Lähteenmäki P M, Sjöblom J, Korhonen T, Salmi T T
Department of Pediatrics, Turku University Hospital, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland.
Arch Dis Child. 2004 Nov;89(11):1008-13. doi: 10.1136/adc.2002.012088.
In a 1 year follow up study, we assessed the life situation of 33 siblings of childhood cancer patients and 357 healthy controls. The hypothesis was that siblings have more behavioural and health related problems just after the cancer diagnosis. Validated assessment methods were used.
Siblings below school age tended to have conduct problems, psychosomatic problems, and a mixed group of other behavioural problems, when assessed 3 months after the cancer diagnosis. These symptoms became less evident during follow up. Among the school aged siblings, however, conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive symptoms, and other behavioural symptoms remained unchanged during follow up. In their self assessments, the school aged siblings showed both state and trait anxiety more often than controls at the first assessment, but later these symptoms settled to the same level as the controls. The overall Children's Depression Inventory (CDI) depression scores did not show differences between the study groups.
The ratings of the parents were in keeping with the self assessment of the school aged siblings only in a few aspects; the emphasis of findings can be changed when proxies are used. The siblings have symptoms and adverse feelings which probably could be relieved by targeted, early information about the illness, and possibly by group discussions or activities, soon after the cancer diagnosis. In order to obtain necessary support for the siblings with educational problems, school personnel need to be informed about the sibling distress.
在一项为期1年的随访研究中,我们评估了33名儿童癌症患者的兄弟姐妹以及357名健康对照者的生活状况。假设是在癌症诊断后不久,患者的兄弟姐妹会出现更多与行为和健康相关的问题。我们采用了经过验证的评估方法。
在癌症诊断后3个月进行评估时,学龄以下的兄弟姐妹往往存在行为问题、心身问题以及其他各类行为问题。这些症状在随访过程中变得不那么明显。然而,在学龄期的兄弟姐妹中,行为问题、学习问题、心身问题、冲动多动症状以及其他行为症状在随访期间保持不变。在自我评估中,学龄期的兄弟姐妹在首次评估时表现出状态焦虑和特质焦虑的频率均高于对照组,但之后这些症状降至与对照组相同的水平。研究组之间儿童抑郁量表(CDI)的总体抑郁得分没有差异。
父母的评分仅在少数方面与学龄期兄弟姐妹的自我评估一致;使用替代者时研究结果的重点可能会改变。在癌症诊断后不久,通过有针对性的、关于疾病的早期信息,以及可能通过小组讨论或活动,患者的兄弟姐妹的症状和不良情绪可能会得到缓解。为了使有教育问题的兄弟姐妹获得必要的支持,学校工作人员需要了解他们的困扰。