Kanser Tanısıyla Hastanede Yatan Ergenlerin Semptomları ile Annelerinin Stres Düzeyinin Ergenlerin Yaşam Kalitesi Üzerine Yordayıcı Etkisi

Giriş: Kanser; ergen ve ailesinin yaşamını etkileyen ve hayatı tehdit eden kronik bir hastalıktır. Amaç: Bu çalışmanın amacı kanser tanısıyla hastanede yatan ergenlerin semptomları ile annelerinin stres düzeyinin ergenlerin yaşam kalitesine etkisini belirlemektir. Yöntem: Bu araştırma tanımlayıcı bir çalışmadır. Araştırmanın örneklemine pediatrik hematoloji ve onkoloji kliniklerinde yatan, 10-18 yaşları arasında kanser olan 83 ergen ve anneleri alınmıştır. Veriler, Memorial Semptom Değerlendirme Ölçeği, Algılanan Stres Ölçeği ve Çocuklar için Yaşam Kalitesi Ölçeği kullanılarak toplanmıştır. Bulgular: Annelerin algılanan stres ölçeği toplam ölçek puanı ortalaması 32.77 ± 8.57 puan olarak bulunmuştur. Bu puan annelerin orta düzeyde stres yaşadığını göstermektedir. Kanser olan ergenlerin yaşam kalitesi ölçeği toplam ölçek puan ortalaması 60.76 ± 16.17 olarak belirlenmiştir. Bu puan ergenlerin yaşam kalitesinin orta düzeyde olduğunu göstermektedir. Değişkenler arasındaki ilişki incelediğinde ise yaşam kalitesi ile Memorial Semptom Değerlendirme Ölçeği Genel Sağlık İndeksi arasında negatif yönde orta derecede anlamlı bir ilişki olduğu saptanmıştır (r = -,57, p = .001). Ergenin yaşam kalitesi ile annenin stres düzeyi arasında negatif yönde zayıf derecede anlamlı ilişki bulunmuştur (r = -,36, p = .001). Ergenlerin semptom puanları ile annelerin stres düzeyi arasında ilişki bulunmamıştır (r = -.05). Sonuç: Ergenlerin semptomları ve annelerinin stres düzeyinin ergenlerin yaşam kalitesini etkilediği görülmektedir. Bu nedenle ergenlerin semptomlarını ve annelerin stres düzeyini azaltmaya yönelik kanıta dayalı hemşirelik girişimlerinin uygulanması kanser olan ergenlerin yaşam kalitesini geliştirebilir.

Anahtar Kelimeler:

Kanser, Ergen, Aile, Stres, Yaşam Kalitesi

Predictive Effect of the Symptoms of the Adolescents with Cancer and Their Mothers’ Stress Levels on the Adolescents’ Quality of Life

Background: Cancer; is a life-threatening, chronic disease that affects the life of the adolescent and his/her family. Objectives: The aim of this study was to carry out the effect of symptoms of the adolescents with cancer and their mothers’ stress levels on the adolescents’ quality of life. Methods: 83 adolescents who are staying in the pediatric hematology and oncology unit and their mothers were included in the research sample. Data were collected using Memorial Symptom Assessment Scale, Perceived Stress Scale and Pediatric Quality of Life Questionnaire. Results: Mothers’ perceived stress scale total mean score was found as 32.77 ± 8.57. Scale total mean score for quality of life of the adolescents with cancer was determined as 60.76 ± 16.17. It was detected that adolescents’ quality of life was moderately correlated to Memorial Symptom Assessment Scale (r = -,57, p = .001). It was found that there was a negative weak correlation between the adolescents’ quality of life and the stress level of the mothers (r = -,36, p = .001). No correlation was found between the symptom of the adolescent and the stress level of the mothers (r = -.05). It was determined that the symptoms of the adolescents and their mothers’ stress level significantly explaining 43.7% of the variance in the adolescents’ quality of life. Conclusions: It is seen that the symptoms of the adolescents and the stress level of the mothers affect the adolescents’ quality of life. Therefore, in order to reduce the symptoms of the adolescents and the stress level of the mothers, the implementation of evidence-based nursing interventions may improve the adolescents’ quality of life.

