The impact of leukemia and its therapy-related symptoms on the physical and psychological well-being among Chinese children in mainland : an exploratory study

Abstract

Background: Research indicates that leukemia and therapy-related symptoms are associated with numerous physiological and psychological health problems for children. However, it is still unknown how leukemia and therapy-related symptoms impact the physical and psychological well-being of children in mainland China and how the children deal with these problems. A review of the literature reveals that there are no studies investigating the impact of leukemia and therapy-related symptoms on the physical and psychological well-being of children with leukemia in Mainland China. Although several studies have been conducted in western countries or Hong Kong to examine this phenomenon, cultural discrepancies make these findings inapplicable to Mainland China. This study aimed to address the literature gap by (1) comparing the quality of life and physical activity levels between children hospitalized with leukemia and their healthy counterparts; (2) exploring the impact of therapy-related symptoms on the physical and psychological well-being of children with leukemia; (3) examining the coping strategies adopted by children hospitalized with leukemia. Methods: A cross-sectional study was conducted. A total of 125 children who underwent leukemia treatment and 243 healthy children randomly selected from the community in Beijing were invited to participate in the study. Participants had to complete a set of questionnaires, including the Chinese University of Hong Kong: Physical Activity Rating for Children and Youth and Pediatric Quality of life Inventory. Children with leukemia were also required to fill in a self-designed symptom checklist and Coping Behavior Checklist for Chinese Children. A total of 15 children with leukemia were purposively selected to have semi-structured interviews. Result: An independent sample t–test showed that there was a statistically significant decline in physical activity levels and quality of life among children with leukemia. Most of them did not perform physical activity regularly. In addition, hierarchical multiple regression analyses showed that physical activity levels, number of treatment-related symptoms, and the mixed coping strategies made statistically significant contributions to children’s quality of life. On the other hand, results of the semi-structured interviews indicated that chronic fatigue, lack of awareness of the benefit of regular physical activity, and advice for more rest given by healthcare professionals were the main reasons preventing leukemia patients from engaging in regular physical activity. Conclusion: This study provides further support that leukemia and therapy-related symptoms can decrease levels of physical activity and quality of life among children with leukemia in Mainland China. Moreover, the results indicated that a higher level of physical activity and mixed coping strategies could contribute to a better quality of life for children undergoing treatment for leukemia. Implications for practice: It is of paramount importance for healthcare professionals in Mainland China to promote regular physical activity for children with leukemia, with the aim of enhancing their physical and psychological well-being and quality of life. Future studies should focus on developing and evaluating the effectiveness of appropriate interventions in achieving this aim.