The majority of children with cancer show great psychosocial resilience during treatment. However, one in five children have persistent behavioral problems that interfere with their daily functioning. Medical Psychologist Simone Sint Nicolaas found out how to screen early for risk factors associated with these problems. As a result, families who need this can be provided with timely extra care. On 21 March 2018, Sint Nicolaas defended her thesis in Nijmegen.Each year, approximately 600 children in the Netherlands are diagnosed with cancer. About 75% of them are cured. One in five of these children experience psychosocial problems during treatment, such as fear, depression or posttraumatic stress symptoms. Simone Sint Nicolaas, a medical psychologist within the theme Mitochondrial diseases, conducted a thesis project to gain more insight into psychosocial functioning of these children. She wanted to find out, for instance, which children do relatively well and which children show more problems.
Risk and protection
In her study, Sint Nicolaas monitored more than 200 children from the moment they were diagnosed with cancer. She examined the risk factors associated with psychosocial problems and the factors protecting against these. Her aim was to identify families with less resilience at an early stage, so that they can be provided with extra care.
Sint Nicolaas showed that parental stress when raising a sick child is the main risk factor for psychosocial problems. Other factors are passive coping strategies and feelings of helplessness with regard to the child’s illness. If parents are able to see the positive side of their child’s illness and enjoy enough social support from their environment, their children are better protected against psychosocial problems.
It is shown that early screening and interventions based on the risk factors found is possible. Sint Nicolaas translated the Psychosocial Assessment Tool, an existing screening instrument from the United States, for use in Dutch practice. She says: “Early screening for psychosocial resilience can help provide families who need this with extra care. It is important to identify not only families at risk, but also families we do not expect to need more psychosocial care than currently provided in order for them to have as few long-term negative psychosocial effects of treatment as possible. As a result, standard care can be sufficient for families with enough resilience to adjust adequately.”
An important finding of this study is that parents play an important role in boosting resilience in their child. Treatments aimed at improving knowledge, networks, skills and trust in parents raising a sick child are very important in terms of boosting resilience. Sint Nicolaas says: “The majority of children in my study showed great psychosocial resilience during the treatment process. That is good news for children diagnosed with cancer and their parents.”
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