Resilience in Transfusion Dependent Thalassemic Adolescents

Background: Resilience represents the ability to cope with stressful situations or events and bounce back positively. Chronic illnesses like thalassemia during adolescence can significantly affect social, psychological and environmental health, not only of the sufferer but also of the siblings and the parents. There is paucity of literature on resilience in thalassemic adolescents in developing countries. Methods: Sixty adolescents aged 10 to 18 years with transfusion dependent thalassemia (TDT) registered with Thalassemia Day Care Centre TDCC of Kalawati Saran Children Hospital, New Delhi. Between November 2014 to April 2016 were include in the study group (Group A). Control Groups consisted of a) sixty age matched adolescents without any chronic illnesses (B1); and b) thirty one age matched adolescent siblings of study group adolescents (B2); with comparable socioeconomic status, academic performance and family type. Adolescents having physical or intellectual disability or having HIV were excluded from study. Adolescent Resilient Questionnaire was provided to the all the three groups, and they scored the questions according to Likert scale. Socio-demographic and clinical profile of patients were recorded on a pretested proforma. Results: Resilience was found to be highest in adolescents with TDT (mean resilience score 310.83 ± 40.44) and almost equal in both, the healthy controls and their normal siblings (mean resilience score: group B1 289.57 ± 35.67; group B2 288.42 ± 34.62) [p value <0.05]. Resilience was found to be significantly higher in younger adolescents with TDT as compared to older adolescents (p value 0.012). Males with TDT were found to be more resilient than females (p value 0.003)]. Resilience increased with increase in the educational status, socioeconomic status and family income of adolescents with TDT. No significant differences was seen in mean resilience scores of TDT adolescents in relation to family type, body mass index, age at diagnosis and time since diagnosis of the disease [p value >0.05]. Resilience among TDT adolescents was higher in patients receiving <15 blood transfusions/year; patients with higher mean pre transfusion hemoglobin (>9 g/dl); and with mean ferritin <1500 ng/ml [p value <0.05]. Conclusions: We conclude that adolescents with TDT have better resilience than their healthy counterparts and their healthy adolescent siblings. Resilience among TDT adolescents was influenced by various demographic variables and various disease related factors such as number of blood transfusions per year; mean pre-transfusion hemoglobin; and mean ferritin levels.