1
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Hsu TW, Liang CS, Tsai SJ, Bai YM, Su TP, Chen TJ, Chen MH. Risk of Major Psychiatric Disorders Among Children and Adolescents Surviving Malignancies: A Nationwide Longitudinal Study. J Clin Oncol 2023; 41:2054-2066. [PMID: 36649568 DOI: 10.1200/jco.22.01189] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Evidence suggests an increased long-term risk of major psychiatric disorders (MPDs) in childhood and adolescent cancer survivors (CACSs). However, definitive conclusions regarding such associations and whether such associations vary for different types of cancers remain unclear. METHODS Using a nationwide data set from 2001 to 2011, we enrolled CACSs and likewise randomly selected individuals without cancer from the general population (1:10 ratio) who were matched to the CACSs with regard to demographic data. We investigated eight organ system-related cancers. The primary outcomes were the risks of seven MPD diagnoses: autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), schizophrenia, bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and post-traumatic stress disorder. RESULTS CACSs (n = 5,121; mean age = 9.08 years) showed increased risks of six MPD diagnoses than controls (n = 51,210), with results as follows (in descending order): ASD (hazard ratio [HR], 10.42; associated 95% CI, 4.58 to 23.69), ADHD (HR, 6.59; 95% CI, 4.91 to 8.86), BD (HR, 2.93; 95% CI, 1.26 to 6.80), MDD (HR, 1.88; 95% CI, 1.26 to 2.79), OCD (HR, 3.37; 95% CI, 1.33 to 8.52), and post-traumatic stress disorder (HR, 6.10; 95% CI, 1.46 to 25.54). CACSs also showed earlier ages at diagnoses of ADHD, schizophrenia, MDD, and OCD than controls. The risks of MPD diagnoses vary according to specific cancer types/categories. Brain cancer and lymphatic/hematopoietic tissue cancer were associated with the greatest number of MPD diagnoses (ie, each was associated with six diagnoses). In addition, ASD and ADHD were associated with most organ system-related cancers (ie, each was associated with five categories). CONCLUSION We found that CACSs were at higher risks of MPD diagnoses than controls. Follow-up care should include psychosocial interventions focusing on early signs of mental health problems and early interventions in this high-risk group.
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Affiliation(s)
- Tien-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan.,Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.,Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming Chiao Tung University, Taipei, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
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2
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Depressive and Anxiety Disorders of Parents of Children with Cancer. J Clin Med 2022; 11:jcm11195670. [PMID: 36233541 PMCID: PMC9572351 DOI: 10.3390/jcm11195670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022] Open
Abstract
Every year in Poland there are approximately 1200 new cases of malignant tumours in children and adolescents. Leukaemia, CNS tumours, and lymphomas are the most frequently diagnosed cancers. Coping with a child’s illness is challenging, which is why many parents suffer from anxiety, depression disorders, and even PTSD (post-traumatic stress disorder). The aim of this study is to assess the anxiety and depression levels of carers of children with cancer. Method: The study participants were 101 carers of children suffering from cancer. The study was conducted using standardized questionnaires: the Zung ccale, HADS scale, and Karnofsky scale, and three questionnaires designed by the author. Results: According to the results of the Karnofsky scale, carers’ anxiety and depression levels were negatively affected by their children’s poor performance. The younger age of children significantly correlated with the severity of depression in their parents. HADS and Zung scale anxiety levels were observed to have statistically significant effect on the severity of depressive disorders. Conclusions: Receiving a diagnosis of childhood cancer contributes to the incidence of depression and anxiety disorders among carers. Carers’ anxiety and depression levels were strongly associated with their child’s age and their child’s performance.
