Illness cognition and associated socio-demographic and clinical factors in parents of children with leukemia.

PURPOSE: Illness cognition is an important mediator between psychological and behavioral adjustment and the quality of life for patients and their caregivers. Evidence related to illness cognition among parents of children with leukemia is limited. The purpose of this study is to explore the illness cognition status and associated factors in parents of children with leukemia. METHODS: A cross-sectional survey was conducted with the parents of 335 children with leukemia from three general children's hospitals in China from January to December 2022. A parents' version of the illness cognition questionnaire was used to collect data. This included three subscales: helplessness, acceptance, and perceived benefits. RESULTS: The mean scores of helplessness, acceptance and perceived benefits of parents regarding their children's disease were 15.56 (4.60), 16.25 (4.41), and 19.96 (3.69) respectively. The multiple regression model indicated seven factors associated with the parents' illness cognition (adjusted R [2] ranged from 0.182 to 0.134): four socio-demographic factors (parent's age, role, education level, and family income) and three clinical factors (length of time spent each day caring for the child, the child's age at diagnosis, and the duration of the disease). CONCLUSION: This study reports on different levels of illness cognition and associated factors among parents of children with leukemia. The results may help pediatric oncology medical staff identify risk factors for poor psychological adjustment to children's diseases. Parents may benefit from psychological support aimed at improving positive illness cognition.

Health locus of control and symptom distress: The mediating role of illness acceptance and symptom severity in acute leukemia patients.

OBJECTIVE: This study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients. METHODS: From June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study. RESULTS: All participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (ß=0.087, 95%CI 0.030-0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (ß=0.131, 95%CI 0.008-0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (ß=0.027, 95%CI 0.001-0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress. CONCLUSION: There is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model. IMPACT ON NURSING PRACTICE: It is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.

Exploring core symptoms and interrelationships among symptoms in children with acute leukemia during chemotherapy: A network analysis.

PURPOSE: Children with acute leukemia have suffered from a considerable symptom burden during chemotherapy. However, few studies have focused on exploring the mechanisms among symptoms in children with acute leukemia. Our study aims to explore core symptoms and describe the interrelationships among symptoms in children with acute leukemia during chemotherapy. METHODS: From January 2021 to March 2023, 469 children with acute leukemia were recruited from 20 Chinese cities. The Memorial Symptom Assessment Scale 10-18 (MSAS 10-18) was used to evaluate the prevalence and severity of symptoms during chemotherapy. A network analysis was performed by the R software based on 31 symptoms. Centrality indices and density were used to explore core symptoms and describe interrelationships among symptoms in the network during chemotherapy. RESULTS: Worrying and feeling irritable were the central symptoms across the three centrality indices, including strength, closeness, and betweenness. Lack of energy was the most prevalent symptom; however, it was less central than other symptoms. The density of the "induction and remission" network significantly differed from other cycles' counterparts (p < 0.001). Global strength was greater in the " ≥ 8 years group " network than the " < 8 years group " network (p = 0.023). CONCLUSION: Network analysis provides a novel approach to identifying the core symptoms and understanding the interrelationships among symptoms. Our study indicates the need to assess emotional symptoms in children with acute leukemia during chemotherapy, especially during the induction and remission phases, as well as in older children. Future research is imperative to construct trajectories of dynamic symptom networks and centrality indices in longitudinal data to investigate the causal relationships among symptoms.

Comparison of the anxiety, depression and their relationship to quality of life among adult acute leukemia patients and their family caregivers: a cross-sectional study in China.

