{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T21:49:33Z","timestamp":1770328173261,"version":"3.49.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The emergence of COVID-19 pandemic has led to heightened fear and uncertainty among parents of children with cancer. This study was conducted to evaluate the parental perceptions toward effects of COVID-19 infection to children with cancer, determine their stress level and factors contributing to high stress level during the pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study was conducted in three paediatric oncology centres in Malaysia from September 2020 until December 2022. A total of 167 parents were recruited. Parents completed a set of questionnaires to assess their perception on effect of COVID-19 infection to children with cancer and COVID Stress Scale (CSS) to assess the parents\u2019 stress level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients\u2019 mean age at study entry was 8.75\u2009years (SD 4.38). Ninety-one (54.5%) patients were still on active treatment. More than 80% of the parents obtained information regarding COVID-19 infection from mass media and social networking. Fear of their children contracting COVID-19 infection was high especially among patients who were still on treatment. Forty-nine (29.3%) parents were significantly affected by the pandemic leading to loss of job or monthly income. Twenty-nine (17.4%) patients required treatment modification during the pandemic. The median total score for CSS was 78.0 (IQR 25<jats:sup>th<\/jats:sup> 64.0; 75<jats:sup>th<\/jats:sup> 95.0). Ninety-one (54.5%) respondents were very\/extremely stressed based on the CSS scores. Components with high scores were xenophobia (median score 18.0; IQR 25<jats:sup>th<\/jats:sup> 13.0, 75<jats:sup>th<\/jats:sup> 22.0), fear of danger (median score 17.0; IQR 25<jats:sup>th<\/jats:sup> 14.0, 75<jats:sup>th<\/jats:sup> 20.0) and contamination fears (median score 16.0; IQR 25<jats:sup>th<\/jats:sup> 12.0, 75<jats:sup>th<\/jats:sup> 19.0). Lower household income was associated with higher stress level (<jats:italic>p<\/jats:italic>\u2009=\u20090.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study demonstrated high awareness regarding risk of COVID-19 infection among parents of oncology children. Half of the parents had high stress level, with low household income identified as a factor associated with high stress level.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1223362","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T04:45:46Z","timestamp":1712551546000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Caring for a child with cancer during COVID-19 pandemic: an assessment of the parents\u2019 perception and stress level"],"prefix":"10.3389","volume":"12","author":[{"given":"Muhamad Aizat","family":"Nawi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sie Chong Doris","family":"Lau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi Tying","family":"Chin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kok Hoi","family":"Teh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee Sue Betty","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamidah","family":"Alias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,8]]},"reference":[{"key":"ref1","unstructured":""},{"key":"ref2","unstructured":"GenevaWorld Health OrganizationWHO COVID-19 dashboard2020"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e702","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China","volume":"145","author":"Dong","year":"","journal-title":"Pediatrics"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1186\/s13045-021-01181-4","article-title":"COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a polish national study","volume":"14","author":"W\u0119c\u0142awek-Tompol","year":"2021","journal-title":"J Hematol Oncol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1038\/s41416-020-01181-0","article-title":"Severity of COVID-19 in children with cancer: report from the United Kingdom Paediatric coronavirus Cancer monitoring project","volume":"124","author":"Millen","year":"2021","journal-title":"Br J Cancer"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1016\/s2352-4642(20)30108-5","article-title":"Delayed access or provision of care in Italy resulting from fear of COVID-19","volume":"4","author":"Lazzerini","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e432","DOI":"10.1016\/s2352-3026(20)30123-x","article-title":"Effect of the COVID-19 pandemic on cancer treatment and research","volume":"7","author":"Saini","year":"2020","journal-title":"Lancet Haematol"},{"key":"ref8","unstructured":""},{"key":"ref9","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/1477-7525-10-88","article-title":"Parental stress when caring for a child with cancer in Jordan: a cross-sectional survey","volume":"10","author":"Masa\u2019Deh","year":"2012","journal-title":"Health Qual Life Outcomes"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"37","DOI":"10.7763\/IJSSH.2011.V1.7","article-title":"Psychological