Psychosocial aspects in children with transfusion-dependent thalassemia

ABSTRACT

Children with transfusion-dependent thalassemia experience stressful conditions related to chronic anemia, repeated blood transfusions, and iron chelation adherence. They are vulnerable to emotional and behavioral problems and psychosocial disturbances. An observational evaluation of psychosocial issues in children with TDTs aged 4–18 using Strengths and Difficulties Questionnaires (SDQ). Psychosocial part in children with TDTs often experiences difficulties in childhood under 10 years old, compared to adolescents (11–18 years) for emotional symptoms and conduct problems. Boys and girls had similar psychosocial problems regarding emotional symptoms, conduct problems, hyperactivity-inatttention, peer relationship problems, and prosocial behavior. In a quarter of cases, they had emotional symptoms, conduct, and hyperactivity-inattention issues, especially in younger children. Interestingly, younger children have more problems than adolescence in peer relations even though they are still under strict parental supervision. Difficulties in emotion, conduct, and hyperactivity would affect their relationship life. Children may try to be accepted by their social environment (prosocial) even though they realize that there are problems in their emotional life and peer relationships. Regular screening of the psychosocial aspects should be followed by counseling because regular transfusion and iron chelation are necessary for long-term management.

KEYWORDS:

• Child
• transfusion-dependent thalassemia
• psychosocial aspects
• emotional and conduct
• peer relationship
• prosocial behavior

Acknowledgments

The author would like to thank all the staff of the Division of Hematology-Oncology and Residents of Pediatrics at the Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethical declaration

Research ethics were obtained from the Health Research Ethics Committee of Clinical Research Unit (CRU) on Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia under the ethics number 0462/KEPK/VIII/2022.

Additional information

Funding

This research did not receive financial assistance from sponsors.

Notes on contributors

Diah Kusuma Arumsari

Diah Kusuma Arumsari, She is a research assistant in Hematology-Oncology Division, Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. She was doing the conceptualization, methodology, writing the manuscript, data sampling and analysis. Email: [email protected]

Andi Cahyadi

Andi Cahyadi, He is a pediatric hematology-oncologist at Hematology Oncology Division, Department of Child Health, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. He was doing the conceptualization, methodology, writing the manuscript, and data analysis. Email: [email protected]

Mia Ratwita Andarsini

Mia Ratwita Andarsini, She is a pediatric hematology-oncologist and also the Head of Hematology Oncology Division, Department of Child Health, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. She was doing the manuscript supervision, validation, and reviewing the clinical aspect. Email: [email protected]

Ferry Efendi

Ferry Efendi, Ph.D, He is the master and doctoral of Community Health Nursing at Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia. He was doing the data analysis, reviewing the psychosocial aspect, and the discussion of the results. Email: [email protected]

Adwina Nurlita Kusuma Wardhani

Adwina Nurlita Kusuma Wardhani, She is a pediatrician in Hematology Oncology Division, Department of Child Health, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. She was doing the data recording and sampling., Email: [email protected]

Maria Christina Shanty Larasati

Maria Christina Shanty Larasati, She is a pediatric hematology-oncologist in the Hematology-Oncology Division, Department of Child Health, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. She is a student in doctoral program of Universitas Airlangga., Email: [email protected]

I Dewa Gede Ugrasena

I Dewa Gede Ugrasena, He is the Professor of Hematology Oncology Division, Department of Child Health, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. He was doing the supervision and reviewing the manuscript. Email: [email protected]