8 Some quantitative studies have identified short-term and long-term problems in the social adaptation of children with leukaemia, such as anxiety, depression and antisocial behaviour due to the disease itself and treatment. Two-thirds of childhood leukaemia survivors have long-term health complications due to treatment, including psychosocial problems related to their illness experience. 9 The burden of childhood cancer in China ranks second in the world, 10 and childhood leukaemia survivors have the highest health burden among all childhood cancer survivors. 8 Currently, the 5-year long-term survival rate of children with leukaemia is 87.8%. With significant progress in treatment methods, leukaemia and other blood system tumours have changed from a fatal to a chronic disease. 7 Leukaemia might occur in children at any age, but the peak age is generally between birth and 14 years old. 6 From 2016 to 2018, the average annual incidence of leukaemia among children aged 0–14 in China was 42.9 per million and the number of leukaemia cases every year was approximately 8000.
In terms of incidence, leukaemia ranks first among paediatric malignancies and is a major disease that seriously threatens the lives and health of children. Similarly, the present study used qualitative research methods to clarify the social maladaptation experience of children with leukaemia of different ages in China and identify their psychological and behavioural problems, with the goal of solving these problems in a targeted manner to improve the status quo of children’s social maladaptation. Their aims were to collect their illness experiences and understand how they felt about school and their daily routines and to identify the best sociodemographic and illness predictors of good readaptation to school and daily life. Tremolada et al 5 adopted semistructured interviews and a mixed-method approach to examine children’s and adolescents’ narratives about their return to school after 2 years of treatment for leukaemia. Children’s life experiences can be intuitively understood through qualitative research. However, there is no indepth understanding of the social maladaptation experience of children with leukaemia. Therefore, it is urgent to improve the social adaptation of children with leukaemia. 4 Eventually, their studies, employment, marriage and family lives are affected. In China, the social adaptability of children with malignant tumours such as leukaemia is significantly worse than that of other children of the same age. In other words, both psychology and behaviour need to be adjusted. 3 Children with leukaemia of different ages show various social maladaptations, which are mainly reflected in psychological and behavioural changes. A study found that the risk of maladjustment among childhood cancer survivors is as high as 23%, with the highest risk among those with leukaemia.
2 This has led to the status quo of social maladjustment in children with leukaemia. Two to three years of repeated hospitalisation, isolation from their peers and poor life experience lead to various social adaptation problems in children with leukaemia due to changes in their living environment.
1 Children with leukaemia are in a special period of growth and development. In the process of interaction between individuals and their environment, social adaptation refers to people ultimately maintaining a dynamic balance with the social environment by adapting to it, adjusting themselves or changing the environment to maintain stability in physical and mental activities.
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