Submit your Assignment by Day 7. For this Assignment, select one of the assignments you completed
earlier in this course to use as the foundation for your comprehensive awareness program. Then, use
your selected assignment health psychology topic to create a comprehensive awareness program for
children and adolescents and their families
The Assignment (12–14 pages of text, plus cover page, abstract, and references)
Describe your comprehensive awareness program including:
o The purpose of your program
o The selected health topic
o The appropriate setting for your program (e.g., schools, hospitals, community
events)
o The projected time frame for your program
Describe a target community and/or culture
Justify why that community and/or culture is in need of education on your selected health
topic
o Explain the health factors related to your topic within this community and/or
culture
o Explain the risk factors for your health topic within this community and/or culture
Explain three goals of your comprehensive awareness program
Explain five elements that you would add to your existing Assignment that you selected
to develop your comprehensive awareness project
Explain how this program may promote positive change
Support your assignment with specific references to all resources used in its preparation. You
are to provide a reference list for all resources, including those in the Learning Resources for
this course.
Running head: PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
Psychological Response in Childhood Leukemia
Walden University
March 27,2016
By Elizabeth Levengood
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PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
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The purpose of this paper is to analyze the psychosocial response of children suffering
from leukemia, and the psychosocial response given by their parents. As shown by evidence,
childhood leukemia can bring significant challenges to a child, and symptoms related to neurosis
and hyperactivity are often common. Variables such as the type of treatment and the age of the
child influence the psychological response to cancer diagnosis and treatment. The psychosocial
well-being of parents with children suffering from leukemia is also compromised, though
mothers and fathers seem to respond differently.
Pediatric cancer is the cancer of a child. The definition of childhood cancer varies, as
some use the ages of 0 to 14 and 11.9 months’ years old as defining parameters, while others also
include the ages between 15 and 19 years old (Katz, Kellerman & Siegel, 1980). The most
common type of pediatric cancer is childhood leukemia. The most common type of childhood
leukemia is acute lymphocytic leukemia. Leukemia is a cancer of the blood, also known as
hematological malignancy. Leukemia develops in the bone marrow, where new blood cells are
made. The bone marrow of children with leukemia produce blood cells that are incapable of
maturing correctly, while normal healthy cells reproduce when there is enough space. The cells
of children suffering from leukemia do not respond to the signals that tell them when to stop
proliferating and when to produce new cells, no matter if there is available space or not (Shah &
Wayne, 2015).
There are several ways though which leukemia can be diagnosed, including bone marrow
aspiration and biopsy. lymph-node biopsy, complete blood count, and spinal tap (Kazak & Noll,
2015). In a bone-marrow aspiration and biopsy the marrow can be removed either through
aspiration either through a needle biopsy. In a lymph-node biopsy the node is removed surgically
and then examined under a microscope in search for cancerous cells. A complete blood counts
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includes measuring the number, size, and maturity of blood cells. Finally, a spinal tap involves a
needle that is placed into the spinal canal from where cerebral spinal fluid is extracted and tested
for the presence of leukemia cells (Shah & Wayne, 2015).
The treatment of childhood leukemia depends on several factors, including the child's
overall health, age, and medical history, tolerance for specific medication and procedures, and
parents’ preferences (Shah & Wayne, 2015). Chemotherapy is a common treatment of leukemia,
and it involves the use of drugs that interfere with the cancer's cells capacity to reproduce and
grow. Chemotherapy is used either alone either in combination with other therapies. Steam cell
transplants is often a treatment option, and it involves inserting healthy cells into the body, in
order to ensure that the body makes enough healthy white blood cells, red cells or platelets.
Childhood leukemia has a better prognosis than adult leukemia, as almost 90% of
children cure. However, it is worth nothing that survival rates depend upon the subtype of
leukemia, as well as other factors. More so, many children suffer from leukemia treatment side
effects that persist into adulthood (Kazak & Noll, 2015).
