Parent-Child Play Therapy on Depression Symptoms
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4 Abstracts - 1st International Nastaran Cancer Symposium-2015 / Journal of Cellular Immunotherapy 1 (2015) 1e45 Parent-child play therapy on depression symptoms in Child depression inventory: It is a self-assessment scale devel- children with cancer decreases perceived stress on their oped by Kovacs (1977), which was designed to assess signs of cogni- mothers and improving parent-child relationship tive, behavioral and emotional depression in children and adolescents a a b aged 7 to 17. In Dehshiri, Najafi, sheikhi and Habibi Askarabad Roya Sadat Alavian , Zahra Tabibi , Abdollah BaniHashem , (2009) test-retest reliability and internal consistency of the question- a,* MohammadSaeid AbdeKhodaee naire respectively was 0/82, 0/83 a b Ferdowsi University of Mashhad, Mashhad, Iran Mashhad Parent-child relationship scale: This scale was developed by University of Medical Sciences, Mashhad, Iran Pianta for the first time in 1994. It contains 33 items that assesses E-mail address: [email protected] parental perception of their relationship with their child. It is applied Extended Abstract for children aged 3-12. This questionnaire was translated by Tahma- sian in 2007 and its validity was assessed by experts. Introduction: Cancer has a difficult therapeutic process. Treat- ment procedures of cancer cause the child be often tired and languish- First the participants answered the PSS, PCRS and CDI question- ing. These children are also more prone to infections and frequently naires as pre-test. Then the individuals in intervention group received e are hospitalized that leads to the separation of children from their 8 sessions of parent child play therapy, at the end, both of interven- families and the community. Pain, fatigue, anxiety, and other symp- tion and control group filled post-test questionnaires. toms are common in those experiencing cancer. Result: Whit regard to depression, the analysis of covariance data Satin, Linden and Philips (2009), in a meta-analysis study found that showed a significant change between pre-test and post-test ¼ < ¼, the risk of death in cancer patients that report depressive symptoms is (F(1,11) 92/34, p 0/001, 0/89). In other words, there is a signif- more than non-depressed patients, The rate of death in patients who icant difference in depression scores between the subjects of experi- show some symptoms of depression is 25%, and in patients with mild mental and control groups at post-test. Post-test scores of Depression or major depression is 39% more than other cancer patients. in the experimental group were significantly lower than the control one. Since childhood cancer is a life-threatening disease, the role of parents, especially mothers as a primary carer, are increasingly high- In the case of perceived stress variable, after controlling the effect lighted and because of changes in the role of parents, parents are fac- of pre-test scores, the efficacy of treatment in post-test scores was not ¼ < ¼, ing with multiple and complex problems. significant (F(1,11) 1/40,p 0/05, 0/11). So, there is no a signifi- cant difference between the subjects of experimental and control Parents often have feelings of depression and anxiety. Patient and groups in mean scores for perceived stress of mothers in the post-test. caregiver characteristics, stressors, stress appraisal, stress coping methods, and social support influence caregivers' quality of life. Stud- For child-parent relationship, there is a significant relationship ies show that mothers of children with cancer report more perceived between pre-test and post-test scores of this variable. The results in stress than mothers of healthy children and even mothers of children the table above shows After controlling effect of pre-test scores, the with Down syndrome. Studies also show that parents of children sur- efficacy of treatment for child-parent relationship in post-test scores ¼ < ¼, vivors of cancer show significantly higher levels of post-traumatic are also significant(F(1,11) 12/84,p 0/01, 0/53). So, there is a stress symptoms compared with healthy children parents. significant difference between the mean scores of parent-child rela- tionship in the post-test in subjects of the experimental and control Play therapy allows children to encounter with emotional needs groups. and doubts, and provide an opportunity to find ways to cope with their hospital circumstances. On the other hand children need sufficient Discussion and conclusion: Childhood cancer is one of the most time to engage emotionally with their parents, and parents should painful diseases for children and families. This illness can threaten know that how interact with their children in an efficient way. The the mental health of the child and his family. Children encounter way in which mothers interact with their children is very important. with painful side effects of cancer medical treatments, such as nausea, Since play therapy is one of the best ways to get into the child's world vomiting, hair loss, fatigue, pain and etc. And because of diseases and it