اختلالات رفتاري- عاطفي در كودكان مبتلابه لوسمي تحت شيمي‌درماني مراجعه‌كننده به مركز آموزشي شهيد مطهري وابسته به دانشگاه علوم پزشكي اروميه

Behavioral-Emotional Disorders in Children with Leukemia Undergoing Chemotherapy: a Cross-Sectional Study

پيش‌زمينه و هدف: لوسمي شايع­ترين تومور دوران كودكي است كه تقريباً يك‌سوم كل سرطان­ هاي اين سنين را تشكيل مي­دهد. كودكان مبتلا به لوسمي غالباً تحت درمان­هاي چندگانه قرار مي­ گيرند كه در اين موارد مي­تواند عوارض جانبي حاد و درازمدتي را ايجاد نمايد. روش­هاي دردناك، بستري شدن طولاني در بيمارستان و پيش ­آگهي نامشخص عوامل استرس­زاي رايجي هستند كه مي ­تواند بر سيستم عاطفي و رفتاري اين كودكان تأثير بگذارد. اين مطالعه­ي مقطعي، باهدف تعيين ميزان مشكلات رفتاري - عاطفي در كودكان مبتلابه لوسمي تحت شيمي‌درماني در مركز آموزشي شهيد مطهري اروميه، 1398 انجام شد. روش كار: اين مطالعه، كه مطالعه‌اي مقطعي است؛ بر روي 163 كودك دچار لوسمي (متوسط سني 2/82±9/27 سال) مراجعه‌كننده به درمانگاه انكولوژي بيمارستان شهيد مطهري، با استفاده از روش نمونه­ گيري در دسترس انتخاب و موردبررسي قرار گرفتند. براي جمع ­آوري اطلاعات از پرسشنامه­ ي اطلاعات دموگرافيك و سياهه­ ي رفتاري كودك استفاده شد كه توسط والدين اين بيماران تكميل گرديد. داده ­هاي جمع‌آوري‌شده با استفاده از روش ­هاي آماري توصيفي و استنباطي (آزمون تي مستقل و آناليز واريانس يك‌طرفه) تجزيه‌وتحليل ‌شدند. يافته‌ها: در اين مطالعه ميانگين و انحراف معيار مشكلات كلي، مشكلات رفتاري درون­سازي و برون­سازي شده به ترتيب 28/24± 97/92، 16/51 ± 61/9 و 11/34 ± 25/11 و بر اساس ميانگين درصدي، بيشترين نمره كسب‌شده مربوط به مؤلفه‌ي گوشه ­گيري/افسردگي (57/81 از 100) بود. آناليز آماري داده ­ها نشان داد كه ميانگين نمره مشكلات رفتاري كل (0/000=p) و تمامي مؤلفه ­هاي آن نيز برحسب مقطع تحصيلي كودك داراي اختلاف آماري معني­دار مي­باشند (0/05>p)، اما با جنس، محل سكونت كودك (شهر / روستا)، تعداد فرزندان، تحصيلات پدر و مادر، شغل پدر و مادر و وضعيت اقتصادي خانواده ارتباط آماري معني­دار نداشت. (0/05

Background & Aims: Leukemia is the most common childhood tumor, accounting for approximately one-third of all cancers of this age. Children with leukemia often receive multimodal treatments, which can cause acute and long-term side effects. Painful procedures, long hospital stays, and unclear prognosis are common stressors that can affect these children's emotional and behavioral systems. This cross-sectional study was performed to determine the extent of behavioral-emotional problems in children with leukemia undergoing chemotherapy at Shahid Motahari Educational Center in Urmia, 2019. Materials & Methods: In this cross-sectional study, 163 children with leukemia (mean age 9.27 ± 2.82 years) who were referred to the oncology clinic of Shahid Motahari Hospital were selected using available sampling method. The demographic information questionnaire and the Child Behavior Checklist (CBCL) were used to collect data. After getting acquainted with the children and their parents, the purpose of the study was explained to them. After obtaining informed consent from the parents of all patients, the questionnaires were completed by the parents. The collected data were analyzed using descriptive and inferential statistical methods (independent t-test and one-way analysis of variance). Results: In this study, the mean and standard deviation of total, internalized, and externalized behavioral problems were 97.92 ± 28.24, 61.9 ± 16.51, and 25.11 ± 11.34, respectively Based on the normalized average, the highest score was related to the withdrawn/depression component (57.81 out of 100). Statistical analysis of the data showed that the mean score of total behavioral problems (p = 0.000) and all the subscales were significantly different among the participants with different levels of education (p<0.05), but they had no significant relationship with gender, place of residence (city / village), number of children, parents' education, parents' occupation and family economic status (p>0.05). In addition, the Pearson correlation coefficient showed that there was a statistically significant positive relationship between the mean score of total problems and quantitative variables of child's age, age of diagnosis, father's age and mother's age (p>0.05). Conclusion: Based on results of this study, the scores of anxiety / depression, isolation / depression, attention problems and internalized behavioral problems were above average. The mean scores of total behavioral problems and their components in school children (the first year of high school) is much higher than the children of lower grades. Therefore, it is important to identify and prevent such cases in high school children with leukemia.