Illness Uncertainty And The Coping Style Among Parents Of Children With Acute Leukemia

Background Leukemia is a malignant proliferative disease of hematopoietic system,and its incidence is increasing year by year,among which acute leukemia accounts for 90%-95%.Acute leukemia has the characteristics of high cost,complex treatment scheme,many complications and uncertain prognosis,which will cause great uncertainty for parents.Uncertainty of disease is a cognitive state.Uncertainty occurs when the person cannot predict the state of disease.Illness uncertainty can lead to negative emotions such as anxiety and depression,which seriously affect the quality of life of parents and their compliance with treatment.It is important to analyze the sources,coping styles and influencing factors of parents’illness uncertainty in children with acute leukemia for identifying high-risk population and formulating effective intervention measures.Objective To understand the status quo of illness uncertainty in parents of children with acute leukemia,analyze and dig out its sources,coping styles and influencing factors,so as to provide theoretical guidance and basis for clinical medical staff to identify high-risk groups of illness uncertainty early and select targeted interventions.Methods Quantitative and qualitative studies were combined to conduct the study.1.Quantitative study We selected 205 parents of children with acute leukemia who were hospitalized from May 2017 to May 2018 in four tertiary first-class hospitals in Henan Province as the research object.There are three research tools:①The general data questionnaire:mainly includes the sociodemographic data such as sex,age.education level of parents,monthly income per capita of family and clinical date such as disease types,risk,clinical stages of children.②Parental Illness Uncertainty Scale:consisting of 4 dimensions and 31 items;③Parental Coping Style Scale:consisting of 3 dimensions and 45 items.SPSS22.0 was used to analyze the data,including descriptive statistical analysis,t-test,variance analysis,pearson correlation analysis and multiple linear regression analysis.2.Qualitative study Adopted the purpose sampling method to conduct semi-structured interviews with parents of children with acute leukemia,and Colaizzi method was used to analyze and summarize the data.Results1.Illness uncertainty scores in parents of children with acute leukemia The score of illness uncertainty in parents of children with acute leukemia was(92.83±13.18).The score of unpredictability dimension was(3.291±0.49).The score of information deficiency dimension was(2.63±0.49).2.Coping style scores in parents of children with acute leukemia The total score(frequency of use)of parents’coping style of children with acute leukemia was(159± 16.12)and the score of items was(3.55±0.36).The first dimension of "maintaining family unity,cooperation and optimism" was the most frequently used and the item score was(4.26±0.44)The third dimension was "to understand the illness through consultation with medical staff and other parents"and the score of items was(3.64±0.55).The second dimension of "seeking social support,maintaining self-esteem and psychological stability"had the lowest frequency of use and the score of items was(2.76±0.44).3.The correlation between parental uncertainty and coping style in children with acute leukemia Pearson correlation analysis showed that the total use frequency of coping style was negatively correlated with the total score of disease uncertainty(r=-0.1 93,P<0.01),negatively correlated with the uncertainty dimension(r=-0.1 50,P<0.05),and negatively correlated with the complexity dimension(r=-0.222,P<0.05).4.The influencing factors of illness uncertainty in parents of children with acute leukemia Independent sample t-test and one-way ANOVA were used to analyze the factors influencing the illness uncertainty in parents of children with acute leukemia.The results showed that there were significant differences in terms of relationship with children,age of parents,monthly family income,gender of children,age of children and clinical stage(P<0.01).The results of multiple stepwise regression analysis showed that children’s gender,children’s age,relationship with children,monthly income per capita and total score of coping style entered the regression equation,which could explain 29%of the total variation of illness uncertainty in parents of children with acute leukemia.5.Theme conciseness mainly revolves around two aspects:①Sources of illness uncertainty in parents of children with acute leukemia were six themes:ignorance of"leukemia"(panic),anxiety about waiting for the results of examination,unbearable suffering of children,anxiety about chemotherapy regimens,talk about "relapse"discoloration and helpless social discrimination.②Measures to cope with illness uncertainty in parents of children with acute leukemia,including four themes:full of hope,social support+family support,peer education and facing the present.Conclusions1.Parents of children with acute leukemia have higher illness uncertainty,in which especially can not predict their children’s future most.Influencing factors included relationship with children,age of parents,monthly family income,gender of children,age of children,clinical stage and coping style.2.Parental illness uncertainty of children with acute leukemia mainly comes from the name of the disease,chemotherapy regimen,examination results,child suffering,fear of recurrence and social discrimination.3.Coping style for parents of children with acute leukemia to cope with illness uncertainty:full of hope,social support+family support,peer education and facing the present.