The following social and psychological researches have been conducted by the department of psychology to find out better ways to prevent and palliate the suffering of children as well as their families’ anxieties and fears about cancer treatment and diagnosis.
1. Effects of preparing child and parent for lumbar puncture/intrathecal injection on reported-pain intensity, distress, situation – related quality of life and changes in heart rate and blood oxygen saturation level in children with cancer
Several invasive and painful procedures, such as lumbar puncture on children with cancer that are associated with pain. Reducing pain distress caused by these procedures is considered an important therapeutic goal. In a pretest-posttest experimental design with control group, the effectiveness of cognitive interventions on reported-pain intensity, distress due to lumbar puncture/intrathecal injection, situation-related quality of life, changing in heart rate and blood oxygen saturation level of children with cancer and the relations between these variables, were evaluated. 41 children – parent pairs were selected and randomly assigned to either an experimental or a control group. Children were visited twice. In the first visit both groups were under routine hospital care and in the second visit, the experimental group received cognitive intervention and the control group received routine hospital care. During each visit, pain intensity, distress levels during the procedure, quality of life were measured by following instruments: Oucher, CHEOPS & The PedsQL Present Functioning visual Analogue Scales. Physiological measures were taken twice, with a pulse oximeter device. Data analysis with analysis of covariance, independent t and Pearson correlations test demonstrated that intervention had a significant effect in reducing reported pain intensity, distress, physiological changes in heart rate; a significant negative correlation between reported-pain intensity and level of distress with physiological in blood oxygen saturation level. Results showed that cognitive interventions are effective in reducing reported-pain intensity, distress and improving situation related quality of children’s life with cancer who are under lumbar puncture/intrathecal injection.
2.Presenting explaining model of depression in adolescents with cancer
This study aimed to present an explaining model for depression in adolescents afflicted with cancer.
174 adolescents’ cancer patients (77 female and 97 male) and one of their parents were selected as the subjects of the study through convenient sampling from a number of cancer treatment centers and hospitals in Tehran, Isfahan and shiraz. The youths completed Beck Depression Inventory for Primary Care (BDI-PC), Coping Inventory for Stressful Situations (CISS-21). Illness Perception Inventory (IPQ- short form), and Multidimensional Health Locus of Control scale-form C (MHLC-C). The parents completed Family Assessment Device (FAD) and Beck Depression Inventory (BDI). A researcher designed questionnaire to demographic and treatment data was also filled out by the participants.
There were significant correlations between adolescents’ depression with the following variables: Parents’ depression, chance health locus of control, all types of coping (emotion focused, problem focused, and avoidance), illness perceptions, and problem solving family functioning, general family functioning and cancer relapse. However no significant relation was indicated between adolescents’ depression with adolescents’ age, gender, the age when diagnosis was made, type of cancer, intensity of disease, family income, Parents’ educational level and migration. The result of multivariable regression analysis showed that a few variables related to adolescents, there were emotion focused coping and illness perception from the list of factors related to parent and family, there was only general family functioning.
Depression in adolescents with cancer is on one hand significantly affected by cognitive factors of adolescents and on the other hand is influenced by psychological factors of parents and family. Hence, it is recommended to design and execute cognitive interventions such as enhancement of adolescents ‘problem focused coping strategies along with parents or family- focused treatment to prevent or manage depression in adolescents with cancer.
3. The relation between parental expression emotion styles and anxiety and depression in 8 to 17 years old children and adolescents with cancer
Cancer for the children and his family is considered as a life threatening event. Although the process of cancer treatment designed to alleviate children’s mortality, therapeutic procedures are source of pain and distress for these children. The important role of communication between parents and children and young adults with cancer is emphasized in the literature. Inability to express emotional states, repression and lack of emotional expression of parents, could create problems in parent-child relationship. Since the parents are the most important people in children and adolescents’ lives who have been diagnosed with cancer, difficulty in communication may be considered as a stressor factor children and adolescents with cancer.
The procedure of the present study is to investigate the relation between parental expression emotion styles and anxiety and depression in 8 to 17 years old children and adolescents with cancer. This research was the correlation types research. To aim this subject, our population is all children and adolescents who are under cancer treatment, whether inpatient or outpatient in specialized hospital in Tehran (6 hospital) from November 2008 to June 2009. The sample participating in his study was 1000 available children and adolescents and their parents (87 mothers & 24 fathers) who accepted to cooperate. Children and adolescent shave completed “Revised children Manifest Anxiety Scale” and “Child and Adolescents Depression Scale” and parents have completed “Emotional Expressiveness Questionnaire EEQ”, “Emotional Control Questionnaire (ECQ)” and “Ambivalence over Emotional Expressiveness Questionnaire (AEQ)”
According to results, depression in children and adolescents with cancer is related to emotional expressiveness of mothers and emotional control of fathers. Also anxiety of children and adolescents with cancer is related to emotional expressiveness and ambivalence over emotional expressiveness of mothers. Finally emotional expression styles in mother accounting for 11% of the variance in childhood anxiety.
