Depression and stressors in children with Cancer in Jakarta: A cross-sectional study

La Saudi; Resi Putri Naulia; Gusrina Komara Putri; Vernando Yanry Lameky; Tsania Ayu Zaharany; Novianti Lailiah; Nurullia Hanum Hilfida; Mei Lestari Ika Widyyati; Ahmadi; Ririn Probowati

doi:10.31893/multiscience.2025472

Keywords:

Abstract

This study aimed to identify the predictors of depression in children with cancer in Jakarta, Indonesia. A cross-sectional design was employed, involving 72 children aged 7 to 18 years who received at Dharmasi Cancer Hospital, Jakarta. The Children's Depression Inventory (CDI), consisting of 27 items, assessed the children's feelings and thoughts. Each item was rated on a scale of 0-2, with total scores ranging from 0-54, which were used to determine the level of depression. Data were analyzed using an independent t-test and one-way analysis of variance (ANOVA). The results indicated that the primary factors associated with depression were negative self-image (42%), self-rejection (41%), doubt (40.5%), doubts about relationships with peers (31%), and physical issues (28%). Among the respondents, 72.2% showed no signs of depression, 11.1% exhibited mild depression, 9.7% had major depression and 6.9% experienced moderate depression. A significant difference in depression levels was observed based on gender, age, and duration of treatment (p<0.05). The findings highlight that children with cancer are at an increased risk of psychological distress, including anxiety and depression. Effective communication with healthcare providers is essential to identifying the underlying causes of these symptoms and formulating appropriate interventions.
References
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33. Pope, N., Tallon, M., McConigley, R., & Wilson, S. (2015). The experiences of acute non-surgical pain of children who present to a healthcare facility for treatment: A systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 13(10), 12–20.
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How to cite

Saudi, L., Naulia, R. P., Putri, G. K., Lameky, V. Y., Zaharany, T. A., Lailiah, N., Hilfida, N. H., Widyyati, M. L. I., Ahmadi, & Probowati, R. (2025). Depression and stressors in children with Cancer in Jakarta: A cross-sectional study. Multidisciplinary Science Journal, 7(10), 2025472. https://doi.org/10.31893/multiscience.2025472

[1] Akimana, B., Abbo, C., Balagadde-Kambugu, J., & Nakimuli-Mpungu, E. (2019). Prevalence and factors associated with major depressive disorder in children and adolescents at the Uganda Cancer Institute. BMC Cancer, 19, 466. https://doi.org/10.1186/s12885-019-5635-z

[2] Austin, A., Drossaert, C. H. C., Sanderman, R., et al. (2021). Experiences of self-criticism and self-compassion in people diagnosed with cancer: A multimethod qualitative study. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2021.737725

[3] Bellizzi, K. M., Smith, A., Schmidt, S., Keegan, T. H. M., Zebrack, B., Lynch, C. F., Deapen, D., Shnorhavorian, M., Tompkins, B. J., Simon, M., et al. (2012). Positive and negative psychosocial impact of being diagnosed with cancer as an adolescent or young adult. Cancer, 118, 5155–5162.

[4] Bhakta, N., Force, L. M., Allemani, C., et al. (2019). Childhood cancer burden: A review of global estimates. The Lancet Oncology, 20(1), 142–153. https://doi.org/10.1016/S1470-2045(18)30761-7

[5] Brown, J. (2017). Guilt, blame, and cancer. Oncology Nursing News. Retrieved November 2023, from https://www.oncnursingnews.com/view/guilt-blame-and-cancer

[6] Buhlinger, K. M., Borlagdan, J., Agegnehu, B., et al. (2021). Results of a pre-implementation analysis of Ethiopia's national pediatric cancer registry. Journal of Oncology Pharmacy Practice, 27, 19407. https://doi.org/10.1177/1078155220980051

[7] Cheng, L., Liu, F., Feng, S., Wang, Y., Gu, Y., & Kang, Q. (2019). Symptom experience of children with cancer younger than eight years of age: An integrative review. Journal of Pain and Symptom Management, 58(1), 157–166.

[8] Davison, T. E., & McCabe, M. (2006). Adolescent body image and psychosocial functioning. The Journal of Social Psychology, 146, 15–30.

