Impact of talking to children with cancer about their disease and treatment on anxiety level and fears

Abstract

PURPOSE: The purpose of the current study was to investigate whether talking to children with cancer about their disease and treatment effects on anxiety level and fears. Obviously, it is a devastating experience for parents to learn that their child has a life threatening illness such as cancer. In Armenia many parents struggle with doubts whether to speak with a child about his or her illness. There’s a big taboo in having conversations with children about their disease and death. Most of the parents believe they can protect their child by withholding the truth. METHODS: This comparative study was conducted at Pediatric hematology department after prof. Yolyan in Armenia. The sample comprised 60 preschoolers with leukemia divided into 2 groups. In one group were included children, whose parents were having honest and sensitive conversations with children about their diagnosis and treatment, discussing children’s fears and questions about disease. In the other group parents attention was mainly focused on child’s physical health, meanwhile emotional and mental health were generally ignored. Data were collected using the following projective METHODS: “Choose the appropriate face” for anxiety measurement and “My fears” for quantitative analysis of fears. RESULTS: The comparison of total scores of anxiety level showed statistically significant difference between two groups (F>2,28). Children, whose parents were talking with them about cancer diagnosis and treatment, represented lower level of anxiety and quantitatively less fears. Fear of death and medical fears were especially highly represented among those children, who didn’t have opportunity to discuss their fears and questions with significant adults. The parents who did have conversations with children, felt positive regarding their decision. CONCLUSIONS: The results of the investigation have shown that children whose parents were providing age-appropriate information about disease and treatment, explaining what will happen during an upcoming medical procedure, represent lower level of anxiety and less fears. Although having honest conversations with children about their diagnosis can be difficult and overwhelming experience for parents but this kind of conversations help to prevent possible misunderstandings. Children feel less anxious and alone if they know what to expect because anxiety is often based on the unknown or on inaccurate beliefs about the future. Research Implications: The significance of the study for the field of psychosocial oncology is in it’s practical meaning for palliative care helping to provide more effective and scientifically-based palliative care and psycho- correction work with children, which will help them to enjoy a high quality of life for as long as possible. Giving children age appropriate knowledge about their disease will allow them to become active participant of the treatment instead of being object of manipulation, which will increase the willingness to cooperate with the medical staff and reduce the level of anxiety and amount of fears. Clinical Implications: The results can offer direction for optimal intervention in specific group and for further researches. Our findings highlight the sensitive and complex issues surrounding these conversations in Armenian society, indicating that there may be a role for psychologists in supporting parents.