4. The study of effect of medical art therapy approach on the hopelessness and anxiety of children cancer
Cancer illness is known to challenge children developmentally and psychologically. The stress of illness negatively affects children’s concepts of themselves and their disease processes. The stress results from pain, fear, anxiety, and abrupt changes in lifestyle. It affects the child’s mind, body, and spirit. Art therapy, when coupled with medical treatment, can help the child cope with the stress and trauma of illness and restore them to appropriate developmental functioning the aim of the study was to the effects of medical art therapy on the hopelessness and anxiety of children cancer. It was hypothesized that if children receive medical art therapy approach programs, then they will exhibit marked reduce in hopelessness and anxiety.
This study pre-experimental (pre-test – past test one sample test) do in MAHAK hospital. Ten adolescents cancer patient participated in this study. Group therapies were conducted for 8 sessions lasting nearly 90 min. The children anxieties Inventory (Reynolds), the hopeless nesses Questionnaire were administered to the participants at two different occasions: pre-treatment, post-treatment.
A man ova was used to examine the effectiveness of the treatments. The results indicated that medical at therapy, led to reduction in the level of anxiety and hopelessness, of children cancer patient (P‹0/.5).: There was significant differences on the both questionnaires post intervention.). It can be explained that medical art therapy approach made child cancer patient able to increase self positive attitude and activities that leaded anxiety to decrease anxiety and hopelessness.
The results showed that there was a significant reduction in the anxiety level, and hopelessness of participants groups after interventions. It can be interested that medical art therapy led to relief from psychological symptoms child patient cancer. To assist children cancer patient in dealing with difficult cancer encounters.
5.Psychological Aspects of Fertility Preservation in Cancer Patients
Introduction: With advances in the treatment of cancer, the number of young survivors with infertility is growing. The aim of this study was to review the literature investigating psychological aspects of fertility issues and fertility preservation in cancer patients.
Materials & Methods: Articles were identified in PubMed, Embase and Psych LIT as well as manually retrieved from literature citations for the time period from 2000 to 2009.
According to the studies on aspect are as follows;
1. Attitude of cancer patients to fertility preservation: Fertility is an important issue for cancer patients and their parents.
2. Attitude of oncologists to fertility preservation: oncologists have insufficient information about ATR and their attitude toward fertility preservation is different.
3. Specific challenges of counseling: As counseling has to be offered in a short period of time within diagnosis and treatment cycle, so the significance of time pressure should be taken into account. Besides decisions concerning treatment strategies the patients concerned have to make an additional decision with regard to fertility preservation and this in a moment that is experienced as a life crisis and considerable challenge by most of them.
4. Models of counseling: shared decision making and implication counseling.
The existing literature demonstrates the need for and limits of current counseling.
Future research should target the means of facilitate the decision making process for patients and their parents.
6. The women’s knowledge about healthy nutrition behaviors in cancer prevention in Iran – 2009
After the heart diseases, cancer is the second agent of death in many developed countries. More than 7 million people (12.5%) who have cancer, have been died yearly. Unhealthy nutrition is an agent of about 40-60% of all cancers. 30%b of cancers in developed countries and 20% in developing countries is related to nutrition.
This is a descriptive study that was done on 125 women aged 20-65. This research has been studied randomly. Tools of assembling data were standard questionnaire which included 3 sections involved demographic characteristics, awareness and behavior of nutrition. Data were collected by interview.
The finding of this survey showed that about 50% of women were 20-35 years and their educational level were secondary school. The awareness of women regard food groups and prevent of cancer inclusive fruit, vegetable, yogurts, oil fluid, sugar, coffee, tea and about preparing, cooking, eating, health and keeping behaviors were in desirable situation.
In the case of consume of low fiber, bean and height fiber bean, sources of animal and red flesh, bean, oil solid and fast food were in undesirable situation.
However, the awareness of women was in desirable level comparatively, we need more educational programs to give information to them because cancer prevention is an important task all over the world.
7.Appraising the predicting factors of adjustment problems in children with cancer
The present study aimed at appraising the predicting factors of adjustment problems in children with cancer. Hence, 200 parents of children with cancer (159 mothers and 41 fathers) were selected from a number of hospitals in Tehran through convenient sampling. Predicting factors in this study consisted of parents’ distress, parent-child relationship, family functioning, parents’ attachment style, intensity of disease, and demographic factors. The criterion factor included internalizing and externalizing behaviors of children with cancer. The aforementioned factors respectively were examined using the following scales: Depression, Anxiety, Stress Scale ( DASS), Child-Parent Relationship Scale-Short Form ( CPRS-S), Family Assessment Device (FAD), Adult Attachment Scale (AAS), two research designed questionnaires, one regarding the disease intensity and the other on the demographic data, and finally Child Behavior Checklist-Parent Form (CBCL). In studying the data, regression analysis revealed that the factors, conflicts in parent-child relationship, parents’ depression, child’s female gender, and positive aspects of child-parent relationship were in order of significance predictive of internalizing behaviors in children with cancer. Furthermore, the factors, conflicts in parent-child relationship, and deficits in expressing emotions in family were in order of significance predictive of externalizing behaviors in these children. It could be concluded that adjustment in children with cancer is significantly affected by psychological factors of parents and family.