Investigation of postoperative psychological behaviors in children with solid tumors and the influencing factors

doi:10.3969/j.issn.1004-583X.2024.09.009

Abstract

Abstract:

Objective To explore the differences in psychological behavior between children with solid tumors after surgery and non-tumor children, and to analyze the influencing factors. Methods Convenience sampling method was used to select 150 children with pathologically diagnosed solid tumors at Children's Hospital Affiliated of Zhengzhou University from May 2022 to April 2023 as the pediatric tumor group. During the same period, 100 healthy children were selected as the control group. The Conners Comprehensive Behavior Rating Scale (CBRS) and the Normal Development of Social Skills from Infame to Junior High School Children (S-M) were used to assess the psychological behavior and social life ability. Influencing factors for postoperative psychological and behavioral abnormalities in children with solid tumors were identified by logistic regression analysis. Results There were significant differences in the scores of learning problems, anxiety, and hyperactivity index in the psychological and behavioral dimensions of children at different age groups (P<0.05). The scores of various psychological and behavioral dimensions in the pediatric tumor group were significantly higher than those of the control group (P<0.05). The scores of sports, independent living, self-management, homework operations, and group activities in the pediatric group were significantly lower than those of the control group (P<0.05). There were significant differences in the age, time to return to school after surgery, completion of treatment, financial burden on the family, harmonious family relationship and social living ability comparison in children between abnormal and normal psychological behavior groups (P<0.05). CBRS score was negatively correlated with the S-M score (r=-0.667, P<0.01). Logistic regression analysis showed that older age, longer time to return to school after surgery, completion of treatment, harmonious family relationship, and good social living ability were protective factors for psychological and behavioral problems after surgery for children with solid tumors, while a heavy family financial burden was a risk factor (P<0.05). Conclusion The psychological and behavioral scores of children with solid tumors are at a moderate level. Paying attention to the postoperative psychological behavior of children with solid tumors and improving their social life abilities can help them integrate into the group and promote healthy growth.

Key words: psycho-oncology, psychological behavior, Conners Comprehensive Behavior Rating Scale, S-M scale

CLC Number:

R730
R395.9

Du Lihui, Lu Hangduo, Zhang Wenjun, Wang Wenhua, Wang Yuanyuan, Jia Yingping. Investigation of postoperative psychological behaviors in children with solid tumors and the influencing factors[J]. Clinical Focus, 2024, 39(9): 816-820.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.09.009

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I9/816

Figures/Tables 5

Tab.1 Psychological behaviors scores in children with solid tumors at different age groups

组别	例数	身心障碍	品行问题	学习问题	焦虑	冲动-多动	多动指数
4~6岁	49	0.271±0.277	0.490±0.314	0.761±0.623	0.732±0.544	0.541±0.414	0.670±0.576
7~12岁	63	0.254±0.261	0.477±0.278	0.594±0.533^*	0.481±0.361^*	0.515±0.392	0.541±0.524^*
13岁及以上	38	0.242±0.253	0.450±0.274	0.330±0.304^*#	0.320±0.279^*#	0.480±0.213	0.370±0.289^*#
$F$ 值		0.134	0.208	7.399	11.149	0.301	3.929
P值		0.875	0.812	<0.001	<0.001	0.740	0.022

Tab.1 Psychological behaviors scores in children with solid tumors at different age groups

组别	例数	身心障碍	品行问题	学习问题	焦虑	冲动-多动	多动指数
4~6岁	49	0.271±0.277	0.490±0.314	0.761±0.623	0.732±0.544	0.541±0.414	0.670±0.576
7~12岁	63	0.254±0.261	0.477±0.278	0.594±0.533^*	0.481±0.361^*	0.515±0.392	0.541±0.524^*
13岁及以上	38	0.242±0.253	0.450±0.274	0.330±0.304^*#	0.320±0.279^*#	0.480±0.213	0.370±0.289^*#
$F$ 值		0.134	0.208	7.399	11.149	0.301	3.929
P值		0.875	0.812	<0.001	<0.001	0.740	0.022