Research has consistently shown that children with cancer and their families often
develop psychological problems during the treatment period (Kazak & Noll, 2015; St. Jude
Children’s Research Hospital & Washington University School of Medicine in St. Louis, 2012;
U.S. Department of Health and Human Services, National Institutes of Health & National Cancer
Institute, 2008). According to research, children with cancer often develop hyperactivity and
neurosis, while behavioral difficulties are usually uncommon. Children with leukemia that
participated in a recent study showed higher levels of hyperactivity and neurosis after the
diagnosis and at the beginning of the treatment, but improved significantly during the following
PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
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6 months (Kazak & Noll, 2015). The development of neurosis, with symptoms such as fear,
anxiety, and distress, seems to be enhanced by several factors. For instance, the stress associated
with the treatment has the potential to cause several chronic problems, including anxiety for
medical procedures such as blood taking (Kazak & Noll, 2015).
Some studies suggest that while much of the nursing and medical staff perceive
significant patient distress when treating children with cancer, the anxiety showed by children in
self-reports is low (U.S. Department of Health and Human Services, National Institutes of Health
& National Cancer Institute, 2008). Most parents of children with cancer seem to recognize the
presence of psychological disturbances such as neurosis and hyperactivity, while the teachers of
these children usually report higher neurosis scores but lower scores for hyperactivity (Kazak &
Noll, 2015). Studies have not found differences in the impact of the subtype of cancer in the
development of psychological disorders. However, as mentioned, children with leukemia tend to
show a higher level of anxiety after the first month of treatment. This might be explained by the
fact that leukemia treatment does not only include intravenous and intrathecal chemotherapy, but
also a significant amount of painful procedures that must be repeated consistently. While these
procedures are often performed under sedation, the children’s stress and concern is usually
increased (Kazak & Noll, 2015). More so, a critical treatment for leukemia therapy includes
interventions based on steroids, which significantly deteriorates the child’s quality of life,
including at the behavioral and emotional level.
The age of the child seems to be an important variable in the development of
psychological problems after a cancer diagnosis and the beginning of treatment. For instance,
younger children with cancer often show higher scores of neurosis and hyperactivity after the
first months of treatment (Kazak & Noll, 2015). It is not clear why younger children are less
PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
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likely to develop significant psychological problems compared to older children. Some
researchers suggests that younger children are more adaptable to the stress of the diagnosis and
treatment because it has less impact on their social life and the children are less likely to
understand the risks of disease and the complications of treatment, More so, young children do
not fully understand the implications of death. Older children, on the other hand, are more
affected by the diagnosis and treatment of cancer because they understand the full meaning of
the disease and its potential consequences, and because they have the cognitive abilities that
enables them to interpret the health information given by the health care staff, which in turns
makes them feel more stressed (U.S. Department of Health and Human Services, National
Institutes of Health & National Cancer Institute, 2008).
While some studies claim that younger children can adapt more easily to a cancer
diagnosis and treatment, other studies suggest that it is actually older children who can adapt
more easily because they have developed more coping skills to face challenges (Kazak & Noll,
2015). There are several factors that have been identified as playing an important role in the
psychological adaptation of children that have been diagnosed with cancer and are undergoing
treatment. Such factors include the diagnosis procedure, the type of treatment received, and the
body response given to the treatment (Katz, Kellerman & Siegel, 1980). The level of
psychosocial and emotional function shown by children suffering from cancer seems to be more
compromised in children that have just been diagnosed compared to children that have survives a
cancer treatment (Kazak & Noll, 2015).
Leukemia diagnostic and treatment also has an important psychosocial impact on parents.
Parents do not only have to provide emotional support to the child undergoing a painful
treatment, but must also take the responsibilities associated with choosing the right treatment.
PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
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More so, parents often have to provide emotional support to siblings, monitor their emotions, be
prepared for potential relapses, and pay attention to medication and side effects, among others
(Shah & Wayne, 2015). The high number of responsibilities that fall on parents of children that
suffer from leukemia and other types of cancer increase the probability of psychological
problems such as depression, anxiety, somatic symptoms, sleep disorders, and risk behaviors,
among others.