[9] DeJong, M., & Fombonne, E. (2006). Depression in pediatric cancer: An overview. Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 15(7), 353–566.

[10] Dobrozsi, S., Yan, K., Hoffmann, R., & Panepinto, J. (2017). Patient-reported health status during pediatric cancer treatment. Pediatric Blood & Cancer, 64(4), e26295.

[11] Donnan, B. M., Webster, T., Wakefield, C. E., Dalla-Pozza, L., Alvaro, F., Lavoipierre, J., et al. (2015). What about school? Educational challenges for children and adolescents with cancer. Educational and Developmental Psychology, 32(1), 23–40. https://doi.org/10.1017/edp.2015.9

[12] Erdmann, F., Frederiksen, L. E., Bonaventure, A., Mader, L., Hasle, H., Robison, L. L., & Winther, J. F. (2021). Childhood cancer: Survival, treatment modalities, late effects and improvements over time. Cancer Epidemiology, 71(Pt B), 101733.

[13] Furlong, W., Rae, C., Feeny, D., et al. (2012). Health-related quality of life among children with acute lymphoblastic leukemia. Pediatric Blood & Cancer, 59(4), 717–724.

[14] Graungaard, A. H., Bendixen, C. R., Haavet, O. R., et al. (2019). Somatic symptoms in children who have a parent with cancer: A systematic review. Child: Care, Health and Development, 45, 147–158. https://doi.org/10.1111/cch.12647

[15] Hedén, L., Pöder, U., von Essen, L., & Ljungman, G. (2013). Parents’ perceptions of their child's symptom burden during and after cancer treatment. Journal of Pain and Symptom Management, 46(3), 366–375.

[16] Kovacs, M. (2015). Children’s Depression Inventory (CDI and CDI 2). In The Encyclopedia of Clinical Psychology (pp. 1–5). John Wiley & Sons. https://doi.org/10.1002/9781118625392.wbecp419

[17] Kunin-Batson, A. S., Lu, X., Balsamo, L., et al. (2016). Prevalence and predictors of anxiety and depression after completion of chemotherapy for childhood acute lymphoblastic leukemia: A prospective longitudinal study. Cancer, 122(10), 1608–1617.

[18] Lameky, V. Y., & Nugroho, H. S. (2024). Book review of Research and Publication Ethics, written by Santosh Kumar Yadav. Switzerland: Springer Cham. Health Dynamics, 1(5), 144–146.

[19] Lazor, T., Pole, J. D., De Souza, C., et al. (2019). Severity, change over time, and risk factors of anxiety in children with cancer depend on anxiety instrument used. Psycho-Oncology, 28(4), 710–717.

[20] Lee, Y.-L., & Santacroce, S. J. (2007). Posttraumatic stress in long-term young adult survivors of childhood cancer: A questionnaire survey. International Journal of Nursing Studies, 44, 1406–1417.

[21] Lewandowska, A., Zych, B., Papp, K., et al. (2021). Problems, stressors and needs of children and adolescents with cancer. Children, 8(12). https://doi.org/10.3390/children8121173

[22] Li, H. C. W., Lopez, V., Chung, O. K. J., Ka Yan Ho, & Chiu, S. Y. (2013). The impact of cancer on the physical, psychological and social well-being of childhood cancer survivors. European Journal of Oncology Nursing, 17(2). https://doi.org/10.1016/j.ejon.2012.07.010

[23] Li, H. C., Chung, O. K., & Chiu, S. Y. (2010). The impact of cancer on children’s physical, emotional, and psychosocial well-being. Cancer Nursing, 33, 47–54.

[24] Lindsey, E., Thompson, K. T. A., & Aaron, F. (2020). A systematic review of somatic symptoms in children with a chronically ill family member. Psychosomatic Medicine, 82(4), 366–376. https://doi.org/10.1097/PSY.0000000000000799

[25] Ljungman, L., Cernvall, M., Grönqvist, H., et al. (2014). Long-term positive and negative psychological late effects for parents of childhood cancer survivors: A systematic review. PLOS ONE, 9(7), 1–15. https://doi.org/10.1371/journal.pone.0103340

[26] Luna-Fineman, S., Ortiz, R., & Ilbawi, A. (2021). Childhood cancer control during the COVID-19 pandemic. The Lancet Oncology, 22, 1348–1350.