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3
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Keim MC, Fladeboe K, Galtieri LR, Kawamura J, King K, Friedman D, Compas B, Breiger D, Lengua L, Katz LF. Primary and secondary caregiver depressive symptoms and family functioning following a pediatric cancer diagnosis: an exploration of the buffering hypothesis. Psychooncology 2021; 30:928-935. [PMID: 33724595 DOI: 10.1002/pon.5676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/04/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE After diagnosis, caregivers of children with cancer, particularly mothers or primary caregivers (PCs), often show elevated depressive symptoms which may negatively impact family functioning. We tested PC and secondary caregiver (SC) depressive symptoms as predictors of family, co-parenting, and marital functioning and whether having a non-depressed SC buffers against potential negative effects of PC depressive symptoms. METHODS Families (N = 137) were recruited from two major children's hospitals following a diagnosis of pediatric cancer. Caregivers completed self-report measures of depressive symptoms (Center for Epidemiological Studies-Depression Scale; Depression, Anxiety, and Stress Scale) and marital functioning (Dyadic Adjustment Scale) at 1-month post-diagnosis. A subset of families (n = 75) completed videotaped interaction tasks at approximately 3-months post-diagnosis that were coded for family and co-parenting interactions. RESULTS Higher PC depressive symptoms at 1-month post-diagnosis was associated with higher adaptability and lower conflict in family functioning. PC depressive symptoms were also associated lower dyadic consensus and lower dyadic satisfaction. SC depressive symptoms were not significantly associated with any family/co-parenting/marital functioning variables. Significant interaction analyses suggested that SC depressive symptoms moderated the effect of PC depressive symptoms on family cohesion, withdrawn parenting, and affective expression in the marriage, such that the relationship between PC depressive symptoms and poorer functioning was attenuated when SC depressive symptoms were at low or average levels. CONCLUSIONS Having a nondepressed SC buffered against negative effects of PC depressive symptoms on certain domains of family, coparenting, and marital functioning. SCs may play a protective role for families of children with cancer.
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Affiliation(s)
- Madelaine C Keim
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Kaitlyn Fladeboe
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Liana R Galtieri
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Joy Kawamura
- Department of Psychology, University of Washington, Seattle, Washington, USA.,Seattle Children's Hospital, Seattle, Washington, USA
| | - Kevin King
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Debra Friedman
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA
| | - Bruce Compas
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - David Breiger
- Department of Psychology, University of Washington, Seattle, Washington, USA.,Seattle Children's Hospital, Seattle, Washington, USA
| | - Liliana Lengua
- Department of Psychology, University of Washington, Seattle, Washington, USA
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4
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Social isolation and connection in adolescents with cancer and survivors of childhood cancer: A systematic review. J Adolesc 2021; 87:15-27. [DOI: 10.1016/j.adolescence.2020.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/20/2020] [Accepted: 12/21/2020] [Indexed: 12/25/2022]
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5
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Wang Q, Liu H, Ren Z, Xiong W, He M, Li N, Fan X, Guo X, Li X, Shi H, Zha S, Zhang X. The Associations of Family Functioning, General Well-Being, and Exercise with Mental Health among End-Stage Renal Disease Patients. Psychiatry Investig 2020; 17:356-365. [PMID: 32252511 PMCID: PMC7176562 DOI: 10.30773/pi.2019.0204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/04/2020] [Accepted: 02/12/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress. Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioning and psychological distress. METHODS Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item General Health Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzed using multiple linear regression analysis and path analysis. RESULTS The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factors of psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by general well-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated by exercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029). CONCLUSION The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercise were associated with psychological distress. Family functioning could affect psychological distress partially by affecting general well-being. Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Xiong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Nan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
- The First Hospital of Qiqihar City, Qiqihar, China
| | - Xinwen Fan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xia Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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Marusak HA, Harper FW, Taub JW, Rabinak CA. Pediatric cancer, posttraumatic stress and fear-related neural circuitry. Int J Hematol Oncol 2019; 8:IJH17. [PMID: 31467663 PMCID: PMC6714068 DOI: 10.2217/ijh-2019-0002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This review examines the neurobiological effects of pediatric cancer-related posttraumatic stress symptoms (PTSS). We first consider studies on prevalence and predictors of childhood cancer-related PTSS and compare these studies to those in typically developing (i.e., noncancer) populations. Then, we briefly introduce the brain regions implicated in PTSS and review neuroimaging studies examining the neural correlates of PTSS in noncancer populations. Next, we present a framework and recommendations for future research. In particular, concurrent evaluation of PTSS and neuroimaging, as well as sociodemographic, medical, family factors, and other life events, are needed to uncover mechanisms leading to cancer-related PTSS. We review findings from neuroimaging studies on childhood cancer and one recent study on cancer-related PTSS as a starting point in this line of research.
