Psychological effects of hematopoietic SCT on pediatric patients, siblings and parents: a review.

Although hematopoietic SCT (HSCT) has become standard therapy for many life-threatening disorders of childhood, there is little research on the psychosocial ramifications of HSCT on patients, siblings and parents. Pediatric patients experience numerous psychological reactions throughout hospitalization, the procedure and recovery process: anxiety, depression, behavioral and social problems, and post-traumatic stress reactions. Similarly, sibling donors are at risk of developing emotional disturbances such as post-traumatic stress reactions, anxiety and low self-esteem. Parental distress, anxiety and depression levels are often increased as a result of their child undergoing the HSCT process. The distress and anxiety may be even greater for parents whose healthy child also becomes part of the HSCT process through donating their marrow. Thus, it is critical to develop interventions for pediatric patients and their families. There is, however, minimal research of interventions aimed at decreasing distress and improving emotional and psychosocial functioning for children undergoing HSCT, siblings and parents. Cognitive-behavioral interventions are the most researched treatment approaches for children with cancer and chronic illness and these are promising in improving emotional distress, compliance with treatment and behavioral problems associated with HSCT. Appropriate arenas in which pediatric patient interventions may focus include social skills and emotional well-being. Familial interventions that aim to enhance protective factors, improve communication, and decrease parental anxiety and depression are crucial, and cancer-specific interventions may serve as a template for the development of HSCT-specific interventions.