Keywords:

Cancer, Adolescent, Family, Stress, Quality of Life,

PDF

___

1. Dünya Sağlık Örgütü. International childhood cancer day: 15 February 2017. URL: http://www.who.int/cancer/iccd_2017/en/ 15 Şubat 2018.
2. Amerikan Kanser Birliği. Childhood leukemia: Detailed guide. Childhood leukemia in children. 2017 URL: https://www.cancer.org/cancer/leukemia-in-children.html 15 Şubat 2018.
3. Kutluk T. Çocukluk çağı kanserlerinin epidemiyolojisi ve Türkiye’deki durum. Turkiye Klin J Pediatr Sci. 2009;5(4):1–8.
4. Cancer Research UK. Children’s cancer statistics. 2016 URL: http://www.cancerresearchuk.org/health-professional/cancer-statistics/childrens-cancers/survival#heading-Zero 30 Temmuz 2018.
5. Robison LL, Armstrong GT, Boice JD, Chow EJ, Davies SM, Donaldson SS, et al. The childhood cancer survivor study: a national cancer institute-supported resource for outcome and intervention research. J Clin Oncol 2009;27(14):2308–18.
6. Björk M, Wiebe T, Hallström I. Striving to survive: families’ lived experiences when a child is diagnosed with cancer. J Pediatr Oncol Nurs 2005;22(5):265–75.
7. Kaakinen JB, Gedaly-Duff V, Hanson SMH. Family health care nursing: theory, practice, and research. 4. basım. Philadelphia F.A. Davis Company; 2010.
8. Dunn MJ, Rodriguez EM, Barnwell AS, Grossenbacher JC, Vannatta K, Gerhardt CA, et al. Posttraumatic stress symptoms in parents of children with cancer within six months of diagnosis. Heal Psychol 2012;31(2):176–85.
9. Kerr LMJ, Harrison MB, Medves J, Tranmer JE, Fitch MI. Understanding the supportive care needs of parents of children with cancer: an approach to local needs assessment. J Pediatr Oncol Nurs 2007;24(5):279–93.
10. Ljungman L, Cernvall M, Grönqvist H, Ljótsson B, Ljungman G, von Essen L. Long-term positive and negative psychological late effects for parents of childhood cancer survivors: a systematic review. PLoS One 2014;9(7):e103340.
11. Cohen S, Janicki-deverts D, Miller GE. Psychological stress and disease. JAMA. 2007;298(14):1685–7.
12. Wakefield CE, Mcloone JK, Butow P, Lenthen K, Cohn RJ, Ch MBB. Parental adjustment to the completion of their child’s cancer treatment. Pediatr Blood Cancer 2011;524–31.
13. Yalug I, Corapcioglu F, Fayda M, Aksu G, Basar E, Yalug K, et al. Posttraumatic stress disorder and risk factors in parents of children with a cancer diagnosis. Pediatr Hematol Oncol 2008;25:27–38.
14. Ponnet K, Wouters E, Mortelmans D, Pasteels I, De Backer C, Van Leeuwen K, et al. The influence of mothers’ and fathers’ parenting stress and depressive symptoms on own and partner’s parent-child communication. Fam Process. 2013;52(2):312–24.
15. Rodriguez EM, Dunn MJ, Zuckerman T, Vannatta K, Gerhardt CA, Compas BE. Cancer-related sources of stress for children with cancer and their parents. J Pediatr Psychol 2012;37(2):185–97.
16. Van Der Geest IM, Van Den Heuvel-Eibrink MM, Passchier J, Van Den Hoed-Heerschop C, Pieters R, Darlington ASE. Parenting stress as a mediator of parents’ negative mood state and behavior problems in children with newly diagnosed cancer. Psychooncology. 2014;23:758–65.
17. Orbuch TL, Parry C, Chesler M, Fritz J, Repetto P. Parent-child relationships and quality of life: Resilience among childhood cancer survivors. Fam Relat. 2005;54(2):171–83.
18. Okado Y, Long AM, Phipps S. Association between parent and child distress and the moderating effects of life events in families with and without a history of pediatric cancer. J Pediatr Psychol 2014;25:1–12.