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Affiliation(s)
- Hilary A Marusak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, MI 48201, USA.,Population Studies & Disparities Research Program, Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Felicity W Harper
- Population Studies & Disparities Research Program, Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Jeffrey W Taub
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI 48201, USA.,Children's Hospital of Michigan, Detroit, MI 48201, USA
| | - Christine A Rabinak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, MI 48201, USA.,Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, MI 48201, USA.,Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA
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7
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Van Schoors M, De Paepe AL, Norga K, Cosyns V, Morren H, Vercruysse T, Goubert L, Verhofstadt LL. Family Members Dealing With Childhood Cancer: A Study on the Role of Family Functioning and Cancer Appraisal. Front Psychol 2019; 10:1405. [PMID: 31275213 PMCID: PMC6594216 DOI: 10.3389/fpsyg.2019.01405] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/31/2019] [Indexed: 12/27/2022] Open
Abstract
Objectives Childhood cancer is a life-threatening disease that poses significant challenges to the life of the diagnosed child and his/her family members. Based on the ABCX-model, the aim of the current study was to explore the association between family functioning, cancer appraisal and the individual adjustment of patients, parents and siblings. Methods Participants were 60 children with leukemia or non-Hodgkin lymphoma, 172 parents and 78 siblings (115 families). Time since diagnosis varied from zero to 33 months. Patients, parents and siblings completed the Family Environment Scale (FES), Perceived Stress Scale, Situation-Specific Emotional Reactions Questionnaire and Pediatric Quality of Life Inventory/Maudsley Marital Questionnaire. Results Family functioning and the appraisal of the cancer diagnosis proved to be related to patients', parents' and siblings' cancer-related emotions and quality of life post-diagnosis. In addition, family members differed in their perception of some family functioning domains, the appraisal of the cancer diagnosis, positive feelings and quality of life. Discussion Our findings led to the conclusion that family functioning and the appraisal of the cancer diagnosis are important for the individual adjustment of patients, parents and siblings when facing a diagnosis of cancer in the child. Differences across members within one family and differences between families speak to the need of screening all family members and intervening at the level of individual as well as the family unit.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Annick Lena De Paepe
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Koenraad Norga
- Department of Pediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
| | - Veerle Cosyns
- Department of Pediatric Oncology, University Hospital Brussels, Brussels, Belgium
| | - Hanne Morren
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Trui Vercruysse
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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8
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Kosir U, Wiedemann M, Wild J, Bowes L. Psychiatric disorders in adolescent cancer survivors: A systematic review of prevalence and predictors. Cancer Rep (Hoboken) 2019. [DOI: 10.1002/cnr2.1168] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Urska Kosir
- Department of Experimental PsychologyUniversity of Oxford Oxford UK
| | - Milan Wiedemann
- Department of Experimental PsychologyUniversity of Oxford Oxford UK
- Clinical Informatics Research OfficeOxford NIHR Mental Health Biomedical Research Centre Oxford UK
| | - Jennifer Wild
- Department of Experimental PsychologyUniversity of Oxford Oxford UK
| | - Lucy Bowes
- Department of Experimental PsychologyUniversity of Oxford Oxford UK
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9
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Hall T. Creative, Culturally-Sensitive Counseling for Pediatric Oncology Patients Undergoing Treatment. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2019. [DOI: 10.1080/15401383.2018.1527738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Tabitha Hall
- Troy University, Troy, Alabama, The United States
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10
