Othman Azizah, Abdul Ghani Mohd Sufian Ardi, Taib Fahisham, Mohamad Norsarwany
Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
Paediatrics Clinic, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia.
Front Pediatr. 2022 Aug 22;10:941202. doi: 10.3389/fped.2022.941202. eCollection 2022.
Thalassemia is a chronic childhood disease that could result in psychological distress not only to the patients but also to their caretakers. Caretakers utilize different coping strategies to reduce stress and maintain a good quality of life.
The study aims to measure the level of psychological distress among caretakers of transfusion-dependent thalassemia patients and identify coping strategies used by them, as well as examine factors related to both outcome measures.
Sixty-eight ( = 68) caretakers of children with transfusion-dependent thalassemia agreed to participate in the study when they were approached during their visits to one of three major hospitals in Kelantan, Malaysia, for the children's medical treatment. They completed the Malay validated Depression Anxiety and Stress Scale 21 (DASS 21) and Brief-COPE self-report, in addition to a brief study proforma.
The majority of the participants reported feeling psychologically well, with no related scores in depression, anxiety, and stress sub-scales. The mean score for anxiety and stress sub-scales were 3.54 (SD = 3.54) and 4.25 (SD = 3.26) respectively. The median score for the depression sub-scale was 2.00 (IQR 4.00). The three mostly utilized coping strategies were religion, acceptance, and positive reframing. Those with depressed and anxious moods were found to engage more in negative coping strategies including substance abuse, denial, and behavioral disengagement. Being female, of younger age, employed, with higher educational level, and income status was found to significantly influence the adoption of positive reframing as a coping strategy.
Psychological distress such as elevated anxiety and depression was found among a small portion of caretakers who have children with thalassemia whose treatment required blood transfusion. They were noted to apply more maladaptive coping strategies compared to their psychologically well counterparts.
地中海贫血是一种儿童慢性疾病，不仅会给患者，也会给他们的照顾者带来心理困扰。照顾者会采用不同的应对策略来减轻压力并维持良好的生活质量。
本研究旨在测量依赖输血的地中海贫血患者照顾者的心理困扰程度，确定他们所采用的应对策略，并研究与这两个结果指标相关的因素。
马来西亚吉兰丹州三家主要医院之一在为患有依赖输血的地中海贫血儿童进行治疗期间，接触了68名此类儿童的照顾者，邀请他们参与研究。他们除了填写一份简短的研究表格外，还完成了马来语版经过验证的21项抑郁焦虑压力量表（DASS 21）和简易应对方式问卷（Brief-COPE）自评量表。
大多数参与者表示心理状况良好，抑郁、焦虑和压力分量表均无相关得分。焦虑和压力分量表的平均得分分别为3.54（标准差=3.54）和4.25（标准差=3.26）。抑郁分量表的中位数得分为2.00（四分位距4.00）。三种最常采用的应对策略是宗教、接受和积极重新评价。发现情绪抑郁和焦虑的人更多地采用消极应对策略，包括药物滥用、否认和行为脱离。结果发现，女性、年龄较小、有工作、教育水平较高和收入状况等因素对采用积极重新评价作为应对策略有显著影响。
在一小部分有需要输血治疗的地中海贫血患儿的照顾者中，发现了焦虑和抑郁等心理困扰。与心理状况良好的照顾者相比，他们被指出采用了更多适应不良的应对策略。