The diagnosis and treatment of childhood cancer can also have an important negative
impact on the social and professional abilities of parents, and many of them leave their jobs in
order to give priority to their children. Some might also experience impaired communication
with other important persons in their life, and marital conflicts are not uncommon (Neu,
Matthews, King, Coock & Laundenslager, 2014). Research literature suggests that the parents’
quality of life during childhood cancer correlates with the child’s quality of life during treatment.
The experience of cancer play an important influence on the emotional response of parents to
their child’s needs, and the ability of the child to deal with a difficult situation correlates with the
parents’ ability to handle crisis situations (Neu, Matthews, King, Coock & Laundenslager, 2014).
Mothers and father often have to face different demands when dealing with childhood
cancer. For example, mothers often assume the role of primary caregiver and offer more
emotional support, while fathers are often providers but try to distance themselves emotionally.
More specifically, mothers are usually involved in the administration of medication, planning
family activities, offering emotional support, and managing the child's behavioral problems when
they exist. Fathers, on the other hand, tend to be in a conflict between staying in the hospital and
working. These differences often observed between mothers and fathers likely creates different
psychological responses to the situation, though more investigation is needed in order to
PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
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elucidate the role of cultural gender in the psychological response of parents (Neu, Matthews,
King, Coock & Laundenslager, 2014).
In conclusion, childhood leukemia can bring significant challenges to a child, and the
most common psychological problems shown by these children are neurosis and hyperactivity,
while behavioral problems are rare. Variables such as the type of treatment and the age of the
child influence the psychological response to cancer diagnosis and treatment, and while some
research suggests that younger children are more resilient than older children, other studies
suggest the contrary. The psychosocial well-being of parents with children suffering from
leukemia is also compromised, and many parents show psychological symptoms such as
depression or anxiety, but also behavioral problems. Though both mothers and fathers are
affected when their child receives a cancer diagnosis and undergoes treatment, they seem to
show a different psychosocial response to the situation. Further research could fully establish the
link between a child’s age and psychological resilience to cancer diagnosis and treatment, as well
as the role of cultural gender in shaping parents’ response to childhood cancer.
PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
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References
Katz, E. R., Kellerman, J., & Siegel, S. E. (1980) Behavioral distress in children with cancer
undergoing medical procedures: Developmental considerations. Journal of Consulting
and Clinical Psychology, 48(3), 356–365. doi: 10.1037/0022-006X.48.3.35
Kazak, A. E., & Noll, R. B. (2015). The integration of psychology in pediatric oncology
research and practice: Collaboration to improve care and outcomes for childrenand
families. American Psychologist, 70(2), 146.
Neu, M., Matthews, E., King, N. A., Cook, P. F., & Laudenslager, M. L. (2014).
Anxiety, depression, stress, and cortisol levels in mothers of children undergoing
maintenance therapy for childhood acute lymphoblastic leukemia. Journal of
Oncology Nursing, 31(2), 104-113.
Shah, N. N., & Wayne, A. S. (2015). Leukemias and Lymphomas. Pediatric Psycho-Oncology:
A Quick Reference on the Psychosocial Dimensions of Cancer Symptom Management.St.
Jude Children’s Research Hospital and Washington University School of Medicine in St.
Louis. (2012) Facts about childhood cancer. Pediatric Cancer Genome Project.
Retrieved from http://www.pediatriccancergenomeproject.org/site/facts-childhoodcancer
U.S. Department of Health and Human Services, National Institutes of Health, National Cancer
Institute (2008). Childhood Cancers [Fact sheet 6.40]. Retrieved from http://
www.cancer.gov/cancertopics/factsheet/Sites-Types/FS6_40.pdf
PSYCHOLOGICAL RESPONSE IN CHILDHOOD LEUKEMIA
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