391: Health, performance and psychosocial adjustment of haematopoietic stem cell transplantation in teenagers

Abstract

This study invesgated health , performance and psychosoical adjustment of post Haematopoetic Stem Cell Transplantation(HSCT) in teenagers for using basal data of rehabilitation and return to normal life after HSCT. Most of pediatric patients are suffering from a high degree of depression, anxiety and lowered self-esteem due to painful invasive treatment for high dose chemotherapy, radiation therapy and admission. HSCT Survivors have experienced physical weakness, loneliness and isolation as well as physical symptoms. Especially, the psychosocial aspect of children after HSCT is very important in health, performance and psychosocial adjustment. We studied 63 teenagers who are 12-17 years old at least 100 days after HSCT. We used Nine symptom checklist of EORTC (European Organization for Research and Treatment of cancer Therapy) QOL-C30; fatigue, nausea and vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, diarrhea and financial difficulties, Lansky scale (Physical performance) and K-CBCL (Korea-child behavior Checklist); Social competence scale, Behavior problem scale. The general characteristics were male 38 (60.3%), female 25 (39.7%), and median age 14.1years old(SD ± 1.53) .The diagnosis were AML 23 (36.5%), ALL 18 (28.6%) and SAA 16(25.4%). The type of transplantation were sibling allogeneic SCT 30 (47.6%), unrelated SCT 25 (39.7%), autologous SCT 3 (4.8%), Cord 2 (3.1%) and FMM 3(4.8%). In Nine symptom checklist of EORTC, fatigue (31.7) was the highest and then financial difficulties (27.1) and poor appetites (8.5). Eighty to one hundred Lansky score which is the performance status scale was 53(91.4%). When both of teenagers compare with standard group, their studying competence is lower but their socialization and total social competence are comparatively high. In conclusion, the major health problems of teenagers(12-17 years old) were fatigue and financial difficulties after HSCT. However, the physical performance competence was affected to maintain active life. The psychosocial adjustment was high males and females. However, the total behavior problem scale of females was very high. We suggest focus on health and psychosocial issues of teenagers and need to nursing intervention for them.Tabled 1> Social competence scale and Behavior problem scale of 12∼17 years oldMale 12-17 (N= 38) Mean ± SDStandard of Male Mean ± SDFemale 12-17 (N= 25) Mean ± SDStandard of Female Mean ± SD< Social competence >Socialization5.63 ± 2.085.48 ± 1.396.09 ± 1.805.55 ± 1.29Studying competence3.60 ± 0.883.83 ± 0.773.78 ± 0.773.84 ± 0.70Total Social competence9.33 ± 2.649.31 ± 1.6910.13 ± 2.059.39 ± 1.58< Behavior problems >Withdrawan2.92 ± 2.472.51 ± 2.603.48 ± 3.152.81 ± 2.86Somatic Complaints3.42 ± 3.462.11 ± 2.352.56 ± 2.702.64 ± 2.73Anxious / Depressed4.13 ± 3.363.31 ± 3.475.84 ± 4.654.18 ± 4.08Social Problems3.47 ± 2.791.93 ± 2.193.00 ± 2.191.90 ± 2.09Thought Problems1.07 ± 1.340.83 ± 1.311.52 ± 1.320.80 ± 1.41Attention Problems4.13 ± 2.804.25 ± 3.434.76 ± 3.213.97 ± 3.30Delinquent Behavior0.97 ± 1.071.64 ± 2.101.36 ± 1.431.20 ± 1.94Aggressive Behavior5.21 ± 3.895.36 ± 5.306.92 ± 3.495.90 ± 5.07Internalizing Problems10.23 ± 6.907.80 ± 6.9811.48 ± 8.389.37 ± 8.11Externalizing Problems6.18 ± 4.357.00 ± 6.638.28 ± 4.557.10 ± 6.47Total Behavior Promblems28.97 ± 16.5025.73 ± 20.6332.64 ± 16.7326.83 ± 21.72 Open table in a new tab