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Burns W, Péloquin K, Rondeau É, Drouin S, Bertout L, Lacoste-Julien A, Krajinovic M, Laverdière C, Sinnett D, Sultan S. Cancer-related effects on relationships, long-term psychological status and relationship satisfaction in couples whose child was treated for leukemia: A PETALE study. PLoS One 2018; 13:e0203435. [PMID: 30192798 PMCID: PMC6128557 DOI: 10.1371/journal.pone.0203435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/21/2018] [Indexed: 01/21/2023] Open
Abstract
Objectives Follow-up studies suggest that the psychosocial impact of pediatric cancer on parents often extends beyond the end of their child’s cancer treatments, and parents can continue to experience both individual and relationship effects. In a long-term study of parents of children who were treated for acute lymphoblastic leukemia (ALL), we aimed to: 1) describe parents’ adjustment (psychological distress, relationship satisfaction; 2) describe the perceived impact of cancer on couples’ relationship, and; 3) identify to what extent the perceived impact of cancer on the couple is related to both parents’ long-term adjustment. Methods Parents of childhood ALL survivors (n = 103 couples) were surveyed as part of a cohort recall (PETALE cohort). Both parents completed questionnaires exploring adjustment (Brief Symptom Inventory-18, Dyadic Adjustment Scale) and perceived impact of cancer on the relationship (Impact of Cancer on the Couple). Mothers’ and fathers’ scores were compared using MANOVAs. We also examined the degree to which a parent’s perceived changes in relationship dynamics following their child’s cancer were associated with their own current adjustment (actor effects), and their partner’s current adjustment (partner effects) using the Actor-Partner Interdependence Model (APIM). Results Frequencies of current distress were normative in parents (mothers/fathers): general distress (6.8/7.8%), anxiety (5.8/6.8%), depression (2.9/6.8%), somatization (13.6/9.7%), and relationship distress (21.4/20.4%). Mothers and fathers typically agreed on their reported relationship satisfaction, and the perceived nature of relationship changes following the illness. Dyadic analyses indicated that whereas mothers’ adjustment was related to their own perceived relationship changes, fathers’ adjustment was primarily related to their partner’s perceptions. Conclusion In long-term stable couples, mothers may act as an influential bridge connecting the illness experiences of survivors and fathers. This could explain why mothers’ perceptions of relationship changes were related to their partners’ long-term adjustment, which was not the case for fathers.
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Affiliation(s)
- Willow Burns
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Katherine Péloquin
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | | | - Maja Krajinovic
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
- * E-mail:
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11
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Gutiérrez-Colina AM, Lee JL, VanDellen M, Mertens A, Marchak JG. Family Functioning and Depressive Symptoms in Adolescent and Young Adult Cancer Survivors and Their Families: A Dyadic Analytic Approach. J Pediatr Psychol 2018; 42:19-27. [PMID: 28173209 DOI: 10.1093/jpepsy/jsw041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/09/2016] [Accepted: 04/15/2016] [Indexed: 11/14/2022] Open
Abstract
Background To examine dyadic relationships between depressive symptoms and family functioning in families of pediatric cancer survivors. Methods Sixty-four adolescent and young adult (AYA) cancer survivors and their caregivers self-reported on depressive symptoms and family functioning. Multilevel modeling analyses were used to test actor–partner interdependence models. Results Significant actor effects of depressive symptoms on domains of family functioning were found for AYAs and their caregivers. Only caregivers’ depressive symptoms exerted a significant effect on AYAs’ report of family cohesion, indicating the presence of significant partner effects for AYAs. Conclusions AYAs’ and caregivers’ depressive symptoms are related to poorer family functioning. Caregivers’ perceptions of depressive symptoms relate not only to their own perceptions of family functioning but also to that of their children. These findings begin to map the complex relationships that exist between AYAs and their caregivers and elucidate some of the mechanisms through which caregiver-related variables affect AYA outcomes.