PURPOSE: To compare the anxiety, depression and explore their relationship to quality of life (QoL) among adult acute leukemia (AL) patients and family caregivers (FCs) in China. METHODS: A multicenter cross-sectional study was conducted from April 2017 to January 2018. The sample comprised 207 dyads of adult AL patients and FCs. The participants were required to complete socio-demographic information and the Hospital Anxiety and Depression Scale (HADS). The Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu, only for patients) and MOS 36-item Short-Form Health Survey (SF-36, only for FCs) were used to measure QoL. RESULTS: The mean scores of anxiety and depression for AL patients were 7.89 ± 3.85 and 7.18 ± 4.23, respectively. For FCs, the mean scores of anxiety and depression were 9.96 ± 3.73 and 8.64 ± 3.74. In this study, adult AL Patients' sex, patients' depression score, whether patients achieving a CR or not, education, FCs' depression score, patients' social/family well-being and emotional well-being were significantly associated with patients' anxiety or depression (p < 0.05). For FCs, depression was significantly related to the physical component summary (ß = 0.127, p = 0.008). There were significant differences in anxiety (t = - 5.92, p < 0.001) and depression (t = - 4.19, p < 0.001) between patients and FCs. CONCLUSIONS: AL patients' FCs showed higher score of anxiety and depression than that of patients. The psychological health may have a potential relationship between AL patients and their FCs. Healthcare professionals can conduct family-center interventions to improve mental health and QoL of AL patients and FCs.

Assessment of the health utility of patients with leukemia in China.

OBJECTIVES: This study aimed to assess the health utility of leukemia patients in China using the EQ-5D-5L, compare it with the population norms, and identify the potential factors associated with health utility. METHODS: A hospital based cross-sectional survey was conducted in three tertiary hospitals from July 2015 to February 2016. A total of 186 patients with leukemia completed the EQ-5D-5L and their health utility scores were calculated using the Chinese value set. EQ-5D-5L utility and dimensions scores of leukemia patients were compared with China's population norms using Kruskal-Wallis test and chi square test. Potential factors associated with health utility were identified using Tobit regression. RESULTS: The mean EQ-5D-5L utility scores of patients with leukemia, grouped by either gender or age, were significantly lower than those of the general population (p < 0.001). The same results were found for individual dimensions of EQ-5D-5L, where leukemia patients reported more health problems than the general population (p < 0.001). The utility score of leukemia patients was found to be significantly related to medical insurance, religious belief, comorbidities, social support and ECOG performance status. CONCLUSION: This study indicated that leukemia patients have worse health status compared to the general population of China and that multiple factors affect the health utility of the patients. The utility scores reported in this study could be useful in future cost-utility analysis.

Hindrances of peripherally inserted central catheter care of leukemia patients: a qualitative study.

OBJECTIVE: A peripherally inserted central catheter (PICC) needs regular care. However, clinical observations found that some discharged leukemia patients in mainland China had not complied with the requirement of regular care. Our study aims to explore the facilitators and hindrances of regular cares of PICC in leukemia patients with the Colaizzi phenomenon analysis. METHODS: This qualitative report used the descriptive phenomenological method to collect information and was conducted in accordance with the COREQ checklist. By purposive sampling, 11 leukemia patients with PICC were selected and interviewed in the Department of Hematology of a first-class hospital in Wuhan (central China). The interviews were conducted from March 2016 to May 2017. RESULTS: Two facilitators for PICC care were extracted through interviews, including fear of nosocomial infection and convenience for treatment. Eleven hindrances were summarized, including high costs, unavailability of local services, worries about affecting family members, a lack of health awareness, inconvenient transportations, fluke minds, physical discomfort, fears of leukemia and chemotherapy, short chemotherapy intervals, damage to appearance, and no insurance coverage of costs. CONCLUSION: Leukemia patients' compliance with PICC care was hindered by several factors. The improvement of PICC care may need joint efforts of patients, nursing professionals, hospitals' managerial staff, and governments.

Health-related Quality of Life for Children With Leukemia: Child and Parental Perceptions.

