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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0043-1768053
Original Article

Mental Wellbeing among Children with Cancer during COVID-19 Pandemic in Indonesia: A Cross-sectional Study

Teny Tjitra Sari
1   Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Tjhin Wiguna
2   Department of Psychiatry, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Sylvia Detri Elvira
2   Department of Psychiatry, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Indah Suci Widyahening
1   Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
3   Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
,
Rinoldy Mangiri
4   Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Apul S. Napitupulu
4   Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Nathania Sutandi 
4   Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
Silvia Tanumiharjo 
4   Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
,
R S. Sitorus 
4   Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
› Author Affiliations Source of Funding The authors received no financial support for the research, authorship, and/or publication of this article.
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Abstract

Introduction Coronavirus disease 2019 (COVID-19) has affected both physical and mental aspect of people worldwide, especially the high-risk group such as pediatric cancer patients. Children with cancer were considered both clinically and mentally vulnerable during this pandemic. They were also affected by the self-isolation, quarantine, and social distancing policy taken as a respond to public threat.

Objectives To evaluate the impact of social distancing and health protocol during COVID-19 on the mental health profile of children with cancer in Indonesia.

Methods A cross-sectional study evaluating the mental health of children with cancer during COVID-19 pandemic was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to September 2020. An online questionnaire was used to collect demographics of parents and children, children's Strength and Difficulties Questionnaire (SDQ) score, and parents' Self-Reporting Questionnaire (SRQ). SDQ score consists of five subscales, including the emotional symptoms, conduct problems, hyperactivity, peer relationships problems and prosocial behavior. Cancer types were grouped into retinoblastoma, nonretinoblastoma (other solid tumors), and leukemia.

Results There were 156 valid responses, consisting of 42 patients with retinoblastoma, 34 patients with nonretinoblastoma (other solid tumors), and 80 patients with leukemia. Pandemic-related lifestyle changes did not significantly impact emotional or behavioral problems. Children with normal total SDQ (odds ratio [OR]: 473, p = 0.001) and emotional scores (OR: 3.19, p = 0.07) had parents with normal SRQ scores (<6). Leukemia patients with shorter diagnosis period had worse hyperactivity score (p = 0.01). On the contrary, leukemia inpatients had better prosocial scores than outpatients (p = 0.03). More bilateral retinoblastoma patients (p = 0.04) with longer duration of cancer diagnosis (p = 0.03) faced peer problems.

Conclusions Our study revealed that lifestyle changes during early COVID-19 pandemic were not major factors impacting emotional and behavioral problems in children with cancer. However, disease-related factors pose great challenges; thus, a holistic mental health support system should be available to both children and parents.

Keywords

mental health - pediatric cancer patients - COVID-19 - psychiatry - hematology - medical oncology - ophthalmology

Authors' Contributions:

R. S. S., T. T. S., T. W., S. D. E., and I. S. W. designed and conceptualized the study. R. M., A. S. N., and N. S. carried out the survey. R. S. S., T. T. S., T. W., S. D. E., I. S. W., N. S., and S. T. analyzed the data and wrote and edited the manuscript. All authors have read and approved this manuscript.


Supplementary Material



Publication History

Article published online:
28 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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