Tab.2 Psychological behaviors scores between the two groups

组别	例数	身心障碍	品行问题	学习问题	焦虑	冲动-多动	多动指数
对照组	100	0.122±0.290	0.390±0.211	0.461±0.412	0.451±0.422	0.182±0.213	0.267±0.194
儿童肿瘤组	150	0.251±0.266	0.471±0.264	0.631±0.559	0.671±0.549	0.522±0.389	0.577±0.529
$t$ 值		3.623	2.569	2.605	3.394	7.978	5.610
P值		<0.001	0.011	0.010	0.001	<0.001	<0.001

Tab.2 Psychological behaviors scores between the two groups

组别	例数	身心障碍	品行问题	学习问题	焦虑	冲动-多动	多动指数
对照组	100	0.122±0.290	0.390±0.211	0.461±0.412	0.451±0.422	0.182±0.213	0.267±0.194
儿童肿瘤组	150	0.251±0.266	0.471±0.264	0.631±0.559	0.671±0.549	0.522±0.389	0.577±0.529
$t$ 值		3.623	2.569	2.605	3.394	7.978	5.610
P值		<0.001	0.011	0.010	0.001	<0.001	<0.001

Tab.3 S-M scores between the two groups

组别	例数	运动	独立生活	自我管理	交往	作业操作	集体活动
对照组	100	8.581±1.532	23.041±2.852	7.291±1.982	13.913±1.918	10.728±1.820	13.063±2.065
儿童肿瘤组	150	8.111±1.518	21.421±2.789	6.521±2.179	13.483±1.852	9.489±2.028	12.354±2.138
$t$ 值		2.389	4.459	2.837	1.773	4.928	2.604
P值		0.018	<0.001	0.005	0.077	<0.001	0.010

Tab.3 S-M scores between the two groups

组别	例数	运动	独立生活	自我管理	交往	作业操作	集体活动
对照组	100	8.581±1.532	23.041±2.852	7.291±1.982	13.913±1.918	10.728±1.820	13.063±2.065
儿童肿瘤组	150	8.111±1.518	21.421±2.789	6.521±2.179	13.483±1.852	9.489±2.028	12.354±2.138
$t$ 值		2.389	4.459	2.837	1.773	4.928	2.604
P值		0.018	<0.001	0.005	0.077	<0.001	0.010

Tab.4 Univariate analysis of psychological behavior in children with solid tumors after surgery

组别		例数		年龄		性别[例(%)]				术后复学时间 (天)		独生子女[例(%)]		是否完成治疗[例(%)]
组别		例数		年龄		男		女		术后复学时间 (天)		是	否	是	否
异常组		59		6.132±1.859		26(44.1)		33(55.9)		60.188±11.572		27(45.8)	32(54.2)	18(30.5)	41(69.5)
正常组		91		11.533±2.911		42(46.2)		49(53.8)		114.716±25.757		46(55.6)	45(49.4)	54(59.3)	37(40.7)
统计值				$t$ =12.667		χ²=0.063				$t$ =15.278		χ²=0.328		χ²=11.921
P值				<0.001		0.802				<0.001		0.567		0.001
组别	例数		家长受教育程度[例(%)]						家庭是否存在经济负担 [例(%)]			家庭关系是否融洽 [例(%)]		患儿社会生活能力 [例(%)]
组别	例数		初中及以下		中专/高中		专科及以上		是		否	是	否	正常	异常
异常组	59		15(25.4)		26(44.1)		18(30.5)		37(62.7)		22(37.3)	26(44.1)	33(55.9)	16(27.1)	73(80.2)
正常组	91		22(24.2)		39(42.9)		30(32.9)		36(39.6)		55(60.4)	63(69.2)	28(30.8)	43(72.9)	18(19.8)
统计值			χ²=0.102						χ²=7.679			χ²=9.393		χ²=41.829
P值			0.950						0.006			0.004		<0.001

Tab.4 Univariate analysis of psychological behavior in children with solid tumors after surgery

