Hanan El Malla, Nathalie Ylitalo Helm, Ulrica Wilderäng, Gunnar Steineck, Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden.
World J Psychiatry. 2013 Jun 22;3(2):25-33. doi: 10.5498/wjp.v3.i2.25.
To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt.
We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read the questions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child's medical journal. The study period consisted of 7 mo (February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher's exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows (SAS Institute Inc., Cary, NC, United States).
Two hundred and eighty-one (90%) parents answered the second questionnaire, regarding their child's adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment (181/281, 64%). Sixty-eight percent (123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance (111/123, 90%) and inadequate information (100/123, 81%). In the adherent group, 20% of the parents (n = 12/58) reported trust in their child's doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123 (7%) for both their child's doctor and other health-care professionals. Almost all of the parents expressed a lack of optimism towards the treatment (116/121, 96%), yet they reported an intention to continue with the treatment for two main reasons, for the sake of their child's life (70%) (P = 0.005) and worry that their child would die if they discontinued the treatment (81%) (P < 0.0001).
Non-adherence to medical regimen is common among children diagnosed with cancer in Egypt, the main reasons being child resistance and inadequate information.
调查埃及癌症患儿对医疗方案的依从性及其不依从的预测因素。
我们对 304 名在埃及开罗儿童癌症医院诊断出患有癌症的儿童的父母进行了两项专门的研究问卷调查，一项在第一次化疗治疗前进行，另一项在第三次化疗治疗前进行。问卷被翻译成通俗的埃及阿拉伯语，由于埃及的文盲率很高，因此每个家长都由一名采访员用阿拉伯语读出问题，并记录答案。两份问卷都包含了近 90 个问题。此外，还从孩子的病历中填写了一份病例报告表。研究期间为 7 个月（2 月至 9 月 2008 年），我们的参与率为 97%。呈现描述性统计数据，并使用 Fisher 确切检验检查依从组和不依从组之间可能存在的差异。P 值低于 0.05 被认为具有统计学意义。使用的软件是 SAS 版本 9.3 for Windows（SAS Institute Inc.，Cary，NC，美国）。
281 名（90%）父母回答了关于孩子依从性行为的第二份问卷。大约三分之二的儿童在接受第一次或第二次化疗治疗出院时接受了医疗建议（181/281，64%）。68%（123/181）接受了医疗建议的父母报告说，他们的孩子没有遵循建议。发现两个主要的不依从预测因素：孩子的抵触（111/123，90%）和信息不足（100/123，81%）。在依从组中，20%的父母（n=12/58）表示信任孩子的医生，而 14%的父母（n=12/58）表示信任其他医疗保健专业人员。不依从组的相应数字分别为 7%（n=8/123），分别是孩子的医生和其他医疗保健专业人员。几乎所有的父母都对治疗表示悲观（116/121，96%），但他们表示出于两个主要原因继续接受治疗，一是为了孩子的生命（70%）（P=0.005），二是担心如果停止治疗，孩子会死（81%）（P<0.0001）。
埃及诊断出患有癌症的儿童中，不遵守医疗方案的情况很常见，主要原因是孩子的抵触和信息不足。