[27] McCaffrey, C. N. (2006). Major stressors and their effects on the well-being of children with cancer. Journal of Pediatric Nursing, 21(1), 59–66.

[28] Michinobu, R., Yamamoto, M., Hori, T., et al. (2022). Children's decision-making in cancer therapy: A long-term observational study. Pediatrics International, 64(1). https://doi.org/10.1111/ped.14700

[29] Myers, R. M., Balsamo, L., Lu, X., et al. (2014). A prospective study of anxiety, depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia: A report from the Children's Oncology Group. Cancer, 120(9), 1417–1425.

[30] Naughton, M. J., & Weaver, K. E. (2014). Physical and mental health among cancer survivors: Considerations for long-term care and quality of life. North Carolina Medical Journal, 75(4), 283–286. https://doi.org/10.18043/ncm.75.4.283

[31] Neves, M. C., Bártolo, A., Prins, J. B., et al. (2023). Taking care of an adolescent and young adult cancer survivor: A systematic review of the impact of cancer on family caregivers. International Journal of Environmental Research and Public Health, 20. https://doi.org/10.3390/ijerph20085488

[32] Park, E. M., Raddin, R. S., Nelson, K. M., et al. (2014). Conducting an antidepressant clinical trial in oncology: Challenges and strategies to address them. General Hospital Psychiatry, 36(5), 474–476.

[33] Pope, N., Tallon, M., McConigley, R., & Wilson, S. (2015). The experiences of acute non-surgical pain of children who present to a healthcare facility for treatment: A systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 13(10), 12–20.

[34] Robertson, E. G., Wakefield, C. E., Shaw, J., et al. (2019). Decision-making in childhood cancer: Parents' and adolescents' views and perceptions. Supportive Care in Cancer, 27(11), 4331–4340. https://doi.org/10.1007/s00520-019-04728-x

[35] Sargın Yildirim, N., Demirkaya, M., Sevinir, B. B., et al. (2017). A prospective follow-up of quality of life, depression, and anxiety in children with lymphoma and solid tumors. Turkish Journal of Medical Sciences, 47(4), 1078–1088.

[36] Sisk, B. A., Kang, T. I., & Mack, J. W. (2020). The evolution of regret: Decision making for parents of children with cancer. Supportive Care in Cancer, 28(3), 1215–1222.

[37] St. Jude Children’s Research Hospital. (2023). Managing guilt. Retrieved November 2023, from https://together.stjude.org/en-us/for-families/parents/managing-guilt.html

[38] The Lancet Child & Adolescent Health. (2019). Fighting childhood cancer with data. The Lancet Child & Adolescent Health, 3(9), 585. https://doi.org/10.1016/S2352-4642(19)30238-X

[39] Thorsteinsson, T., Schmiegelow, K., Thing, L. F., et al. (2019). Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study. European Journal of Cancer Care, 28(5), e13121. https://doi.org/10.1111/ecc.13121

[40] Ward, Z. J., Yeh, J. M., Bhakta, N., et al. (2019). Estimating the total incidence of global childhood cancer: A simulation-based analysis. The Lancet Oncology, 20(4), 483–493. https://doi.org/10.1016/S1470-2045(18)30909-4

[41] World Health Organization. (2020). Global health estimates: Leading causes of death. Retrieved from https://www.who.int/data/global-health-estimates

[42] Yamaji, N., Suto, M., Takemoto, Y., et al. (2020). Supporting the decision making of children with cancer: A meta-synthesis. Journal of Pediatric Oncology Nursing, 37(6), 1–13. https://doi.org/10.1177/1043454220919711

[43] Yardeni, M., Abebe Campino, G., Bursztyn, S., et al. (2020). A three-tier process for screening depression and anxiety among children and adolescents with cancer. Psycho-Oncology, 29, 2019–2027.

[44] Yardeni, M., Campino, G. A., Hasson-Ohayon, I., et al. (2021). Trajectories and risk factors for anxiety and depression in children and adolescents with cancer: A 1-year follow-up. Cancer Medicine, 10(16), 1–8. https://doi.org/10.1002/cam4.4100

Abstract

References

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