BACKGROUND: The importance of health-related quality of life (HRQoL) in patients with acute lymphoblastic leukemia (ALL) has increased in recent years. This study aimed to assess HRQoL in children with ALL, affecting factors, and the relationship between parent proxy-report and child self-report HRQoL. MATERIALS AND METHODS: A total of 59 children and their parents (both mother and father) were enrolled in this cross-sectional study. Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Modules were used to determine HRQoL. RESULTS: According to subscales of the self-report form, nausea and operational anxiety scores differed significantly by the treatment status; communication score varied considerably by the hospitalization length of stay; pain and hurt, cognitive problems, and perceived physical appearance scores differed significantly by the maternal chronic disease status (P<0.05). The presence of maternal chronic disease was significantly related to the total score of the parent-proxy report (mother) (P<0.05). There was a moderate correlation between total scores of child and mother (P<0.05, r=0.419) but not with the father. CONCLUSION: Children on-treatment had significant problems in nausea and procedural anxiety subscales; however, children who were hospitalized more had fewer issues in the communication subscale. Also, children whose mother had chronic disease had poorer HRQoL regarding pain and hurt cognitive problems and treatment anxiety. Given the importance of assessment and monitoring HRQoL in children with ALL, health professionals should be aware of how parents' chronic disease affects HRQoL. Psychosocial support should be provided to children and their parents, especially for those whose parents have a chronic illness.

Parents' perception of their children's process of reintegration after childhood cancer treatment.

Our objective was to further the understanding of the process of reintegration of childhood cancer patients after treatment and to identify factors influencing that process. Using a qualitative approach, we conducted 49 interviews with parents (n = 29 mothers, n = 20 fathers) from 31 families with a child (<18 years) with leukemia or CNS tumor. Interviews were conducted about 16 to 24 months after the end of the treatment. We used a semi-structured interview guideline and analyzed the data using content analysis. Average age of pediatric cancer patients was 5.5 years at the time of diagnosis; mean time since diagnosis was 3.5 years. Parents reported immediate impact of the disease on their children. Reintegration had gone along with delayed nursery/school enrollment or social challenges. In most cases reintegration was organized with a gradual increase of attendance. Due to exhaustion by obligatory activities, reintegration in leisure time activities was demanding and parents reported a gradual increase of activity level for their children. Parents described several barriers and facilitators influencing the reintegration process into nursery/school and leisure time activities (structural support, social support, health status, intrapersonal aspects). Although many children reintegrate well, the process takes lots of effort from parents and children. Childhood cancer survivors and their families should be supported after the end of intensive treatment to facilitate reintegration.

Social-ecological predictors of school functioning in Hispanic children treated for cancer with central nervous system-directed therapies.

BACKGROUND: Children with brain tumor or acute leukemia are at risk for neurotoxic side effects associated with their cancer therapies. These long-term deficits include poor health-related quality of life (HRQOL) in school and lower educational achievement. Although social-ecological factors may impact these outcomes, it is not known which factors play a role. Our objective was to evaluate the factors affecting school HRQOL in Hispanic childhood cancer survivors, an important at-risk group. PROCEDURE: Multivariable regression analyses examined whether selected social-ecological factors contribute toward suboptimal school HRQOL in 73 Hispanic children treated with central nervous system (CNS)-directed cancer therapies after accounting for effects associated with established cancer-related risk factors. RESULTS: Consistent with expectations from prior research, in our multivariate analysis, the cancer-related factors of having a brain tumor diagnosis and being younger at cancer diagnosis were significant predictors of reduced parent-reported school HRQOL (F(2,65) = 5.46, P < .01) and accounted for 14% of the variance. Adding the social-ecological variables of parent education, child motivation, and parental knowledge accounted for an additional 25% of the variance in school HRQOL, where higher levels were associated with better child school HRQOL. Parenting knowledge was a contributor even after controlling for effects associated with the other variables in the model (F(1,62) = 4.88, P < .05). CONCLUSIONS: Cancer survivorship care should incorporate parent education interventions to enhance the child's school functioning, particularly for Hispanic childhood cancer survivors from predominantly Spanish-speaking families. Future research should consider other at-risk groups and incorporate social-ecological indicators to predict HRQOL outcomes.

Associations between Pretend Play, Psychological Functioning and Coping Strategies in Pediatric Chronic Diseases: A Cross-Illness Study.

