Cross-sectional study in eastern india--论文代写范文

由于医疗系统缺乏信息和/或低教育水平,无法获得整体和治疗结果。同一项研究指出，父母了解不同的应对模式,有助于他们适应压力。下面的paper代写范文进行论述。

Coping pattern I is composed of 19 behavior items that centered around family life and relationships and the parent's outlook on life and the affected child. Coping pattern II is composed of 18 behavior items that focus on the parents' efforts to maintain a sense of their own ‘well-being’ through social relationships, involvement in activities that have the potential of enhancing one’s self-esteem and doing things to manage psychological tension and strains. Coping pattern III is composed of eight behavior items that focus on relationships between other parents with ill child and the medical staff and its program. It includes behavior directed at understanding and mastering the medical information needed to care the ill child and use the medical equipment in home [10]. 

  One important finding of our study was our study group used less coping strategies. Poor coping skill may arise from many causes. Many depend on the personality type, e.g. an inhibited anxious temperament, having the lower drive to socialize or being rigid, inflexible and intolerant of change. Being poor or having low or no formal education may hinder coping with situation effectively. Taanila A et al in 2001 assessed coping mechanism in parents of physically and/ or intellectually disabled children. They found that ‘information and acceptance’ were the most effective method of coping. The parents in the high-coping group were of the opinion that they had been informed well about their child’s diagnosis and treatment, and they themselves had sought information actively to cope in the stressful situation. 

  The parents felt that a realistic outlook of the child’s disability and acceptance of the situation had helped them cope [13]. We think our patients lack in this area. Due to lack of information from medical system and/or low education level, they are unable to get the holistic picture about the nature, status and outcome of the treatment. The same study noted that the highcoping group had very extensive formal and informal social support networks, whereas the networks in the low-coping group were very small and mainly formal. In our case also coping behavior II, which includes support (maintaining social support, self-esteem and psychological stability), was used less by our patients. 

  The social support groups of parents have not come up as a means of a successful way of coping because these social groups are not available locally. Our patients and family members travel a considerable amount of distance to avail this treatment. Therefore, investing further time becomes impractical. So, it can be inferred that lack of exposure resulted in failure to adopt this coping mechanism Our cross-sectional study tried to identify different coping patterns that parents recognize as helpful to them in adapting to the stress and strains associated with managing family life involving a child with cancer. Seven of the top ten coping strategies used by mothers were related to positive definition of the situation and strengthening family life (coping pattern, I). 

  Nature of those statements shows that mother’s coping pattern plays a major part in encouraging family members to be concerned, helpful and supportive of each other and in encouraging members to act openly and to express their feelings directly. This finding is supported by a study by Evangelia Patistea in 2005 in which she studied the coping behavior of parents of children with ALL. They also noted that parental coping styles in childhood cancer primarily focus on preserving and empowering a cohesive family structure. Increased emotional bonding can help the family realize its strengths and become more self-reliant and stronger as a unit. These strategies seem to enable parents to maintain their hope while coping with the demands of living with a child having leukaemia [14].

  In our study group coping, behavior II and III (support and medical subscale) didn’t help the mothers much which means parents didn’t use social support and didn’t try to understand the medical situation through communication with other parents or medical professionals. In a similar study in Korea, the finding was that mothers of children with cancer had deficient coping, particularly in support-seeking. One possibility might be that mothers may have chosen to withdraw from social interactions in response to the child’s illness that required constant vigilance and care [15]. 

  Evidence seems consistent to suggest that the existence of a child’s disability tends to return the family to the traditional pattern of gender relations with mothers taking more responsibility in the medical referral process, being responsible for the child’s behavior, and dealing with the child’s educational problems. Another relevant explanation might be that at least one dominant coping pattern (e.g. coping pattern, I) was already taking an effect, while confusion in information gathering was stressful. Again, the medical support subscale has been unhelpful because of lack of awareness among patient’s family members and lack of education. In a study of coping behavior of Indian wives with alcoholic husbands, it was noted that avoidance was the most commonly endorsed coping behavior [16]. Drawing from this finding it can be said that due to lack of knowledge and understanding the medical support subscale has been avoided by parents.

  Most of our patients were either dysphoric or depressed and although statistically not significant, fewer depressed patients used more coping skill specially pattern I. Undoubtedly, this is an important finding because childhood cancer has social or psychological consequences that at times may be more serious and debilitating than the physical illness itself, an understanding of parental appraisal and coping is of great significance. Limitations of our study included small sample size and lacking a control group. A qualitative study in this area would be beneficial in exploring other coping mechanisms which the study group may use. Educate the parents about healthy coping mechanism can be a good way to reduce stress in them. 

  To reduce overwhelming worry for the child’s life and well-being, health care professionals need to inform parents that most pediatric cancers are now curable with contemporary treatment protocols. However, at the same time, they should acknowledge the possible long-term complications as observed in clinical oncology and described in the literature, and be aware that the helpfulness of information as a coping strategy has received low ratings in oncology studies [17], especially among parents who perceive that the child’s disease does not cause much difficulty [18]. Educate patient about the positive effects of having a good social support may be a good option to combat stress and anxiety in them. Building up social support groups at the treatment centre itself can enhance the likelihood of accepting it as a coping mechanism.(paper代写)

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