Caring for a child with cancer during COVID-19 pandemic: an assessment of the parents' perception and stress level

Muhamad Aizat Nawi; Sie Chong Doris Lau; Shi Tying Chin; Kok Hoi Teh; Lee Sue Betty Ho; Hamidah Alias

doi:10.3389/fpubh.2024.1223362

Caring for a child with cancer during COVID-19 pandemic: an assessment of the parents' perception and stress level

Front Public Health. 2024 Apr 8:12:1223362. doi: 10.3389/fpubh.2024.1223362. eCollection 2024.

Authors

Muhamad Aizat Nawi¹, Sie Chong Doris Lau¹, Shi Tying Chin², Kok Hoi Teh³, Lee Sue Betty Ho², Hamidah Alias¹

Affiliations

¹ Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
² Department of Paediatrics, Sarawak General Hospital, Kuching, Malaysia.
³ Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.

Abstract

Background: The emergence of COVID-19 pandemic has led to heightened fear and uncertainty among parents of children with cancer. This study was conducted to evaluate the parental perceptions toward effects of COVID-19 infection to children with cancer, determine their stress level and factors contributing to high stress level during the pandemic.

Methods: This cross-sectional study was conducted in three paediatric oncology centres in Malaysia from September 2020 until December 2022. A total of 167 parents were recruited. Parents completed a set of questionnaires to assess their perception on effect of COVID-19 infection to children with cancer and COVID Stress Scale (CSS) to assess the parents' stress level.

Results: Patients' mean age at study entry was 8.75 years (SD 4.38). Ninety-one (54.5%) patients were still on active treatment. More than 80% of the parents obtained information regarding COVID-19 infection from mass media and social networking. Fear of their children contracting COVID-19 infection was high especially among patients who were still on treatment. Forty-nine (29.3%) parents were significantly affected by the pandemic leading to loss of job or monthly income. Twenty-nine (17.4%) patients required treatment modification during the pandemic. The median total score for CSS was 78.0 (IQR 25^th 64.0; 75^th 95.0). Ninety-one (54.5%) respondents were very/extremely stressed based on the CSS scores. Components with high scores were xenophobia (median score 18.0; IQR 25^th 13.0, 75^th 22.0), fear of danger (median score 17.0; IQR 25^th 14.0, 75^th 20.0) and contamination fears (median score 16.0; IQR 25^th 12.0, 75^th 19.0). Lower household income was associated with higher stress level (p = 0.006).

Conclusion: Our study demonstrated high awareness regarding risk of COVID-19 infection among parents of oncology children. Half of the parents had high stress level, with low household income identified as a factor associated with high stress level.

Keywords: COVID-19; cancer; children; paediatric oncology; perception.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
COVID-19* / epidemiology
COVID-19* / psychology
Child
Child, Preschool
Cross-Sectional Studies
Fear / psychology
Female
Humans
Malaysia / epidemiology
Male
Neoplasms* / psychology
Pandemics
Parents* / psychology
Perception
SARS-CoV-2
Stress, Psychological* / psychology
Surveys and Questionnaires

Grants and funding

This study was approved by the Research Ethics Committee, The National University of Malaysia (JEP-2021-028) and The Ministry of Health Medical Research Ethics Committee (MREC) of Malaysia (NMRR-20-3028-56868) without any funding.