distress and associated factors in parents of child with cancer","volume":"1","author":"Othman","year":"2011","journal-title":"Int J Soc Sci Humanity"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e28790","DOI":"10.1002\/pbc.28790","article-title":"COVID-19 and children with cancer: Parents\u2019 experiences, anxieties and support needs","volume":"68","author":"Darlington","year":"2021","journal-title":"Pediatr Blood Cancer"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.1002\/pon.5444","article-title":"How paediatric psycho-oncology is changing during the COVID-19 epidemic in Italy: new approaches","volume":"29","author":"Zucchetti","year":"2020","journal-title":"Psychooncology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e28318","DOI":"10.1002\/pbc.28318","article-title":"How young patients with cancer perceive the COVID-19 (coronavirus) epidemic in Milan, Italy: is there room for other fears?","volume":"67","author":"Casanova","year":"2020","journal-title":"Pediatr Blood Cancer"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"102232","DOI":"10.1016\/j.janxdis.2020.102232","article-title":"Development and initial validation of the COVID stress scales","volume":"72","author":"Taylor","year":"2020","journal-title":"J Anxiety Disord"},{"key":"ref15","unstructured":""},{"key":"ref16","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.vacun.2022.07.004","article-title":"Parents\u2019 perception of COVID-19 risk of infection and intention to vaccinate their children","volume":"24","author":"Sabra","year":"2023","journal-title":"Vacunas"},{"key":"ref17","unstructured":"2021"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1007\/s00431-021-04338-y","article-title":"SARS-CoV-2 in pediatric cancer: a systematic review","volume":"181","author":"Schlage","year":"2022","journal-title":"Eur J Pediatr"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e28557","DOI":"10.1002\/pbc.28557","article-title":"Initial report on Spanish pediatric oncologic, hematologic, and post stem cell transplantation patients during SARS-CoV-2 pandemic","volume":"67","author":"Faura","year":"2020","journal-title":"Pediatr Blood Cancer"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1093\/jpids\/piaa088","article-title":"Clinical characteristics and outcome of severe acute respiratory syndrome coronavirus 2 infection in Italian pediatric oncology patients: a study from the infectious diseases working Group of the Associazione Italiana di Oncologia e Ematologia Pediatrica","volume":"9","author":"Bisogno","year":"2020","journal-title":"J Pediatric Infect Dis Soc"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e853","DOI":"10.1016\/j.clml.2021.07.025","article-title":"Management and outcome of coronavirus disease 2019 (COVID-19) in pediatric Cancer patients: a single Centre experience from a developing country","volume":"21","author":"Hammad","year":"2021","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.ejca.2021.09.027","article-title":"SARS-CoV-2 in children with cancer or after haematopoietic stem cell transplant: an analysis of 131 patients","volume":"159","author":"Haeusler","year":"2021","journal-title":"Eur J Cancer"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e29079","DOI":"10.1002\/pbc.29079","article-title":"COVID-19 among children with cancer in Greece (2020): results from the Nationwide registry of childhood hematological malignancies and solid tumors (NARECHEM-ST)","volume":"68","author":"Baka","year":"2021","journal-title":"Pediatr Blood Cancer"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e28827","DOI":"10.1002\/pbc.28827","article-title":"No increase in psychosocial stress of Dutch children with cancer and their caregivers during the first months of the COVID-19 pandemic","volume":"68","author":"van Gorp","year":"2021","journal-title":"Pediatr Blood Cancer"},{"key":"ref25","first-page":"73","article-title":"Parenting stress in childhood leukemia","volume":"7","author":"Latiff","year":"2012","journal-title":"Med Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e0259062","DOI":"10.1371\/journal.pone.0259062","article-title":"Validity and reliability of the Serbian COVID stress scales","volume":"16","author":"Milic","year":"2021","journal-title":"PLoS One"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1002\/da.23071","article-title":"COVID stress syndrome: concept, structure, and correlates","volume":"37","author":"Taylor","year":"2020","journal-title":"Depress Anxiety"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1223362\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T04:45:52Z","timestamp":1712551552000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1223362\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,8]]},"references-count":27,"alternative-id":["10.3389\/fpubh.2024.1223362"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1223362","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,8]]},"article-number":"1223362"}}