Children with chronic illnesses are called to undertake complicated processes of adjustment and re-organization in their daily lives; as a result, they could experience several internalizing problems. Symbolic play could be a useful way to cope with these difficulties. The main aim of this paper is to assess pretend play, coping, and psychological symptoms in three groups of school-aged children with pediatric chronic diseases. The study involved 44 Italian school-aged, chronically ill children: 16 with type 1 diabetes mellitus (T1DM), 12 with cystic fibrosis (CF), and 15 with Leukemia. All patients were assessed by the Affect in Play Scale-Brief version (APS-Br), and the Children's Coping Strategies Checklist-Revision1 (CCSC-R1). Children with T1DM and CF also completed the Separation Anxiety Symptom Inventory for Children (SASI-C) and the Strengths and Difficulties Questionnaire (SDQ)-children's version. Cohen's d (effect size) was applied between clinical and normative samples, and it showed a more organized play (APS-BR), but a more negative affect tone, comfort, and frequency of affect expression. Comparing APS-BR and CCSC-R1 rates between the three groups, significant differences were found for all the APS-BR dimensions, except for tone, and for CCSC-R1 seeking understanding. Comparing SASI-C score between T1DM and CF, higher scores were found for children with CF. In the end, correlations between all dimensions highlighted several relationships between play, coping, and adjustment problems for children with T1DM, and relationship between affect play and all variables for children with CF. Symbolic play helps chronically ill children to express emotions; helping them, as well as clinicians, to understand the difficulties caused by chronic conditions, and to cope with them.

Family filial value on caring children with leukemia

OBJECTIVE: Family centered empowerment is a nursing intervention by increasing family filial value which consists of responsibility, respect, and family care. The purpose of this study was to explain the family filial value in treating leukemia children. METHOD: The design of this study was descriptive with a cross-sectional design. The population in this study were families with children suffering from leukemia who were treated at Dr. Soetomo Surabaya. A sample of 140 respondents were recruited by consecutive sampling technique. Data was collected by questionnaire. The independent variable is family filial value and the dependent variable is the family's ability to caring children with leukemia. Data were collected by questionnaire and analyzed with spearman correlation (∝<0.05). RESULT: Responsibility is the highest indicator of family filial value (16.4%). The results showed that there was an influence of family filial value (responsibility p = 0.000; r=0.520, respect p = 0.000; r=0.403 and care p = 0.000; r=0.297) on the family's ability to care for leukemia children. CONCLUSION: Filial value of the family can improve the family's ability to care for leukemic children that have an impact on children's health indicators

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Experiencias de la sexualidad en pacientes adultos con diagnóstico de leucemia sometidos a quimioterapia / Experiences of sexuality on adult patients diagnosed with leukemia submitted to chemotherapy

OBJETIVO PRINCIPAL: describir las experiencias de la sexualidad en adultos con diagnóstico de leucemia sometidos a quimioterapia. METODOLOGÍA: estudio exploratorio cualitativo de tendencia fenomenológica, ocho participantes y dos entrevistas a profundidad por cada uno. El análisis hizo un acopio de toda la información y un rastreo de temas, se intentó captar la esencia, emergieron temas y se profundizó en el significado de la experiencia. Fue aprobado por el Comité de Ética. RESULTADOS PRINCIPALES: se develaron tres temas analíticos: (1) las relaciones se fortalecen, (2) con la enfermedad, el deseo sexual está inhibido y (3) hay necesidades de información sobre sexualidad. CONCLUSIÓN PRINCIPAL: la sexualidad se expresa en las relaciones interpersonales y la interacción con la familia. El deseo sexual está inhibido porque hay otras prioridades. Es necesario informar sobre la sexualidad por parte del personal de salud