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Affiliation(s)
| | - Jennifer L Lee
- Children's Healthcare of Atlanta.,Emory University School of Medicine
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12
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Deatrick JA, Barakat LP, Knafl GJ, Hobbie W, Ogle S, Ginsberg JP, Fisher MJ, Hardie T, Reilly M, Broden E, Toth J, SanGiacomo N, Knafl KA. Patterns of family management for adolescent and young adult brain tumor survivors. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:321-332. [PMID: 29698006 PMCID: PMC5926795 DOI: 10.1037/fam0000352] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Little is known about how families systemically incorporate the work of caring for adolescent and young adult (AYA) survivors of childhood brain tumors who often remain dependent on their families well into adulthood. The primary aim of this study was to develop a typology of family management (FM) patterns for AYA survivors. The secondary aims were to compare them with FM patterns previously described for children with chronic health conditions and to validate the patterns using quantitative and qualitative data. Guided by the Family Management Styles Framework, a sequential, mixed-methods design was used to gather quantitative data from 186 mothers (primary caregivers) and 134 AYA survivors. FM patterns (family focused; somewhat family focused; somewhat condition focused; and condition focused) were identified using cluster analysis of data from the Family Management Measure. FM patterns were found to be similar to those for children with chronic health physical conditions and were significantly related to maternal quality of life, survivor quality of life (health-related quality of life [self- and mother proxy report]), cancer-related variables (treatment intensity, medical late effects), and family functioning in theoretically meaningfully ways. Significant demographic characteristics included private insurance and AYA survivors' engagement in school or employment. Qualitative analysis of data from 45 interviews with mothers from the larger sample provided additional support for and elaborated descriptions of FM patterns. Identification of FM patterns moves the science of family caregiving forward by aggregating data into a conceptually based typology, thereby taking into account the complex intersection of the condition, the family, and condition management. (PsycINFO Database Record
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Affiliation(s)
| | | | - George J Knafl
- School of Nursing, University of North Carolina at Chapel Hill
| | | | - Sue Ogle
- The Children's Hospital of Philadelphia
| | | | | | - Thomas Hardie
- Hardie, School of Nursing, University of Pennsylvania
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13
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Friend AJ, Feltbower RG, Hughes EJ, Dye KP, Glaser AW. Mental health of long‐term survivors of childhood and young adult cancer: A systematic review. Int J Cancer 2018; 143:1279-1286. [DOI: 10.1002/ijc.31337] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 01/26/2018] [Accepted: 02/08/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Amanda J. Friend
- School of MedicineUniversity of LeedsLeeds United Kingdom
- Leeds Institute of Data Analytics, University of LeedsLeeds United Kingdom
- Leeds Institute for Cancer and Pathology, University of LeedsLeeds United Kingdom
- Department of Paediatric OncologyLeeds Children's Hospital, Clarendon Wing, Leeds General InfirmaryLeeds United Kingdom
| | - Richard G. Feltbower
- School of MedicineUniversity of LeedsLeeds United Kingdom
- Leeds Institute of Data Analytics, University of LeedsLeeds United Kingdom
| | - Emily J. Hughes
- School of MedicineUniversity of SouthamptonSouthampton United Kingdom
| | - Kristian P. Dye
- Department of AnaestheticsYork Teaching Hospitals NHS TrustYork United Kingdom
| | - Adam W Glaser
- School of MedicineUniversity of LeedsLeeds United Kingdom
- Leeds Institute of Data Analytics, University of LeedsLeeds United Kingdom
- Leeds Institute for Cancer and Pathology, University of LeedsLeeds United Kingdom
- Department of Paediatric OncologyLeeds Children's Hospital, Clarendon Wing, Leeds General InfirmaryLeeds United Kingdom
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14
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Abstract
Adolescent and young adult (AYA) individuals with a history of cancer make up a fraction of the total number of cancer survivors in the United States, but they represent a population with needs distinct from either the childhood or the older adult cancer populations. Fertility concerns, psychosocial factors, and health care access are just a few of the distinguishing characteristics. Caring for AYA cancer survivors presents unique opportunities for primary care providers to collaborate with oncology colleagues to minimize the long-term cancer burden.
