrust, and anger were observed significantly more in children with cancer ( P < .05). Although anxiety was equal in the two groups, shyness was observed more in the cancer group, though the difference was not significant ( P > .05). The emotional indicators of both groups of children did not have an effect on their depression scores.

Effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of Hong Kong Chinese children hospitalized with cancer

PURPOSE. To examine the effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of children hospitalized with cancer. DESIGN AND METHODS. A nonequivalent control group design was employed. Children (8-16 years of age; n= 122) admitted to a pediatric oncology ward during a 14-month period were recruited. RESULTS. The results support the effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of children hospitalized with cancer. PRACTICE IMPLICATIONS. The results heighten the awareness in nurses of the importance of integrating play activities as an essential component of holistic and quality nursing care.