Perspectiva de pais sobre o ajustamento psicológico de crianças em recidiva e remissão de câncer

Wechsler, Amanda Muglia; Bragado-Álvarez, Carmen; Hernández-Lloreda, María José; Lopes, Luiz Fernando; Perina, Elisa Maria

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Brasil

Estudos de Psicologia (Campinas)

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Brasil

Español English

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Sumário

RESEARCH REPORT | Health Psychology • Estud. psicol. 41 • 2024 • https://doi.org/10.1590/1982-0275202441e210164 copiar

Perspectiva de pais sobre o ajustamento psicológico de crianças em recidiva e remissão de câncer

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Objetivo

O presente artigo visou avaliar o ajustamento psicológico de crianças brasileiras em recidiva de câncer comparando-as com sobreviventes de câncer e com crianças “saudáveis”, a partir do relato de seus pais/cuidadores.

Método

Os participantes foram 140 cuidadores de crianças em recidiva (n = 24), remissão (n = 59) e controle (n = 57). Foram aplicadas a Escala de Avaliação Comportamental para Crianças e a Family Environment Scale. As análises de dados foram realizadas com t de Student, Qui-quadrado, análises de variância e correlações de Pearson.

Resultados

Os resultados mostraram que as crianças com câncer não apresentaram mais psicopatologias que o grupo controle, mas mostraram mais habilidades sociais e de liderança. Também se observaram fatores protetores (coesão familiar) e de risco (idade, número de recidivas, duração do tratamento, renda e nível educacional dos cuidadores).

Conclusão

Propõe-se o rastreio de sintomas psicológicos nos subgrupos de risco e o delineamento de estratégias interventivas para esta população.

Palavras-chave
Adaptação; Câncer em crianças; Ajustamento emocional; Psico-Oncologia; Recidiva

Variables		Relapse		Remission		Control
Variables		n	%	n	%	n	%
Child’s gender - valid n		24		59		57
	Female	12	50	31	52.5	34	59.6
	Male	12	50	28	47.5	23	40.4
Caregiver’s Marital Status - valid n		24		59		55
	With partner	17	71	45	76	32	58
	Without partner	7	29	14	24	23	42
Caregiver’s Education Level - valid n		23		59		55
	Elementary	8	35	23	39	25	45
	High school/higher education	15	65	36	61	30	55
Variables		Relapse		Remission		Control
Variables		M	SD	M	SD	M	SD
Child’s age - valid n		24		59		57
Child’s age - valid n		9.1	1.1	9.5	01.4	10.1	01.5
Family income - valid n		22		59		55
Family income - valid n		2.1	1.5	5.3	05.6	02.3	01.7
Time in current situation (months) - valid n		24		59		–
Time in current situation (months) - valid n		06.57	7.41	61.75	25.31	–	–
Time in treatment (months) - valid n		24		59		–
Time in treatment (months) - valid n		39.59	31.03	12.20	010.85	–	–

Subscale		Relapse		Remission		Control		F	p	Cohen’s d	ɳ²
Subscale		M	SD	M	SD	M	SD	F	p	Cohen’s d	ɳ²
Clinical Scales
	Aggression	10.54	07.52	9.36	5.38	8.72	06.00	0.78^* * p < 0.05.			0.01
	Hyperactivity	11.55	05.99	10.61	5.41	9.33	04.46	1.60^* * p < 0.05.			0.02
	Conduct Problems	3.13	02.94	03.64	3.15	4.42	03.94	1.40^* * p < 0.05.			0.02
	Attention Problems	011.04	3.41	10.74	2.70	9.74	02.70	2.60^* * p < 0.05.			0.04
	Atypicality	06.88	04.28	7.12	4.50	8.68	04.45	3.60^* * p < 0.05.	0.03^a a Significant differences between RG (group in cancer relapse) and CG (control group); 0.03^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.41^a a Significant differences between RG (group in cancer relapse) and CG (control group); 0.35^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.05
	Depression	11.00	06.53	8.76	5.74	8.72	05.05	1.61^* * p < 0.05.			0.02
	Anxiety	8.45	03.50	7.11	3.44	8.62	3.51	1.11^* * p < 0.05.			0.02
	Withdrawal	8.21	3.31	6.52	2.98	6.42	3.71	2.68^* * p < 0.05.			0.03
	Somatization	08.79	04.26	07.41	5.35	8.14	05.00	0.70^* * p < 0.05.			0.01
	Adaptive Scales
Adaptability		15.25	04.48	14.67	2.83	13.44	03.85	2.79^* * p < 0.05.			0.03
	Social Skills	28.46	07.13	26.26	5.90	23.74	06.56	5.12^* * p < 0.05.	0.00^a a Significant differences between RG (group in cancer relapse) and CG (control group); 0.03^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.69^a a Significant differences between RG (group in cancer relapse) and CG (control group); 0.40^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.07
	Leadership	15.88	04.40	16.28	3.67	14.09	4.11	4.62^* * p < 0.05.	0.00^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.56^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.06
General Scales
	Externalizing Problems	25.73	14.92	23.46	11.82	22.44	12.77	0.80^* * p < 0.05.			0.01
	Internalizing Problems	29.14	11.69	22.93	11.03	25.02	10.06	1.45^* * p < 0.05.			0.02
	Adaptive Skills	59.58	13.55	57.21	10.65	51.26	12.81	5.40^* * p < 0.05.	0.00^a a Significant differences between RG (group in cancer relapse) and CG (control group); 0.00^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.63^a a Significant differences between RG (group in cancer relapse) and CG (control group); 0.50^b b Significant differences between RMG (group in cancer remission) and CG (control group).	0.07
	Behavioral Symptoms Index	59.29	23.85	53.67	19.59	53.79	19.85	0.73^* * p < 0.05.			0.01