can also have a positive impact on the children's physical and children cannot participate in peers and family communities, their mental health, so if the mothers enter this field, the play can be an life change considerably. Children with cancer are more likely to effective way for mothers to interact with their children. experience symptoms of depression and, compared with other chil- dren, and the risk of death in the children that represent more symp- Material and methods: Participants: Participants were recruited toms of depression is more than other children. from the inpatient oncology unit at Dr. Sheikh Hospital in the city of ’ ’ Mashhad, Iran, over a 5 month period. Patients were included in the Also psychological conditions of the children s parents affect the study if their diagnosis was cancer, they were between 7-12 years old, child behaviors and emotions. Children who have a better relationship their mothers were primary caregiver and were capable of participat- with their parents and their parents experience less stress, have less ing in a 1-hour 8 sessions of play therapy. So 14 children diagnosed behavioral problems and greater adherence to treatment. with cancer and their mothers (28 individuals) entered in final Psychological interventions that aim these problems are great help program. for these children and their parents. One of these interventions is play Measures and procedure: The instruments used to measure therapy that is enjoyable activity for children. On the other side, depression symptoms, perceived stress and Parent-Child Relationship involvement of parents in treatment can lead to better results. were Perceived Stress Scale (PSS), Child depression inventory (CDI), Current study also aims to reduce the symptoms of childhood and Parent-Child Relationship Scale (PCRS). depression, reduce perceived stress on their mothers and improve Perceived stress scale: This scale has three versions with 4, 10 parent - child relationship used parent child play therapy. Parent-child and 14 items respectively. Cohen et al (1983), conducted a study to play therapy involves child and his parent in enjoyable and purposeful evaluate the psychometric properties of all these three versions. Cron- activities, to express emotions and thoughts in a secure atmosphere. bach's alpha of 14-item version was 0/84 and 0/86. In a study carried Training of relaxation techniques to both child and mother and to out by Ghorbani et al (2002) in the Iranian society, Cronbach's alpha instruct empathy and behavior management techniques to mother was 0/81. helps to solve parent and child psychological problems. Intervention Abstracts - 1st International Nastaran Cancer Symposium-2015 / Journal of Cellular Immunotherapy 1 (2015) 1e45 5 that used in current study is effective in reducing symptoms of delivered by adenovirus vectors, is now widespread and other bio- depression and improve parent e child relationship, but it is not logic approaches like the development of oncolytic viruses designed effective on reducing of mothers Perceived stress. to replicate and kill only p53 defective cells. The other way is the development of siRNA and antisense RNA's that activate p53 by Cancer gene therapy to restore P53 function: New way for inhibiting the function of the negative regulators Mdm2, MdmX, an old aim and HPV E6 is effective too. In conclusion Adenovirus-based p53 gene therapy as well as using small molecules include PRIMA that Farzaneh Iravani a, Majid Mojarrad a,b,* can restore the transcriptional function to mutant p53 cell, or NUT- a Department of Medical Genetics, Mashhad University of Medical LIN and RITA which interfere with MDM2-directed p53 degradation, Science, Mashhad, Iran b Medical Genetics Research Center, have been tested in a preclinical stage and some of these approaches Mashhad University of Medical Sciences, Mashhad, Iran are currently in clinical development. E-mail address: [email protected] TOX3 and the risk of breast cancer; an overview Extended Abstract a a a Introduction: The first description of p53 protein is in 1979 and Amir Tajbakhsh , Fahimeh Afzal Javan , Mahdi Rivandi , b,c, since that time there have been more than 35 000 papers published on Alireza Pasdar * a this topic. However even after 30 years after its discovery, it is still Student Research Committee, Department of New Sciences and somewhat of a mystery. The gene encodes transcription factor p53 Technology, Faculty of Medicine, Mashhad University of Medical b is TP53, one of the most commonly altered genes in human cancers. Sciences, Mashhad, IR, Iran Department of New Sciences & P53 protein plays a central role to regulate cell cycle progression, dif- Technology, School of Medicine, Mashhad University of Medical c ferentiation, senescence, DNA repair, and apoptosis. In response of Sciences, Mashhad, Iran Division of Applied Medicine, Medical DNA damage or other stress signals, p53 activity is up-regulated School, University of Aberdeen, Forester Hill, Aberdeen, UK and a series of biological events cascade is initiated that eventually E-mail address: [email protected] results in prevention of tumor development and expansion.