Background: Childhood cancer diagnosis and treatment can cause behavioral issues among pediatric patients. Identifying these issues and providing timely intervention is important as it can have an effect on their treatment journey and survivorship. While previous researches have often assessed behavioral issues at a single time point, limited studies have explored changes across the treatment trajectory. The present study aimed to understand the behavioral issues of paediatric cancer patients during the course of cancer treatment.
Methods: This was a prospective study conducted at a Regional Cancer Centre in Chennai, India between February 2023 and May 2024. Behavioral issues among pediatric cancer patients aged 6- and 15-years was assessed using Child Behavioral Checklist (CBCL) at four time points: baseline (before initiation of active treatment) (A1), and at one (A2), three (A3), and six-months (A4) during treatment. Data was analyzed using descriptive and inferential statistics (chi-square and Repeated Measures ANOVA with Bonferroni).
Results: Among the 139 participants, majority were boys (64.5%) and aged between 11 and 15 years (61.2%). At A1, 61.2% were in normal, 22.3% and 16.5% were in borderline and clinical range for internalizing behavior, whereas 77.7%, 8.6%, and 13.7% were in normal, borderline and clinical range for externalizing behavior, respectively. Significant association was found between awareness of diagnosis and externalizing behavior (p<0.05) in A1. The repeated measures analysis revealed significant difference in the internalizing behavior between A1 and A3(p<0.05), externalizing behavior between A1 and A3(p<0.05) and the total scores between A1 and A2 (p<0.05), A1 and A3 (p<0.01), A1 and A4 (p<0.05).
Conclusions: Children diagnosed with cancer exhibit behavioral issues during the initial treatment time which decreases over time. Psychosocial care needs to be provided for pediatric cancer patients from the initial phase of the treatment.
Keywords: Pediatric, Cancer, Behavioral issues, treatment