MAIN OBJECTIVE: To describe sexuality experiences, in adults diagnosed with leukemia, undergoing chemotherapy. METHODOLOGY: Qualitative, exploratory study of phenomenological trend. A total of eight participants. Two in-depth interviews were conducted for each one. The analysis was collected of all information and tracked topics. The essence was captured and some sub-topics were established. The meaning of the experience of sexuality was deepened. It was approved by the Ethics Committee. MAIN RESULTS: Three analytical topics were unveiled: (1) Relations are strengthened, (2) With the disease sexual desire is inhibited and (3) Information needs about sexuality. MAIN CONCLUSION: Sexuality is expressed in relationships and interaction with family. Sexual desire is inhibited because sex is outside its priorities. It is necessary complete and clear information about sexuality by the health personnel

Incidence of and sociological risk factors for suicide death in patients with leukemia: A population-based study.

OBJECTIVES: Suicide is closely related to sociological factors, but sociological analyses of suicide risk in leukemia are lacking. This study is the first to use the Surveillance, Epidemiology, and End Results Program (SEER) database to analyze sociological risk factors for suicide death in leukemia patients. METHODS: A retrospective search of the SEER database was conducted. Logistic regression was used to identify independent risk factors for suicide death. Variables significant in the univariate logistic regression models were subsequently analyzed using multivariate regression. RESULTS: The death rate was highest in California (1.73%). Suicide mortality was more common during the 1970s and 1980s, after which it trended downward. Young age at diagnosis (18-34 vs. >64 years: odds ratio [OR] = 1.537, 95% confidence interval [CI] = 1.007-2.347; 35-64 vs. >64 years: OR = 1.610, 95% CI = 1.309-1.979), being male (OR = 1.518, 95% CI = 1.230-1.873), and living where a high proportion of people have at least a bachelor's degree (>50% vs. <20%: OR = 8.115, 95% CI = 5.053-13.034) significantly increased suicide death risk. CONCLUSION: Our findings could increase clinician awareness of and appropriate support for leukemia patients at risk of death by suicide.

Evaluation of quality of life and its influencing factors after transplantation of leukemia patients based on SF-36 score: a cohort study.

PURPOSE: The aim of this study is to clarify the short-term quality of life (QoL) of acute leukemia (AL) patients early after stem cell transplantation (SCT) and related predictors of QoL recovery. METHODS: We investigated adult AL patients who underwent SCT at the Institute of Hematology and Blood Diseases Hospital after transplantation. Physical/functional and emotional/mental recovery were evaluated using the Short Form 36 (SF-36) questionnaire to identify its trajectory as well as related predictors for the physical component summary (PCS) and mental component summary (MCS). The score was also used to establish a QoL prediction model. RESULTS: A total of 326 AL patients responded to our QoL survey. The results revealed the profile of patient follow-up from 2013 to 2015. Along follow-up after transplantation, there was a significant increase in PCS (p = 0.139) and MCS (p = 0.122). On multivariate regression analysis, apart from follow-up, marriage, financial situation, employment situation, and history of chronic graft-versus-host disease (cGVHD) had clinical significance for both PCS and MCS. A prediction model for patient risk hierarchy estimation was further established. The logistic results revealed that the significant characteristics of patients with high PCS and high MCS were unmarried, without financial burden, reliable on drugs, and with history of acute graft-versus-host disease (aGVHD). CONCLUSIONS: This well-established study enabled evaluation of the QoL of AL patients post-HSCT in China. The established prediction model could provide more indications and insights into improvement in quality of life for better medical interventions.

The Effect of Auricular Acupressure on Sleep Disturbance Among Patients With Leukemia: A Feasibility Study.

Auricular acupressure (AA) is widely used in East Asia and Europe to manage patients with sleep disturbance. This feasibility study was performed to demonstrate the potential of AA for sleep disturbance in patients with leukemia. Thirty-two patients with leukemia with poor sleep quality received AA 3 times a day for a total of 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at baseline, at a 2-week intervention, and after a 4-week intervention. Compared with baseline scores, PSQI scores and the use of sleep medicine were significantly improved at week 2 and week 4 (P < .05). As a potential safety therapy, AA could be an alternative or complementary intervention to improve sleep quality for patients with leukemia with sleep disturbance.

