Investigation of post-traumatic growth with traumatic and psychological effects in children and adolescents diagnosed with cancer

Abstract

Purpose: The aim of this study was to evaluate and compare traumatic and mental effects and PTG by
comparing a patient group in hematological-oncological cancer remission with a healthy control group.
Materials and methods: Children and adolescents aged 8-18 years, who were in remission with a diagnosis of
childhood cancer, and presented at the Paediatric Hematology Department of Pamukkale Unıversity between 1
September 2021 and 30 April 2022 were included as the study group and a control group was formed of healthy
children and adolescents with no history of cancer diagnosis. The Post-Traumatic Growth Inventory (PTGI), the
Child Revised Impact of Events Scale (CRIES-13) and the Revised Child Anxiety and Depression Scale-Child
Version (RCADS-CV) were applied to all the children in both groups. A sociodemographic information form
prepared by the researchers, and the Revised Child Anxiety and Depression Scale- Parent Version (RCADSPV)
were applied to parents.
Results: Evaluation was made of 27 patients aged 8-18 years with a diagnosis of childhood cancer who were
in remission, and a control group of 25 healthy children. No statistically significant difference was determined
between the groups in respect of parental ages, family structure, parental educational levels, and mean monthly
family income (p>0.05). In the comparisons of the raw scores of the RCADS-PV between the two groups,
RCADS-PV Panic Disorder, Obsessive Compulsive Disorder, and Depression subscale scores were found to
be statistically significantly higher in the control group than in the remission group (p=0.048; p=0.045; p=0.047).
When the CRIES-13 scores of the two groups were compared, no statistically significant difference was found
(p=0.659).When the PTGI scales and subscales of the two groups were compared; while no statistically
significant difference was found in the total PTGI score (p=0.066), the change in life philosophy subscale and
the change in relationships with others subscale was found to be statistically significantly higher in the remission
group than in the control group (p=0.038; p=0.05).Considering the relationship between CRIES-13 and PTGI
scale scores, no statistically significant relationship was found in the remission group.
Conclusion: Cancer survivors grow from this negative experience, become stronger and survive with positive
gains; they can adjust their expectations from themselves, the world and their future. Considering the current
prevalence of cancer and increasing survival rates with treatments, new multicenter studies with larger samples
are needed on this subject.

Keywords

• post-traumatic growth
• trauma
• cancer
• child
• adolescent

Kanser tanılı çocuk ve ergenlerde travma sonrası büyüme ile travmatik ve ruhsal etkilenmenin incelenmesi

Abstract

Amaç: Hematoloji-onkoloji kanser remisyonunda olan hasta grubu ve sağlıklı kontrol grubunun karşılaştırarak
travmatik ve ruhsal etkilenmelerini ve post travmatik büyümelerini değerlendirmek ve karşılaştırmak
amaçlanmıştır.
Gereç ve yöntem: 01 Eylül 2021-30 Nisan 2022 tarihleri arasında Pamukkale Üniversitesi Çocuk Hematolojisi
Anabilim Dalı’na başvuran ve çalışmaya katılmayı kabul eden çocukluk çağı kanser tanısı remisyonda olan 8-18
yaş arası çocuk ve ergenler ile daha önce çocukluk çağı kanser tanısı almamış sağlıklı kontrol grubu çocuk ve
ergenler ile çalışma tamamlanmıştır. Çocuk ve ergenlere Travma Sonrası Büyüme Envanteri (PTGI), Revize
Edilmiş Çocuk Olayın Etkisi Ölçeği -13 (CRIES-13), Çocuklarda Anksiyete ve Depresyon Ölçeği-YenilenmişÇocuk
Formu (ÇADÖ-Y-ÇF) ölçekleri uygulanmıştır. Ebeveynlere de Sosyodemografik form ve Çocuklarda
Anksiyete ve Depresyon Ölçeği-Yenilenmiş-Ebeveyn Formu (ÇADÖ-Y-EF) uygulanmıştır.
Bulgular: Çalışmaya 8-18 yaş arası, 27 çocukluk çağı kanser tanısı remisyonda olan hasta ve 25 sağlıklı kontrol
katılmıştır. İki grup arasında anne baba yaşı, aile yapısı, anne ve babanın öğrenim durumu ve ortalama aylık gelir dağılımında istatistiksel olarak anlamlı düzeyde bir farklılık saptanmamıştır (p>0,05). ÇADÖ-Y-EF Panik
Bozukluk, Obsesif Kompulsif Bozukluk, Depresyon alt ölçek skorları kontrol grubunda remisyon grubuna göre
istatistiksel olarak anlamlı düzeyde yüksek saptanmıştır (p=0,048; p=0,045; p=0,047). İki grubun CRIES-13
puanları karşılaştırıldığında istatistiksel olarak anlamlı farklılık bulunmamıştır (p=0,659). İki grubun PTGI ölçek
ve alt ölçekleri karşılaştırıldığında; total PTGI puanında istatistiksel olarak anlamlı farklılık saptanmazken
(p=0,066), PTGI ölçeğinin Yaşam Felsefesinde Değişim ve Başkalarıyla İlişkilerde Değişim alt ölçek ortalaması
hasta grubunda kontrol grubuna göre istatistiksel olarak anlamlı düzeyde yüksek saptanmıştır (p=0,038;
p=0,05). CRIES-13 ve PTGI ölçek puanları arasındaki ilişkiye bakıldığında, remisyon grubunda istatistiksel
olarak anlamlı ilişki bulunmamıştır.
Sonuç: Kanseri yenenler bu olumsuz deneyimden büyüyerek, güçlenerek ve olumlu kazanımlarla sağ çıkarak;
kendilerinden, dünyadan ve geleceklerinden beklentilerini ayarlayabilmektedir. Günümüzdeki kanser prevalansı
ve tedavilerle artan sağkalım oranları göz önüne alındığında bu konuda yapılacak çok merkezli ve daha büyük
örneklemli yeni çalışmalara ihtiyaç vardır.

Keywords

• Travma sonrası büyüme
• travma
• kanser
• çocuk
• ergen

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