An investigation into the psychological wellbeing of children and young people with cancer in Jordan
General Material Designation
[Thesis]
First Statement of Responsibility
Arabiat, Diana H.
Subsequent Statement of Responsibility
Elliott, Barbara ; Draper, PeterArabiat, Diana H.Elliott, Barbara ; Draper, Peter
.PUBLICATION, DISTRIBUTION, ETC
Name of Publisher, Distributor, etc.
University of Hull
Date of Publication, Distribution, etc.
2007
DISSERTATION (THESIS) NOTE
Dissertation or thesis details and type of degree
Thesis (Ph.D.)
Text preceding or following the note
2007
SUMMARY OR ABSTRACT
Text of Note
Now treatment of paediatric malignancies is capable of extending the life of children with cancer, there is an increase move toward investigating the quality of life and needs experienced by children and young people diagnosed with cancer. Although earlier investigations examined differences in adjustment among children with cancer and their healthy counterparts, the results of these studies were inconclusive, and there is a considerable lack of studies of the psychological wellbeing of children in the Middle East. In this thesis, two central themes are examined: first, the psychological status of children and young people with cancer in Jordan as indicated by their quality of life and symptoms of anxiety and depression; second, patterns of communication of cancer diagnosis in families caring for children with cancer, to develop a better understanding of Jordanian children's experience with cancer. Fifty eight children and young people and their mothers attending the paediatric oncology services in Jordan participated in this study. In an attempt to explore their psychological wellbeing in greater detail, the study involved another group of fifty six children and young people with chronic illness and a control group of sixty four healthy peers. Three assessment tools were translated into Arabic, piloted and tested for reliability and validity at a number of schools all over Jordan. Then, the tools were administered to the three groups. Participating children and young people were asked to complete self-reported depression and anxiety scales, as well as an instrument to measure the quality of life. Thirty seven mothers of children and young people with cancer completed a self-report measure of stress, anxiety and depression. Mothers were also asked during the interview about the amount of information they shared with their children and their satisfaction with the way the cancer diagnosis was communicated to their children. The results showed that children and young people with cancer function at a very similar level to children and young people without cancer. There were no significant differences on the measure of depression, between the scores of children and young people with cancer, chronic illness and the healthy group. On the quality of life measure, the healthy group scored significantly higher than the children and young people in the other two groups. At the same time, the healthy group scored significantly higher on the anxiety measure. It is suggested that children and young people with cancer are able to cope with their illness because they utilise defensiveness as an adaptive mechanism, since higher scores for defensiveness were associated with lower scores for child-reported depression and anxiety in this group and a significant difference in the level of defensiveness exists between the three groups. This supports previous findings. In addition to these results, this thesis shows that exploring children's and young people's psychological distress in a culture where this is not recognised provides the researcher with a number of concerns. The influence of Arab culture and religion on Jordanian children and young people, the communication patterns of cancer diagnosis, the wisdom of their elders, and the importance of their family result in reluctance to show emotion or to question decisions made on their behalf. The results of quantitative findings and contextual information from the interviews in this thesis go some way to demonstrate the impact that cancer can have on both the patient and family in the Jordanian culture. The child's quality of life can be compromised by the illness. Moreover, communication of the diagnosis of illness has a detrimental effect on both child's and mother's psychological wellbeing.