Psychological Wellbeing in Adolescents with Leukaemia: A Comparative Study with Typical Development Peers.

There is still little research on psychological wellbeing, life satisfaction and reported problems in preadolescents and adolescents under therapy for leukaemia, and also little research comparing them with their healthy peers. The present study aimed to analyse the life satisfaction, hope, psychological wellbeing and reported problems' intensity in 60 patients aged 8-18 during the first year of therapy, to identify those more at risk and to compare their reports with matched healthy peers. A battery of self-reported questionnaires was administered during hospitalisation or day hospital admissions post 6 months and post 12 months from the diagnosis. Younger patients (aged 8-13 years) were more at risk than older ones in their problems' intensity and psychological symptoms; females and Acute Myeloid Leukaemia patients reported lower current life satisfaction perceptions; hope was associated with lower depression symptoms and mood problems. Healthy peers have a better perception of current life, but reported a lower hope score, more anxiety symptoms and more cognitive problems than patients. The first 6 months were more critical for patients' psychological health. Basing on these empirical data, the inclusion of mental health care professionals or supportive psychotherapy into the treatment is recognized as extremely useful.

Comparing the Impact of Cancer and Treatment-Related Effects on Psychological Well-being and Quality of Life Between Hong Kong Survivors of Childhood Solid Tumors and Leukemia.

BACKGROUND: Evidence shows that survivors of solid tumors have a lower survival rate and shorter disease-free survival time than survivors of leukemia. However, the psychological well-being and health-related quality of life (HRQOL) of these 2 groups of cancer survivors have not been compared. OBJECTIVE: To examine and compare the impact of cancer and treatment-related effects on psychological well-being and HRQOL between survivors of childhood solid tumors and leukemia. METHODS: We conducted a cross-sectional study involving 65 Hong Kong survivors of solid tumors and 70 survivors of leukemia aged 8 to 18 years who had their medical follow-up in a pediatric outpatient clinic. Participants' depressive symptoms, self-esteem, and HRQOL were assessed. Twenty-two survivors of childhood solid tumors and 15 survivors of childhood leukemia were then selected for semistructured interviews. RESULTS: Survivors of childhood solid tumors reported significantly higher mean scores for depressive symptoms, and lower mean self-esteem and HRQOL scores than survivors of childhood leukemia. Qualitative data revealed that survivors of childhood solid tumors faced more challenges in their daily life than survivors of childhood leukemia. CONCLUSIONS: Survivors of childhood solid tumors reported poorer psychological well-being and HRQOL than survivors of childhood leukemia. This vulnerable group warrants more attention and support. IMPLICATIONS FOR PRACTICE: It is vital for healthcare professionals to understand the impact of cancer and treatment-related effects in the context of different types of cancer. This will facilitate development and evaluation of appropriate psychological interventions to promote psychological well-being and HRQOL among childhood cancer survivors.

Emotion And Symptom-focused Engagement (EASE): a randomized phase II trial of an integrated psychological and palliative care intervention for patients with acute leukemia.

