PSYCHOSOCIAL EFFECTS OF HEMATOPOIETIC STEM CELL TRANSPLANTATION IN PEDIATRIC PATIENTS

• DOI: https://doi.org/10.22533/at.ed.1595252525067

• Palavras-chave: Hematopoietic stem cell transplantation. Psychosocial effects. Pediatric HSCT.

• Keywords: Hematopoietic stem cell transplantation. Psychosocial effects. Pediatric HSCT.

• Abstract:

  Introduction. Hematopoietic stem cell transplantation (HSCT) is widely accepted for the treatment of various hematological and oncological diseases in childhood. The complexity of the procedure has repercussions on the psychological suffering of children, adolescents and their families. However, the characteristics of this suffering, especially in the Brazilian population, still need to be better understood. Objective. The main objective of this study was to assess the effects on the psychological and social aspects of pediatric patients undergoing HSCT. Methodology. An observational, longitudinal and descriptive study was conducted in a pediatric hospital. The sample consisted of 19 participants and their respective main caregivers, who were assessed at three points in time: fifteen days prior to hospitalization for HSCT; in the first month after HSCT; at the 100-day post-HSCT visit. The assessments consisted of analyzing data from medical records and applying structured questionnaires: Child Behavior Checklist (CBCL); PedsQL (Pediatric Quality of Life Questionnaire); Socioeconomic Questionnaire of the Brazilian Association of Research Companies (ABEP); Sociodemographic Questionnaire of the Main Caregiver. In addition to applying the instruments, in each of the three surveys, the researchers provided a listening space to welcome the patient and their family member. If the children or family members identified a need for mental health care, they were referred to a specialized mental health service. Results and discussion. Of the 19 pediatric patients interviewed, there was a balanced distribution of age groups, with 10 participants aged between 1 and 5 years and 9 participants aged between 6 and 18 years. The majority were boys (84.2%), born and raised in the South of the country (57.9%). Statistical analysis showed a significant improvement in externalizing symptoms measured by the CBCL in patients aged between 6 and 18 at the 100-day follow-up after the procedure. There was a statistically significant association between the participants' need to change their city and the quality of life indices in the second assessment, as well as between the number of complications in pediatric patients and the education level of the main caregivers. It is understood that HSCT interferes with various aspects of a pediatric patient's life - emotional, social and behavioral. In addition, the process of dealing with the aftermath of HSCT can have consequences that impact on the quality of life of this population as a whole. It is therefore essential to approach pediatric patients in the pre-HSCT period to identify factors that predispose to psychological distress, with a view to both prophylaxis and anticipating possible interventions. Conclusion. Considering the particularities of the Brazilian population, as well as the scarcity of data in the area, understanding the psychosocial effects of child HSCT is fundamental for building health services that are better able to provide adequate care for this population at a time of great vulnerability.