Discussion
In recent years, the requirements for the quality of life of child
patients have increased and the development of modern tumor theories has
led to great changes in the principles and concepts of treatment of
pediatric cancers15. The purpose of treatment can not
only be satisfied with the improvement of survival rate but also
requires improvement of the quality of life.
However, in clinical practice, there are still many problems and
challenges in the actual situation of children’s psychological status,
which seriously affects their life quality. A study from the United
States surveyed online pediatric oncologists (n=99), psychosocial
leaders (n=132), and pediatric oncology managers (n=58) from 144
training programs in 44 states and the Columbia region. The results
showed that most of the participants indicated that the psychosocial
care provided by their centers met the relevant standards based on
evidence-based medicine. However, only half of the pediatric oncologists
(55.6%) and psychosocial leaders (45.6%) believed that their
psychosocial and social care is comprehensive and advanced, but it is
usually provided when children have mental problems16.
A study in South Korea in 2018 showed that 20% to 25% of pediatric
cancer survivors had no friends after returning to school, 41% had
learning difficulties, and 53% had lower academic performance than
before, suggesting that education support should be provided for
children with pediatric cancers to return to school17.
Through questionnaire surveys and interviews, we learned that the WSP
has an overall good effect on the child patients. In the perspective of
children, the WSP has a positive effect on their life quality and social
mental functions, especially on the aspects of self-conception and
learning skills. In terms of quality of life, the IDP group believed
they are more energetic, happier in life, and better in memory than the
OP group. At the same time, the children of the IDP group are more
satisfied with their health and sleep quality. In terms of learning
skills, the specific performance is that learning ability can be more
persistent, easier to remember knowledge points, and willing to do other
things besides homework for the children of IDP group. However, this
project did not improve the relationship between children and their
friends, teachers, and parents. They still feel nervous and scared from
time to time, worry about doing something wrong, which indicated the
child patients may need further psychological assistance and
psychosocial care during the clinical treatment.
Besides, This WSP has greatly improved the children’s character problems
and relieved their anxiety from the perspective of their parents. In
terms of character, the children of the IDP group became more polite to
the elders, their tempers became better, more honest, and more
disciplined compared to the children of the OP group. Furthermore, the
parents found that this project alleviated children’s anxiety. The
children of the IDP group became less shy, no longer afraid of strangers
and new environments, and no longer worried about bad things such as
loneliness, illness, and death. In addition, the parents found that the
WSP alleviated children’s anxiety. But they also found that children are
still more sensitive and impulsive, and often feel headaches,
stomachache, and other discomforts. In addition, contrary to the
opinions of the children, the parents still found that the children have
difficulty in learning, lack concentration during the learning process,
and are easily distracted and discouraged. These results suggested that
the parents have high expectations for their children’s learning, and it
also demonstrated the child patients and their parents need more
communication to promote mutual understanding and deepen the
parent-child relationship.
Of note, this pilot project could guide us to respond promptly to the
quality of life and psychological changes of children with pediatric
cancers during the clinical treatment, and it also allows us to provide
psychological intervention and psychosocial support for them as early as
possible. Although our sample size was limited, all of the participants
endorsed the WSP as a meaningful and valuable project of psychological
intervention support during the treatment.
The WSP developed by our team uses cultural subjects and psychological
counseling courses to improve the scientific knowledge of children with
pediatric cancers so that the children will be easier to return and
adopt the school life after treatment. Campus life also improves the
quality of life of children and reduces their feelings of social
isolation. This program has clinical value in improving the quality of
life and psychosocial issues of child patients. Therefore, based on the
preliminary work of this study, we will develop a prospective study to
further explore the impact of the WSP on the quality of life and
psychosocial behavior of children with pediatric cancers.