19. Maurice-Stam H, Oort FJ, Last BF, Brons PPT, Caron HN, Grootenhuis MA. Longitudinal assessment of health-related quality of life in preschool children with non-CNS cancer after the end of successful treatment. Pediatr Blood Cancer 2008;50(5):1047–51.
20. Hile S, Erickson SJ, Agee B, Annett RD. Parental stress predicts functional outcome in pediatric cancer survivors. Psychooncology. 2014;23(10):1157–64.
21. Hamner T, Latzman RD, Latzman NE, Elkin TD, Majumdar S. Quality of life among pediatric patients with cancer: Contributions of time since diagnosis and parental chronic stress. Pediatr Blood Cancer 2015;62(7):1232–6.
22. Ruland CM, Hamilton GA, Schjødt-Osmo B. The complexity of symptoms and problems experienced in children with cancer: a review of the literature. J Pain Symptom Manage 2009;37(3):403–18.
23. Jones BL. The challenge of quality care for family caregivers in pediatric cancer care. Semin Oncol Nurs. 2012;28(4):213–20.
24. Litzelman K, Catrine K, Gangnon R, Witt WP. Quality of life among parents of children with cancer or brain tumors: the impact of child characteristics and parental psychosocial factors. Qual Life Res. 2011;20(8):1261–9.
25. Arslan Taş F, Başbakkal Z, Kantar M. Quality of life and chemotherapy-related symptoms of turkish cancer children undergoing chemotherapy. Asian Pacific J cancer Prev 2013;14(3):1761–8.
26. Chou FY, Dodd M, Abrams D, Padilla G. Symptoms, self-care, and quality of life of Chinese American patients with cancer. Oncol Nurs Forum. 2007;34(6):1162–7.
27. Kaleyias J, Manley P, Kothare SV. Sleep disorders in children with cancer. Semin Pediatr Neurol 2012;19(1):25–34.
28. Savage E, Riordan AO, Hughes M. Quality of life in children with acute lymphoblastic leukaemia: A systematic review. Eur J Oncol Nurs 2009;13(1):36–48.
29. Cantrell MA. The art of pediatric oncology nursing practice. J Pediatr Oncol Nurs 2007;24(3):132–8.
30. MacKay LJ, Gregory D. Exploring family-centered care among pediatric oncology nurses. J Pediatr Oncol Nurs. 2011;28(1):43–52.
31. Kostak MA, Avci G. Hopelessness and depression levels of parents of children with cancer. Asian Pacific J Cancer Prev. 2013;14(11):6833–8.
32. Matziou V, Perdikaris P, Feloni D, Moshovi M, Tsoumakas K, Merkouris A. Cancer in childhood: children’s and parents’ aspects for quality of life. Eur J Oncol Nurs. 2008;12(3):209–16.
33. Collins JJ, Byrnes ME, Dunkel IJ, Lapin J, Nadel T, Thaler HT, et al. The measurement of symptoms in children with cancer. J Pain Symptom Manage 2000;19(5):363–77.
34. Atay S, Conk Z, Bahar Z, Kantar M, Bolışık B. Memorial semptom değerlendirme ölçeği’nin (msdö 10-18) Türkçe geçerlik ve güvenirlik çalışması. Ege Pediatr Bülteni. 2007;14:93–100.
35. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Heal Soc Behav. 1983;24:385–96.
36. Eskin M, Harlak H, Demirkıran F, Dereboy Ç. Algılanan stres ölçeğinin Türkçeye uyarlanması : güvenirlik ve geçerlik analizi. Yeni sempozyum dergisi 2013;132–40.
37. Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001;39(8):800–12.
38. Varni JW, Seid M, Rode C. The PedsQL: measurement model for the pediatric quality of life inventory. Med Care. 1999;37:126–39.
39. Memik Çakın N, Ağaoğlu B, Coşkun A, Üneri ŞÖ, Karakaya I. Çocuklar için yaşam kalitesi ölçeğinin 13-18 yaş ergen formunun geçerlik ve güvenilirliği. Türk Psikiyatr Derg. 2007;18(4):353–63.
