The psychosocial effects of cancer on children and their families.

Abstract

Psychosocial oncology is well established in Europe and in America. Similar initiatives are, however, rare in Africa. On the African continent, psychosocial services are scarce and often a luxury although the importance of psychosocial variables as mediators in the paediatric cancer outcomes have been widely recognised. The apartheid system in South Africa was instrumental in causing major disparities in health, education and socioeconomic status. In order to provide a more holistic service it becomes imperative to assess not only the psychosocial needs and resources of both children and parents who endure the disease but also the influence of socio-demographic variables such as race, educational level and socioeconomic status. This research was limited to collecting baseline information on how parents and children communicate about the illness, emotional responses and the psychological resources that they utilise to deal with the childhood cancer trajectory. The study group consisted of 100 children between the ages of 5 and 16 years who had been diagnosed with cancer and one or both parents of those children. Data was collected through semi-structured interviews and standardised self-report measures. The results of the study indicate that both parents and children did not suffer disabling psychopathology, but certainly evidenced symptoms of depression and anxiety indicative of adjustment difficulties. Communicating about the illness was generally limited to physiological aspects of the disease and medically related matters, while emotional issues were rarely articulated. Children, parents and their siblings relied heavily on medical staff for their information needs. The age of the child was a significant factor with reference to amount and complexity of information imparted to children: adolescents were given more information about the treatment and prognosis; while younger children were given a limited amount of information. Race, socioeconomic status and educational levels of parents not only influenced the meanings and beliefs families developed around the cancer experience, but also the manner in which they expressed their emotions and the coping strategies that they employed.