الفهرس 
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Abstract
Parents, the main actors in child care, are the most affected with the diagnosis of cancer. It is noteworthy that parents may exhibit physical and emotional symptoms divided in two domains child’s domains such as: (Distractibility/hyperactivity, adaptability, parental reinforcement, acceptability, attachment and demandingness); and parental domains such as: (competence, social isolation, attachments, depression, spouse relation and parental health) , which present a higher risk of developing mental illness (Norberg et al., 2012). These reactions may be present in the relationship with the healthcare team and can interfere with parents’ level of understanding, in adherence to treatment, and negatively influence on child self esteem (Streisand et al .,2001).
The present study was carried out to assess parental stress and self esteem of children receiving chemotherapy. To achieve this aims; a sample of convenience comprised 100 children receiving chemotherapy and their accompanying parents. The studied subjects were recruited from the inpatient departments of oncology units at Special Pediatric Hospital in Benha City and Sednawy Pediatric Hospital in Zagazig City. Data were collected over a period of three months, three tools: 1) A structured interviewing questionnaire was used to assess socio- demographic characteristics for diseased child and his/her parent. 2) Parental Stress Index to assess Parental stress level through two domains (child domains & parental domains); and 3) Self Esteem Scale to assess self esteem of children receiving chemotherapy. The main findings of this study can be summarized as the following:
The present study result showed that more than half of the studied children’s age was between 9-11 years. Less than three fifths of the studied children were females, and more than half of studied subjects were living in rural areas. Nearly half of studied children ranked second in the family, while nearly to one third of them ranked the first. Less than half of studied fathers their ages ranged 40 years or more and half of studied mothers their ages ranged from 30-<40 years. Most of studied fathers were working, while more than half of studied mothers were housewives. For less than half of studied children, their family number was 6 or more, and for less than three fifths of their sibling’s number ranged between 3-5 members. Half of studied children was diagnosed with cancer since 3-<5 years. The majority suffer from fever, the minority suffers from constipation. Most of studied children take chemotherapy intravenously injection once a week.
The study also revealed that the majority of the studied children had low level of self esteem. Concerning child’s domains of parental stress, more than two thirds of studied children were low distracted. As regards their parent’s reinforcement more than three quarter of studied parent were negatively reinforced, and more than two quarters of studied children had low mood. More than two thirds of studied children were low acceptability, more than half of studied children were poor adaptability. Less than two third of studied children had high demandingness.
Concerning parent’s domains of parental stress, the present study showed that, nearly to three quarters of parents had low sense of competence, and nearly two thirds of them were negatively reinforced.
More than three quarters of studied parents had high parental restriction. The present study result revealed also that, more than two thirds of studied parent s had high level of depression. In relation to spouse relation, almost three fifth of studied parents had poor relation. Concerning social isolation, nearly two thirds of studied parents had high social isolation and the majority of parents had good health.
The current study showed that, there was a statistically significant difference between onset of the disease of studied children and their total parental stress score. Concerning parent’s personal characteristics and child’s domains of parental stress, there was highly statistically significant difference between mother’s occupation and total parental stress score related to child’s domains, while there were statistically significant differences between father’s and mother’s age and total parental stress score related to child domains. Concerning relation between child’s self esteem and his/her personal characteristics, there was a statistically significant difference between onset of the disease of studied children and level of self esteem. There were no statistically significant differences between personal characteristics of studied parents and total parental stress score related to parents’ domains.
The present study showed that, concerning correlations between parent’s domains and child’s domains of parental stress, there were highly statistically significant positive correlations between parent’s domain of attachment and child’s domains of parent reinforcement, mood, distraction, adaptability and demandingness. Regarding parent’s domain of restriction, there were highly statistically significant positive correlations between parent’s domains of restriction and child domains of parent reinforcement, mood, distraction, adaptability and demandingness. Concerning of parent’s depression domain, there was a highly statistically significant positive correlation between parent’s depression and child’s domains of mood, distraction, adaptability and demandingness.
In relation to parent domain of spouse relation, there were highly positive significant correlations between parent domain of spouse relation and child domains of parent’s reinforces, mood, distraction and acceptability. Regards Social isolation of parent domain, there were highly statistically significant positive correlations between parent domain of Social isolation and child domains of mood, distraction, adaptability and Demandingness. There were highly positive significant correlations between parent domain of competence and child’s domains of parent’s reinforcement and mood. There were statistically significant positive correlations between parent’s domain of competence and child’s domains of adaptability and acceptability.
Concerning correlations between parental stress related to child’s domains and the child level of self esteem, there were only significant positive correlation between acceptability as one item of child domain of parental stress and child level of self esteem.
In the light of the results of the present study it can be concluded that:
The majority of parents of children receiving chemotherapy had high level of stress and the majority of studied children had low level of self esteem. There were association between onset of the disease of studied children and their total parental stress score. There were associations between child’s domains and parent’s domains of parental stress. There were associations between child’s level of self esteem and two domains of parental stress (Child’s domains & Parent’s domains).
In the light of finding of finding of the present study the following recommendation are suggested:
• Develop and implement educational programs for parents of children with cancer to minimize parental stress by giving factual information to help correct any false ideas about cancer and cancer treatment, to get through difficult situations and enhance child’s self esteem.
• Greater consideration should be given to children with cancer and their parents, especially for nurses who spend more time with child suffer from cancer and their parent. Nurse should give appropriate information about stress management technique to relieve parental pressure and promote child’s self esteem. Parents of children with cancer and the children themselves often become acquainted with one another.
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