ABSTRACT
The main aim of this study is to evaluate the relationship between depression and immunological function in parents of children with cancer. Thirty-two parents participated in the study. The parents completed the following assessments: a list of major stressful events in a Hemato-Oncology ward, beck depression inventory II (BDI-II), posttraumatic diagnostic scale (PDS) and quality of life (QOL) questionnaire. A single blood sample was drawn from parents for evaluation of cortisol levels and lymphocyte cell subgroups. The parents were divided into two groups: Those who suffered from depression as defined by BDI-II cutoff score of 14 (depressed parents (DP), n = 7), and non-depressed parents (non-DP, n = 25). In parents of children with cancer the DP group had statistically significantly higher stressful event scores, dysfunction scores (from the PDS) and CD8 percentage compared to the non-DP group. QOL, CD4 percentage and CD4/CD8 ratio were significantly lower in the DP group. The BDI scores significantly positively correlated with events and dysfunctional scores, and significantly negatively correlated with QOL scores and CD4/CD8 ratio. High psychiatric morbidity was found in parents of children with cancer. The findings of altered immunity in DP provide further evidence that the physiological response to stress and depression may alter immune functions.
Subject(s)
Neoplasms/psychology , Parents/psychology , Quality of Life , Stress, Psychological/immunology , Adult , Antigens, CD/metabolism , Child , Female , Humans , Hydrocortisone/blood , Lymphocytes/classification , Lymphocytes/immunology , Lymphocytes/metabolism , Male , Middle Aged , Psychiatric Status Rating Scales , Retrospective Studies , Statistics, Nonparametric , Stress, Psychological/blood , Stress, Psychological/psychology , Surveys and QuestionnairesABSTRACT
PURPOSE/OBJECTIVES: To investigate the prevalence, symptom severity, and risk factors associated with post-traumatic stress disorder (PTSD) in childhood cancer survivors. DESIGN: Descriptive, correlational study. SETTING: Follow-up clinic in Petach Tikva, Israel. SAMPLE: Convenience sample of 70 adult Israeli survivors of childhood cancer. METHODS: Questionnaires (the Post-Traumatic Diagnostic Scale and the Multidimensional Scale of Perceived Social Support) were distributed to participants, and demographic and clinical data were obtained from medical records. MAIN RESEARCH VARIABLES: Post-traumatic stress, social support, and clinical and demographic data. FINDINGS: Twenty (29%) of the participants met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for PTSD; 10% experienced mild, 40% moderate, and 50% moderate to severe symptoms. Only 16% of the sample did not experience any symptoms of PTSD. A statistically significant negative relationship was found between PTSD symptom scores and the current age of the respondent (r(s) = -0.27, p = 0.03) and time since medical treatment (r(s) = -0.34, p = 0.004) but not any other demographic or clinical variables or social support. CONCLUSIONS: Higher severity of PTSD symptoms was found, possibly because of local living conditions. Most clinical and demographic variables were not risk factors. This population should be studied further in an effort to prevent PTSD via early diagnosis. IMPLICATIONS FOR NURSING: Oncology nurses should be aware of the potential risk factors (recent completion of treatment and younger current age) and the high prevalence and severity of PTSD among survivors of childhood cancer to identify patients at higher risk and develop programs that prevent, limit, and treat PTSD.