组别		例数		年龄		性别[例(%)]				术后复学时间 (天)		独生子女[例(%)]		是否完成治疗[例(%)]
组别		例数		年龄		男		女		术后复学时间 (天)		是	否	是	否
异常组		59		6.132±1.859		26(44.1)		33(55.9)		60.188±11.572		27(45.8)	32(54.2)	18(30.5)	41(69.5)
正常组		91		11.533±2.911		42(46.2)		49(53.8)		114.716±25.757		46(55.6)	45(49.4)	54(59.3)	37(40.7)
统计值				$t$ =12.667		χ²=0.063				$t$ =15.278		χ²=0.328		χ²=11.921
P值				<0.001		0.802				<0.001		0.567		0.001
组别	例数		家长受教育程度[例(%)]						家庭是否存在经济负担 [例(%)]			家庭关系是否融洽 [例(%)]		患儿社会生活能力 [例(%)]
组别	例数		初中及以下		中专/高中		专科及以上		是		否	是	否	正常	异常
异常组	59		15(25.4)		26(44.1)		18(30.5)		37(62.7)		22(37.3)	26(44.1)	33(55.9)	16(27.1)	73(80.2)
正常组	91		22(24.2)		39(42.9)		30(32.9)		36(39.6)		55(60.4)	63(69.2)	28(30.8)	43(72.9)	18(19.8)
统计值			χ²=0.102						χ²=7.679			χ²=9.393		χ²=41.829
P值			0.950						0.006			0.004		<0.001

Tab.5 Logistics regression analysis of the influencing factors of psychological behavior in children with solid tumors after surgery

指标	回归系数	标准误	Wald χ²值	P值	$O R$ 值	95% $C I$
指标	回归系数	标准误	Wald χ²值	P值	$O R$ 值	下限	上限
常量	5.178	0.369	16.647	<0.001
年龄	-0.616	0.272	8.141	0.025	0.540	0.318	0.819
术后复学时间	-0.535	0.251	7.428	0.035	0.586	0.316	0.986
完成治疗	-0.127	0.039	13.847	0.001	0.881	0.241	0.982
家庭存在经济负担	1.113	0.327	11.545	<0.001	3.043	1.009	4.276
家庭关系融洽	-0.367	0.096	14.071	<0.001	0.693	0.382	0.953
社会生活能力	-0.416	0.124	12.398	0.001	0.659	0.178	0.725

Tab.5 Logistics regression analysis of the influencing factors of psychological behavior in children with solid tumors after surgery

指标	回归系数	标准误	Wald χ²值	P值	$O R$ 值	95% $C I$
指标	回归系数	标准误	Wald χ²值	P值	$O R$ 值	下限	上限
常量	5.178	0.369	16.647	<0.001
年龄	-0.616	0.272	8.141	0.025	0.540	0.318	0.819
术后复学时间	-0.535	0.251	7.428	0.035	0.586	0.316	0.986
完成治疗	-0.127	0.039	13.847	0.001	0.881	0.241	0.982
家庭存在经济负担	1.113	0.327	11.545	<0.001	3.043	1.009	4.276
家庭关系融洽	-0.367	0.096	14.071	<0.001	0.693	0.382	0.953
社会生活能力	-0.416	0.124	12.398	0.001	0.659	0.178	0.725