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Affiliation(s)
- Linda Overholser
- Division of General Internal Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B180, Aurora, CO 80045, USA.
| | - Kristin Kilbourn
- Department of Psychology, College of Liberal Arts and Sciences, University of Colorado Denver, 1200 Larimer Street, NC 5002-M, PO Box 173364, Denver, CO 80017, USA
| | - Arthur Liu
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Ct, MS F706 Aurora, CO 80045, USA
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Anxiety Among Adolescent Survivors of Pediatric Cancer. J Adolesc Health 2017; 61:409-423. [PMID: 28729145 PMCID: PMC5665366 DOI: 10.1016/j.jadohealth.2017.04.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 04/14/2017] [Accepted: 04/14/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this review was to synthesize current knowledge about anxiety among adolescent survivors of pediatric cancer and highlights areas for future research. METHODS Systematic literature searches were conducted in five databases for articles published anytime before December 28, 2015. Manuscripts were reviewed by a team of six coders. Included manuscripts reported outcomes relevant to anxiety, worry, and post-traumatic stress in survivors of pediatric cancer (age at the time of study: 10-22 years) who were off treatment. RESULTS Twenty-four articles met inclusion criteria. Included results were categorized into the following domains: post-traumatic stress, anxiety, cancer-related worry, and interventions. With the exception of post-traumatic stress, there was little research about anxiety in this population; however, studies generally indicated that adolescent survivors of pediatric cancer are at elevated risk for anxiety, post-traumatic stress symptoms, and cancer-related worry. CONCLUSIONS This review provides preliminary evidence that anxiety is a relevant, but understudied, psychosocial outcome for adolescent survivors of pediatric cancer. More research is needed to better understand the presentation of anxiety in this population, its effect on survivors' quality of life, and possible areas for intervention.
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Kay JS, Juth V, Silver RC, Sender LS. Support and conflict in relationships and psychological health in adolescents and young adults with cancer. J Health Psychol 2017; 24:502-517. [PMID: 28810372 DOI: 10.1177/1359105316676629] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Perceived support and conflict between adolescents and young adults with cancer and their primary caregivers, other family, close friends, and medical staff were examined in relation to adolescents and young adults' psychological health. Adolescents and young adults ( n = 115, 51% male, ages 12-24 years, M (standard deviation) = 16.07 (2.29)) in outpatient cancer treatment perceived more support and conflict within familial relationships than other relationships. Among familial relationships, perceived support and conflict were associated with psychological health; within other relationships, only support was associated with psychological health. Interactions among family were most strongly correlated with psychological distress; interactions with friends were stronger correlates of posttraumatic stress symptoms, positive affect, and posttraumatic growth.
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Affiliation(s)
| | | | | | - Leonard S Sender
- 1 University of California, Irvine, USA.,2 Children's Hospital of Orange County, USA
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Thabrew H, McDowell H, Given K, Murrell K. Systematic Review of Screening Instruments for Psychosocial Problems in Children and Adolescents With Long-Term Physical Conditions. Glob Pediatr Health 2017; 4:2333794X17690314. [PMID: 28255576 PMCID: PMC5315369 DOI: 10.1177/2333794x17690314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/27/2016] [Indexed: 01/03/2023] Open
Abstract
Children and adolescents with long-term physical conditions (LTPCs) are at greater risk of developing psychosocial problems. Screening for such problems may be undertaken using validated psychometric instruments to facilitate early intervention. A systematic review was undertaken to identify clinically utilized and psychometrically validated instruments for identifying depression, anxiety, behavior problems, substance use problems, family problems, and multiple problems in children and adolescents with LTPCs. Comprehensive searches of articles published in English between 1994 and 2014 were completed via Medline, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases, and by examining reference lists of identified articles and previous related reviews. Forty-four potential screening instruments were identified, described, and evaluated against predetermined clinical and psychometric criteria. Despite limitations in the evidence regarding their clinical and psychometric validity in this population, a handful of instruments, available at varying cost, in multiple languages and formats, were identified to support targeted, but not universal, screening for psychosocial problems in children and adolescents with LTPCs.