Variables		Group	1	2	3	4	5
1.	Externalizing	RG	–
	Problems	RMG	–
		CG	–
2.	Internalizing	RG	0.70^ p < 0.001. CG:	–
	Problems	RMG	0.69^ p < 0.001. CG:	–
		CG	0.60^ p < 0.001. CG:	–
3.	Adaptive	RG	-0.01	0.04	–
	Skills	RMG	0.06	-0.11	–
		CG	0.10	0.39^ p < 0.001. CG:	–
4.	Behavioral symptoms Index	RG	0.92^ p < 0.001. CG:	0.89^ p < 0.001. CG:	-0.01	–
		RMG	0.89^ p < 0.001. CG:	0.87^ p < 0.001. CG:	-0.06	–
		CG	0.87^ p < 0.001. CG:	0.86^ p < 0.001. CG:	0.27^* * p < 0.05;	–
5.	Family Cohesion	RG	0.01	0.12	0.38	0.04	–
		RMG	-0.34^* * p < 0.05;	-0.46^* * p < 0.05;	0.22	-0.37^* * p < 0.05;	–
		CG	-0.180	-0.07	0.09	-0.15	–

Variable		Group	1	2	3	4	5	6	7	8	9
1.	Externalizing	RG	–
	Problems	RMG	–
		CG	–
2.	Internalizing	RG	0.70^ p < 0.001.	–
	Problems	RMG	0.69^ p < 0.001.	–
		CG	0.60^ p < 0.001.	–
3.	Adaptive	RG	-0.01	0.04	–
	Skills	RMG	0.00	-0.11	–
		CG	0.10	0.39^ p < 0.001.	–
4.	Behavior symptoms index	RG	0.92^ p < 0.001.	0.89^ p < 0.001.	-0.01	–
		RMG	0.89^ p < 0.001.	0.87^ p < 0.001.	-0.06	–
		CG	0.88^ p < 0.001.	0.86^ p < 0.001.	0.27^* * p < 0.05;	–
5.	Child’s gender	RG	0.33	0.03	-0.33	0.17	–
		RMG	0.14	0.07	-0.19	0.19	–
		CG	0.13	-0.18	-0.23	-0.01	–
6.	Child’s age	RG	-0.35	-0.15	0.15	-0.31	-0.30	–
6.	Child’s age	RMG	-0.09	-0.05	0.28^* * p < 0.05;	-0.10	0.18	–
		CG	-0.13	-0.07	-0.08	-0.17	-0.17	–
7.	Caregiver’s Marital Status	RG	0.32	0.31	-0.18	0.39	0.08	-0.21	–
		RMG	-0.13	-0.06	-0.14	-0.09	0.07	0.16	–
		CG	-0.27^* * p < 0.05;	-0.25	0.04	-0.27^* * p < 0.05;	0.15	-0.03	–
8.	Caregiver’s Educ. Lvl.	RG	0.02	-0.26	0.25	-0.20	-0.03	0.14	-0.48^* * p < 0.05;	–
		RMG	-0.17	-0.29^* * p < 0.05;	0.07	-0.23	0.07	0.10	-0.10	–
		CG	-0.31^* * p < 0.05;	-0.15	-0.02	-0.19	-0.11	-0.04	-0.08	–
9.	Family income	RG	0.07	0.12	-0.06	0.12	-0.16	0.51*	-0.24	0.46^* * p < 0.05;	–
		RMG	-0.26^* * p < 0.05;	-0.27^* * p < 0.05;	0.14	-0.26^* * p < 0.05;	-0.02	0.07	-0.23	0.47^ p < 0.001.	–
		CG	-0.20	-0.11	-0.06	-0.17	-0.11	0.01	-0.16	0.37^ p < 0.001.	–

Variables		Group	1	2	3	4	5	6	7
1.	Externalizing	RG	–
	Problems	RMG	–
2.	Internalizing	RG	0.70^ p < 0.001.	–
	Problems	RMG	0.69^ p < 0.001.	–
3.	Adaptive	RG	-0.01	0.04	–
	Skills	RMG	0.00	-0.11	–
4.	Behavioral symptoms index	RG	0.92^ p < 0.001.	0.89^ p < 0.001.	-0.01	–
4.	Behavioral symptoms index	RMG	0.89^ p < 0.001.	0.87^ p < 0.001.	-0.06	–
5.	Time in current situation	RG	0.20	0.02	-0.20	0.09	–
5.	Time in current situation	RMG	0.08	-0.8	0.15	0.01	–
6.	Time in treatment	RG	0.26	0.45^* * p < 0.05;	-0.18	0.38	0.26	–
6.	Time in treatment	RMG	-0.07	0.04	0.05	-0.01	-0.46^ p < 0.001.	–
7.	Number of relapses	RG	0.44^* * p < 0.05;	0.50^* * p < 0.05;	-0.09	0.46^* * p < 0.05;	0.02	0.36	–

Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas Editora Splendet, Pontifícia Universidade Católica de Campinas, Campus I, Rua Prof. Dr. Euryclides de Jesus Zerbini, 1516, Pq. Rural Fazenda Santa Cândida, Telefone: (55 19) 3343-7223. - Campinas - SP - Brazil
E-mail: psychologicalstudies@puc-campinas.edu.br

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