References 26

[1]	Raimondo S, Zito G. Imaging to study solid tumour origin and progression: Lessons from research and clinical oncology[J]. Immunol Cell Biol, 2017, 95(6):531-537. doi: 10.1038/icb.2017.17 pmid: 28294139
[2]	郭碧赟, 王玥, 温红, 等. 闽南地区儿童实体肿瘤单中心研究[J]. 中国小儿血液与肿瘤杂志, 2021, 26(5):294-297,309.
[3]	王静, 刘芸, 黄浩宇, 等. 国内外儿童肿瘤康复管理现状及策略[J]. 肿瘤代谢与营养电子杂志, 2024, 11(2):276-282.
[4]	许玉洋, 陈青华, 刘艳, 等. 肿瘤儿童预防接种现状与效果及安全性的研究进展[J]. 中华预防医学杂志, 2024, 58(1):87-91.
[5]	朱慧, 朱梦蝶, 陈凯, 等. 儿童实体肿瘤手术后回归社会调查研究[J]. 教育生物学杂志, 2021, 9(2):135-140.
[6]	李凌轩, 王瑞芬, 管雯斌, 等. 儿童多原发肿瘤4例临床病理学分析[J]. 中华病理学杂志, 2024, 53(6):605-609.
[7]	胡晓彤, 王倩, 蔡炜嵩. 小儿实体肿瘤发病因素研究进展[J]. 中国医师进修杂志, 2018, 41(10):935-938.
[8]	莫绪明, 笪敏. 中国儿童胸部实体肿瘤诊疗现状[J]. 临床小儿外科杂志, 2022, 21(3):201-207.
[9]	周爱保, 岳红云, 张百红. 癌症确诊事件相关心理应激现象与临床干预[J]. 医学与哲学, 2019, 40(23):46-50.
[10]	刘倩, 莫霖, 唐心悦, 等. 提升复原力干预策略对改善恶性肿瘤患儿心理社会适应水平的效果[J]. 中国护理管理, 2021, 21(9):1329-1334.
[11]	胡慧敏, 张伟令, 黄东生, 等. 儿童恶性实体瘤发生中枢神经系统转移的临床分析[J]. 中华神经科杂志, 2020, 53(5):348-355.
[12]	刘倩, 莫霖, 黄先巧, 等. 治疗期儿童青少年恶性肿瘤患儿社会适应相关因素分析[J]. 中国卫生统计, 2021, 38(3):391-395.
[13]	张致祥, 雷贞武. “婴儿-初中学生社会生活能力量表”再标准化[J]. 中国临床心理学杂志, 1995, 3(1):12-15.
[14]	Lee JA. Solid Tumors in Children and Adolescents[J]. Korean Med Sci, 2018, 33(41):e269.
[15]	Van Paemel R, Vlug R, De Preter K, et al. Correction to: The pitfalls and promise of liquid biopsies for diagnosing and treating solid tumors in children: As review[J]. Eur J Pediatr, 2020, 179(9):1497-1498. doi: 10.1007/s00431-020-03692-7 pmid: 32447561
[16]	闫焕, 杨正兵. 神经母细胞瘤患儿原发肿瘤手术切除程度与生存预后的关系[J]. 中国肿瘤临床与康复, 2019, 26(3):280-283.
[17]	Steliarova-Foucher E, Stiller C, Lacour B, et al. International classification of childhood cancer, third edition[J]. Cancer, 2005, 103(7):1457-1467. doi: 10.1002/cncr.20910 pmid: 15712273
[18]	Radhi M, Fulbright JM, Ginn KF, et al. Childhood cancer for the primary care physician[J]. Prim Care, 2015, 42(1):43-55. doi: 10.1016/j.pop.2014.09.006 pmid: 25634704
[19]	王欣迪, 李斯慧, 段超, 等. 儿童恶性实体肿瘤早期识别及转诊前治疗的研究进展[J]. 中华实用儿科临床杂志, 2017, 32(15):1192-1195.
[20]	Tinkle CL, Singh C, Lloyd S, et al. Stereotactic body radiation therapy for metastatic and recurrent solid tumors in children and young adults[J]. Int J Radiat Oncol Biol Phys, 2021, 109(5):1396-1405.
[21]	李志杰. 儿童实体瘤靶向治疗的研究进展[J]. 中国小儿血液与肿瘤杂志, 2019, 24(2):57-61.
[22]	温贤浩, 郭玉霞, 管贤敏, 等. 儿童肿瘤患者治疗及长期生存质量的研究进展[J]. 分子影像学杂志, 2019, 42(4):506-509.
[23]	段毅楠, 曹洪丽. 作业治疗对恶性肿瘤患者生活质量影响的研究进展[J]. 中国康复理论与实践, 2020, 26(12):1427-1431. doi: 10.3969/j.issn.1006-9771.2020.12.009
[24]	Desjardins L, Solomon A, Shama W, et al. The impact of caregiver anxiety/depression symptoms and family functioning on child quality of life during pediatric cancer treatment: From diagnosis to 6 months[J]. J Psychosoc Oncol, 2022, 40(6):790-807.
[25]	曾值, 邓窈窕. 儿童心理社会肿瘤学临床研究进展[J]. 中国全科医学, 2019, 22(6):626-632. doi: 10.12114/j.issn.1007-9572.2018.00.449
[26]	刘明法. 儿童恶性肿瘤幸存者健康生活质量影响因素的研究进展[J]. 职业与健康, 2021, 37(9):1293-1296.