Depression and anxiety in mothers of children--论文代写范文精选

家庭的困难可能是客观的,如金融需求,家务和工作活动。主观困难是指家庭成员的情绪反应,担心孩子的未来。这篇report代写范文研究，照顾他们的孩子不仅增加了母亲的工作负载，还可能会导致自己的身体健康受到影响。

Abstract 
  Objective: Cancer is a chronic, long-term illness that affects not only the child but also the family as a whole. The family faces objective as well as subjective difficulties, e.g. stress, anxiety and depression. The burden is often experienced by mothers, since they take on the major responsibility of care giving. We conducted a study in mothers of children with acute lymphoblastic leukemia (ALL) and determined whether their coping mechanisms were acceptable and if these mechanisms were helpful to reduce depression. Methods: Mothers of 58 children with Pre (precursor) B cell leukemia were evaluated using Beck's depressive inventory (BDI), Coping Health Inventory for Parents (CHIP), and State-Trait Anxiety Inventory (STAI). Results: Coping with behaviors used by mothers of children with ALL was ineffective. The mothers mostly used coping behavior, which involved family life and relationships, and the parents' outlook on life of the affected child. 

  The use of CHIP sub scale-type I, ie.“talking with other individuals/parents in my same situation” was significantly related to more use of sub scale-type II, ie. “doing things together as a family, involving all members of the family” are both were significantly related to STAI (p < 0.001). However total BDI score was not significantly related with any of the coping scores (BDI scores more than 9). Patients with higher BDI scores had lower scores in all sub scales of CHIP. Conclusions: Our subjects did not use social support and did not understand the medical situation through communication with other parents, or medical professionals. Fewer depressed patients used more coping skills. Educating the parents about healthy coping mechanism can be a good way to reduce stress. Encouraging social support networking and providing information about the disease may help to increase the acceptance among the mothers with ALL. ASEAN Journal of Psychiatry, Vol. 17 (1): January – June 2016: XX XX. 
Keywords: Depression, Anxiety, Mothers of Children with Cancer, Coping Mechanism, India

 Introduction 
  Parents describe the diagnosis and treatment of a child with cancer as one of the most stressful times in their lives [1].The difficulties for families may be objective, such as financial needs, housekeeping, and work activities. Subjective difficulties refer to the emotional reactions that family member’s experience, such as communicating with siblings of the ill child and concerns about the child's future and depression. Providing emotional and physical care for their child not only increases the mother’s workload but may cause her own physical health to suffer. In a recent study, mothers reported higher level of stress than fathers. 

  Various studies have shown that mothers display symptoms such as hopelessness, despair, anger, stress, anxiety, and depression [2]. Very handful Indian studies are available in this area. However, a study in Canada assessing cultural beliefs and coping strategies related in South Asian immigrant parents of children with cancer showed that parental coping strategies included gaining information about the child’s cancer, practicing religious rituals and prayers, trusting the health care professionals, and obtaining mutual support from other parents [3]. Sharan et al studied the coping and adaptation of parents of children with ALL with TAT (Thematic apperception test-Indian adaptation). 

  Emotional distress was evident in the stories of 83%, only 37% maintained an expectation of a positive outcome [4]. The life situations of these parents demand exceptional psychological resources. The interplay between demands and resources of parents whose child has cancer is often referred to as ‘‘coping’’, commonly defined as the cognitive or behavioral effort to eliminate the negative emotions elicited by excessive demands [5]. Among the vast groups of pediatric cancers Acute Lymphoblastic Leukemia (ALL) is the commonest type. ALL accounts for approximately 70% of childhood leukemia (0- 19yars). 

  It has a peak incidence at 2-5years, decreasing in incidence with increasing age. ALL is slightly more common in male than female. Classification of ALL based on immune-phenotype (done by cytogenetic test, flow cytometry and other lab test) are Early Pre-B cell (60-65 %), Pre-B Cell (20-25%), Mature B Cell (2-3 %) and T-Cell (15-18 %). This Classification has been useful in predicting clinical outcome as well as determining treatment options. ALL is treated by chemo therapy, steroid, radiation therapy; and intensive combined treatment (including bone marrow transplantation). Currently, the survival rate of ALL has improved due to new chemotherapeutic agents and Stem cell transplantation (SCT). In India each year, over 6000 children under 15-years age developed ALL [6]. 

  Medical College and Hospital are a tertiary care center situated in the city of Kolkata, West Bengal, Eastern India. It gets about 30 new cases per month of ALL patients (pediatric), amounting to almost 350-400 patients each year. Most of the patients remain admitted during intensive phase of therapy (1st phase of the management), and their caregivers in 99% cases have been their mothers. So we wanted to explore the emotional reactions of the mothers and how well they are coping with this situation. We studied the cases where at least one month has passed after the diagnosis, and we questioned about their mental states and how they had been coping with this adverse situation. Our objective was to assess: (i) whether coping mechanisms used by the mothers were adequate; (ii) which coping mechanisms were helpful to reduce depression; and (iii) which of the coping mechanisms they had been using the most and which the least.(report代写)

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