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18
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Al-Gamal E, Long T. Psychometric properties of the Arabic version of the PedsQL Family Impact Scale. J Res Nurs 2016. [DOI: 10.1177/1744987116670204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Treatment of childhood cancer and its side effects can exert a negative impact on patients’ parents. A valid and reliable instrument to measure family functioning in Arabic families was considered to be a vital resource. The Pediatric Quality of Life Inventory (PedsQL) Family Impact Scale and the PedsQL Healthcare Satisfaction Hematology/Oncology Scale – Parent Report were completed by 113 Jordanian parents of children with cancer. Cronbach’s alpha coefficient was found to be excellent at 0.93 for the total PedsQL Family Impact Scale, which correlated significantly with the PedsQL Healthcare Satisfaction Hematology/Oncology Scale – Parent Report demonstrating good construct validity. The Arabic version of the PedsQL Family Impact Scale is both valid and reliable for use with parents of children with cancer.
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Affiliation(s)
- Ekhlas Al-Gamal
- Associate Professor, Faculty of Nursing, The University of Jordan, Jordan
- Associate Professor, College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Tony Long
- Professor of Child and Family Health, School of Nursing, Midwifery and Social Work, University of Salford, UK
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Prevalence and predictors of posttraumatic stress symptoms in parents of children with ongoing treatment for cancer in South China: a multi-centered cross-sectional study. Support Care Cancer 2016; 25:1159-1167. [PMID: 27966022 DOI: 10.1007/s00520-016-3506-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Parents of children with ongoing cancer treatment are exposed to risks of developing posttraumatic stress symptoms (PTSS), but little is known about the prevalence and predictors of PTSS among Chinese parents of children with cancer. This study aimed to examine the predictors of PTSS, and explored the correlation of depression, resilience, and family functions with severe PTSS. METHODS This cross-sectional survey was conducted from May 2014 to September 2015 among the parents of cancer children treated in four general hospitals in South China. PTSS in the parents were measured using post-traumatic stress checklist-civilian version (PCL-C). Multiple regression analyses were performed to evaluate the predictive values of depression, resilience, family functioning, and the demographic variables for severe PTSS. RESULTS A total of 279 parents (192 mothers and 87 fathers) participated in the survey. Severe PTSS, as defined by a PCL-C score ≥50, were reported in 32.97% (n = 92) of the total participants, 26.44% (23/87) in the fathers and 35.94% (69/192) in the mothers. The level of PTSS was positively correlated with depression (r = 0.782, P < 0.01) and a poor general family function (r = 0.325, P < 0.01) and negatively correlated with resilience (r = -0.236, P < 0.01). Multivariate analyses indicated that depression, general family function, gender, and education level were significant predictive factors of severe PTSS in the overall parents, accounting for 64.2% of the variance in the prediction of PTSS (R 2 = 0.642, F = 122.602, P = 0.000). For the mothers, depression and family function accounted for 66.5% of the variance in the prediction of PTSS (R 2 = 0.665, F = 187.451, P = 0.000); for the fathers, depression and educational level accounted for 58.8% of the variance in the prediction of PTSS (R 2 = 0.588, F = 59.829, P = 0.000). CONCLUSION Parents, especially the mothers, of children with ongoing treatment for cancer are at risk of developing PTSS. Supportive psychological interventions to attenuate the negative emotions of the parents and improve their family functions are important means to promote their natural protective mechanisms to cope with the stressful events.
