Dissertation committee:
Βασλαματζής Γρηγόριος, Ομότιμος Καθηγητής ,Ιατρική, ΕΚΠΑ, Επιβλέπων
Ζωγράφος Γεώργιος, Καθηγητής Χειρουργικής,Ιατρική, ΕΚΠΑ
Κολαΐτης Γεράσιμος, Καθηγητής, Ιατρική, ΕΚΠΑ
Λαζαράτου Ελένη, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Παπανικολάου Αικατερίνη, Αναπληρώτρια Καθηγήτρια , Ιατρική, ΕΚΠΑ
Χριστογιώργος Στυλιανός, Αναπληρωτής Καθηγητής Παιδοψυχιατρικής, ΕΚΠΑ
Γιαννοπούλου Ιωάννα, Επίκουρη Καθηγήτρια Παιδοψυχιατρικής, ΕΚΠΑ
Summary:
Introduction: A significant number of breast cancer survivors are parents of minor children, worldwide. These children may experience anxiety, sadness, fear, depression or may exhibit better health-related quality of life and enhanced social/school performance. Emotional and behavioral disorders may continue in adulthood. This study aims to investigate such disorders, as well as factors related to them, in children, whose mother is diagnosed with breast cancer, one month and one year after the mother's surgery.
Methodology: Mothers (n=164) being diagnosed with breast cancer and having minor children, completed the following scales, one month and one year after surgery: (a) for one of their children: Child Behavior Checklist (CBCL/1.5-5 & CBCL/6-18), (b) for themselves: Symptom Checklist-90-R (SCL90-R), Body Image Scale (BIS), 12-Item Health Survey (SF-12 v2®), Ways of Coping Checklist, Defense Style Questionnaire (DSQ) and (c) for the family: Family Assessment Device - General Functioning Subscale (FAD-GFS), Family Crisis Oriented Personal Evaluation Scales (F-COPES).
Results: The sample's mean age was for children 11.1 ± 4.5 years and for mothers 44 ± 5.5 years. The 52.4% of children were boys. The 54.9% of mothers had undergone mastectomy. In both the first and second assessment, the majority of the participants, had talked on their own to the child about the disease (83.4% and 84.2%, respectively) and the mastectomy (60.7% and 65.5%, respectively). At the second assessment, was observed: increase (10.8%) in the information provided by mothers to child (regarding the disease), increase (3.9%) in children’s Internalizing Problems, decrease (2.2%) in children’s Externalizing Problems and increase (1.2%) in children’s Total Problems. Between the first and the second evaluation, children’s Internalizing Problems were more frequent (14.2% and 18.1%, respectively) than Externalizing (11.6% and 9.4%, respectively), while, there were no statistically significant changes in the mean value of the "CBCL" subscales.
According to the results of multivariate analyses, the maternal Global Severity Index (SCL-90) is associated with children’s Internalizing (P=0.012), Externalizing (P=0.036) and Total Problems (P=0.001) on CBCL, at the first evaluation. The maternal Positive Symptom Total (SCL-90) is associated with children’s Internalizing Problems (P=0.018) at the second evaluation. The maternal Positive Approach (Ways of Coping) is negatively associated with children’s Internalizing Problems (P=0.046) at the first evaluation, while, the maternal Confrontive Coping (Ways of Coping) is associated with children’s Internalizing (P=0.001), Externalizing (P=0.000) and Total Problems (P=0.001) at the first evaluation and Externalizing Problems (P=0.031) at the second. The maternal Self-Sacrificing Style (DSQ) is associated with children’s Internalizing Problems (P=0.034), at the first evaluation, and Internalizing (P=0.030) and Total Problems (P=0.004) at the second. The maternal Maladaptive Style (DSQ) is associated with children’s Externalizing Problems (P=0.006) at the second evaluation. Higher scores on FAD-GFS are associated with higher children’s Internalizing (P=0.009) and Total Problems (P=0.005) at the second evaluation. Whether the mother had talked to the child, about the mastectomy, is associated with children’s Internalizing (P=0.014), Externalizing (P=0.050) and Total Problems (P=0.010) at the first evaluation and Internalizing Problems (P=0.017) at the second.
Conclusions: A minority of children experienced emotional and behavioral disorders (11.6% - 14.2% in the first evaluation and 9.4% - 18.1% in the second), but these children may need psychosocial support. Same factors associated with the disorders in the two measurements were revealed, but sometimes for different types of problems. The findings of the study are consistent with the literature and can form the basis for preventive strategies and early detection of intervention needs of the child, the mother and the whole family. Further research involving the children themselves (over 11 years old) and the father is needed, as well as longer follow up.
Keywords:
Child, Emotional and behavioral disorders, Mother, Breast cancer