40. Memik Çakın N, Ağaoğlu B, Çoşkun A, I. K. Çocuklar için yaşam kalitesi ölçeğinin 8-12 yaş çocuk formunun geçerlik ve güvenirliği. Çocuk ve Gençlik Ruh Sağlığı Derg. 2008;15(2):87–98.
41. Batalha LMC, Fernandes AM, Campos C de. Quality of life among children with cancer: agreement between child and parent reports. Esc Anna Nery - Rev Enferm 2015;19(2):292–6.
42. Eiser C, Eiser JR, Stride CB. Quality of life in children newly diagnosed with cancer and their mothers. Health Qual Life Outcomes. 2005;3:29.
43. Klassen AF, Anthony SJ, Khan A, Sung L, Klaassen R. Identifying determinants of quality of life of children with cancer and childhood cancer survivors: A systematic review. Support Care Cancer. 2011;19(9):1275–87.
44. Macartney G, Harrison MB, VanDenKerkhof E, Stacey D, McCarthy P. Quality of life and symptoms in pediatric brain tumor survivors: a systematic review. J Pediatr Oncol Nurs. 2014;31(2):65–77.
45. McDougall J, Tsonis M. Quality of life in survivors of childhood cancer: A systematic review of the literature (2001-2008). Support Care Cancer. 2009;17(10):1231–46.
46. Yağcı-Küpeli B, Akyüz C, Küpeli S, Büyükpamukçu M. Health-related quality of life in pediatric cancer survivors: a multifactorial assessment including parental factors. J Pediatr Hematol Oncol 2012;34(3):194–9.
47. Upton P, Eiser C, Cheung I, Hutchings HA, Jenney M, Maddocks A, et al. Measurement properties of the un-English version of the pediatric quality of life inventory 4.0 (PedsQL) generic gore scales. Health Qual Life Outcomes. 2005;3:1–7.
48. Varni JW, Seid M, Knight TS, Uzark K, Szer IS. The pedsQL 4.0 generic core scales: sensitivity, responsivennes, and impact on clinical decision-making. J Beavioral Med. 2002;25(2):175–93.
49. Amerikan Kanser Birliği. Improving quality of life for children with cancer. 2014 URL: www.acscan.org • 202-661-5700 15 Şubat 2018
50. Novrianda D, Khairina I. The effect of educational intervention on the quality of life of acute lymphocytic leukemia who undergoing chemotherapy. Int J Res Med Sci. 2015;3(1):69–73.
51. Meeske KA, Patel SK, Palmer SN, Nelson MB, Parow AM. Factors associated with health-related quality of life in pediatric cancer survivors. Pediatr Blood Cancer 2007;49(3):298–305.
52. De Caroli ME, Sagone E. Stress and support in relation to parental self: A comparison between mothers of children in cancer treatment and mothers of healthy children. Procedia - Soc Behav Sci 2014;114(2003):211–5.
53. Deh RM, Collier J, Hall C. Parental stress when caring for a child with cancer in Jordan : a cross-sectional survey. Health Qual Life Outcomes. 2012; 28(10):88.
54. Kim DH, Chung N, Lee S. The effect of perceived parental rearing behaviors on health-related quality of life in adolescents with leukemia. J Pediatr Oncol Nurs. 2015;32(5):295–303.
55. Huang IC, Brinkman TM, Kenzik K, Gurney JG, Ness KK, Lanctot J, et al. Association between the prevalence of symptoms and health-related quality of life in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort study. J Clin Oncol. 2013;31(33):4242–51.
56. Li HCW, Williams DP, Lopez V, Chung OKJ, Chiu SY. Relationships among therapy-related symptoms, depressive symptoms, and quality of life in chinese children hospitalized with cancer. Cancer Nurs. 2013;36(5):346–54.
57. Dupuis LL, Staszczak A, Sung L. Quality improvement in pediatric oncology: timely and appropriate symptom control 2016. URL: http://quality.asco.org/quality-improvement-pediatric-oncology-timely-and-appropriate-symptom-control