Psychosocial Impact of Childhood Malignancies On Families and Their Children.

Abstract

Malignant disease in children was regarded as an invariably fatal disease. Advances in the management changed the prognosis from a fatal to a chronic illness with an uncertain survival. It affects the child and family in different aspect to a great degree. The study was conducted to look into the psychosocial impact of the malignant disease on the family and child as well as the clinical pattern of the disease. The study was conducted mainly in the (RICK) , KTECH, Khartoum North, Suba Hospital and Omdurman Hospital.The study group consisted of 153 patients and their families. The male to female ratio was found to be 64.1% in the males. The incidence was high (33.3 %) among the group age 6-10 years (30%) of the patients were from the western states. Leukaemia was the most common tumour (39.9%) , followed by Lymphoma(23.5%), Retinoblastoma (10 .5%) , Bone tumour and soft tissue (9.1%) and Nasopharyngial carcinoma in (3.8%). Patients with Lymphoma (58.3%) presented with cervical lymphadenopathy , and (32.6%) presented with hepatosplenomegally. (61.7%) Patients with Leukemia presented with hepatosplenomegally and purpura (53.3%). Medications were very expensive and (44.4%) had to take loans (41.2%) sold their assets. The monthly expenses were in the range of 30 000-50000 in (41.8%) of the families were supported financially by the relatives and Deiwan Elzakah respectively. Cost of the chemotherapy was the main problem encountered in (91.5%) of the families. Siblings were affected by the illness of the child in (39.1%) in the form of behavioural and school problems. Anxiety was experienced by (98%) of the guardians of the patients and depression was encountered by all guardians. When the Guardians were assessed 3 month later they were found to be more and were significantly more depressed. Final psychological score of the child was abnormal in (45.4%). Emotional Symptoms were reported in (25%) of patients. Peer and prosocial affection were in (13%) and (16.7%) of patients respectively.(72.6%) of patients stopped going to school since the diagnosis of the disease . Doctors disclosed the information to the families in (60%) of cases. Knowledge of the guardians was regarded as poor in (24%) of the patients and average in (51.2%) of the guardians. One of the guardians had good attitude and (20%) of guardians had good practices.