PURPOSE: We designed a novel, manualized intervention called Emotion And Symptom-focused Engagement (EASE) for acute leukemia (AL) and report here on a phase II randomized controlled trial (RCT) to assess its feasibility and preliminary efficacy. METHODS: Patients were recruited within 1 month of hospital admission and randomized to EASE plus usual care (UC) or UC alone. EASE includes (1) EASE-psy, a tailored psychotherapy delivered over 8 weeks, and (2) EASE-phys, weekly physical symptom screening over 8 weeks to trigger early palliative care. The primary outcome was traumatic stress symptoms; secondary outcomes included physical symptom burden and quality of life. Assessments were conducted at baseline and at 4, 8, and 12 weeks. Between-group differences were evaluated using multilevel modeling. RESULTS: Forty-two patients were randomized to EASE (n = 22) or UC (n = 20), with 76% retention at 12 weeks. Predefined feasibility outcomes were met: 86% (19/22) of EASE participants completed ≥ 50% of EASE-psy sessions (goal ≥ 64%); 100% received Edmonton Symptom Assessment System (ESAS, modified for AL) screenings, 64% (14/22) of whom completed ≥ 50% of planned screenings (goal ≥50%); and 100% with scores ≥ 4/10 on any physical ESAS-AL item had ≥ 1 meeting with the EASE-phys team (goal 100%). Significant treatment-group differences favoring EASE were observed in traumatic stress symptoms at 4 and 12 weeks, and pain intensity and interference at 12 weeks (all p < .05). CONCLUSIONS: EASE is feasible in patients newly diagnosed with AL and shows promise of effectiveness. These results warrant a larger RCT to provide evidence for its more routine use as a standard of care.

Emotional symptoms and family functioning in caregivers of children with newly diagnosed leukemia/lymphomas and solid tumors: Short-term changes and related demographic factors.

BACKGROUND: Pediatric oncology diagnoses are distressing to caregivers. However, researchers have not investigated the impact that the type of cancer diagnosis has on caregiver anxiety, depression, distress, and family functioning. The purpose of this study was to longitudinally investigate the early trajectory of caregiver psychological symptoms of anxiety, depression, distress, and family functioning near diagnosis and 6 months later by cancer type, and to examine the demographic factors that may be associated with caregiver emotional and family functioning outcomes. METHODS: Caregivers (n = 122) of children with a recent diagnosis of leukemia/lymphoma or solid tumor completed self-report measures of psychological and family functioning (Hospital Anxiety and Depression Scale, Distress Thermometer, and Family Environment Scale). RESULTS: In general, caregivers endorsed elevated psychological symptoms at the time of diagnosis, which decreased 6 months later. Caregivers of children with solid tumors endorsed greater anxiety across time than caregivers of children with leukemia/lymphoma did. In addition to caring for a child with a solid tumor, female sex, non-White ethnicity, and non-English language spoken in the home were factors associated with anxious and depressive symptoms and poorer family functioning. CONCLUSION: When creating psychosocial interventions for families of children with cancer, the unique demands of solid tumor treatments, the caregiver's sex, and cultural characteristics must be considered to promote coping, resiliency, and problem-solving skills around the time of diagnosis, particularly in more vulnerable families.

Anxiety and depression in patients with acute leukaemia treated with hematopoietic stem cell transplantation.

BACKGROUND: Acute leukemia and hospitalization for hematopoietic stem cell transplantation (HCT) are the great psychological stressors. The aim of this study was to assess anxiety and depression associated with such conditions and their psychophysical predictors before and after HCT. SUBJECTS AND METHODS: We conducted a longitudinal study using self-descriptive tools. The questionnaires: LOT-R, AIS, Mini-Mac, CECS, RSCL and HADS were filled by 60 patients with acute leukaemia before and after HCT. RESULTS: Anxiety and depressive symptoms correlated positively with psychological symptom distress. The correlation with depressive symptoms was weak, however, with anxious symptoms was moderate. In both cases, the higher was a level of psychological symptom distress, the higher level of anxiety and depression was observed in patients. The results indicated the weak, positive correlation between onerousness of physical symptoms and a level of anxiety. The greater was the severity of physical symptoms, the higher was the level of anxiety. The negative predictor of anxious symptoms was control of anxiety but it was weakly associated with a lower level of the explained variable. The negative predictor of anxious symptoms was also dispositional optimism whose high level accompanied the lower severity of the explained variable. However, the positive predictor of anxious symptoms was the variable of onerousness of symptoms whose high level accompanied the higher severity of anxious symptoms in the examined group CONCLUSION: Patients with acute leukemia who are hospitalized for HCT require detailed monitoring of their psychological distress to introduce the proper psychological and pharmacological interventions that reduce anxiety as well as boost "dispositional optimism" and mechanisms of control.