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20
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Van Schoors M, Caes L, Knoble NB, Goubert L, Verhofstadt LL, Alderfer MA. Systematic Review: Associations Between Family Functioning and Child Adjustment After Pediatric Cancer Diagnosis: A Meta-Analysis. J Pediatr Psychol 2016; 42:6-18. [DOI: 10.1093/jpepsy/jsw070] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 07/20/2016] [Accepted: 07/27/2016] [Indexed: 11/12/2022] Open
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21
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Sultan S, Leclair T, Rondeau É, Burns W, Abate C. A systematic review on factors and consequences of parental distress as related to childhood cancer. Eur J Cancer Care (Engl) 2016; 25:616-37. [PMID: 26354003 PMCID: PMC5049674 DOI: 10.1111/ecc.12361] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 01/08/2023]
Abstract
The literature including correlates of parental distress as related to childhood cancer is abundant. It is important to identify predictive factors and outcomes of this distress in parents. The objective of this review was to update previous syntheses on factors of distress and to identify outcomes of parents' distress in the recent literature (2007-2012). We performed a systematic review to identify all quantitative studies including measures of parental distress and associated factors during the study period. We found 56 eligible studies, of which 43 had a Low risk of bias (Cochrane guidelines). Forty-two reports included potential predictive factors. Significant relationships were found with clinical history of the child, sex of the parent, coping response and personal resources, pre-diagnosis family functioning, but not education/income or marital status. Twenty-five reports studied potential consequences of distress and focused on psychological adjustment in parents and children. Compared to past periods, a higher proportion of studies included fathers. Measures used to evaluate distress were also more homogeneous in certain domains of distress. This review underscores the need for appropriate methods for selecting participants and reporting results in future studies. Appropriate methods should be used to demonstrate causality between factors/consequences and distress.
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Affiliation(s)
- S Sultan
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Centre de cancérologie Charles-Bruneau, Hôpital Sainte-Justine, CHU Sainte-Justine, Montreal, QC, Canada
| | - T Leclair
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - É Rondeau
- Centre de cancérologie Charles-Bruneau, Hôpital Sainte-Justine, CHU Sainte-Justine, Montreal, QC, Canada
| | - W Burns
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - C Abate
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
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Bitsko MJ, Cohen D, Dillon R, Harvey J, Krull K, Klosky JL. Psychosocial Late Effects in Pediatric Cancer Survivors: A Report From the Children's Oncology Group. Pediatr Blood Cancer 2016; 63:337-43. [PMID: 26488337 PMCID: PMC4715481 DOI: 10.1002/pbc.25773] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/31/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND This review was conducted to update the Children's Oncology Group (COG) Long-Term Follow-Up Guidelines (COG-LTFU Guidelines, version 4.0) regarding screening for psychosocial late effects of pediatric cancer. PROCEDURE Articles published between August 2009 and January 2011 that addressed psychosocial late effects of long-term survivors of pediatric cancer (n = 35) were reviewed by a multidisciplinary team of COG late effect experts. RESULTS The majority of studies in this time period indicate that survivors experience few psychosocial problems in long-term survivorship. A critical subset, however, is at increased risk for psychosocial late effects secondary to the treatment. Highlighted findings from this review include increased rates of suicidal ideation (SI), and health beliefs as robust predictors of SI, anxiety, and global distress. Survivors' health beliefs were associated with their perceptions of physical limitations, overall late effects, and cancer-related pain. While many survivorship studies continue to specify risk factors for anxiety and posttraumatic stress symptoms/posttraumatic stress disorder, others outcomes (e.g., developmental, interpersonal, and familial factors) appear to be emerging in importance. CONCLUSIONS Although the majority of childhood cancer survivors do not experience psychosocial problems, a subset will. The recent research findings have been included in the new COG-LTFU Guidelines that will assist in the targeted assessment and the treatment of survivors' psychosocial health.
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Affiliation(s)
- Matthew J. Bitsko
- Children’s Hospital of Richmond, Richmond, VA 23298, USA,Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, 23298, USA,Correspondence to: Matthew J. Bitsko, PhD, Children’s Hospital of Richmond at VCU, Department of Pediatrics, PO Box 980440, Virginia Commonwealth University, Richmond, VA 23298-0440, Tel: 804-828-9048,
| | - Debra Cohen
- Children’s Hospital of Richmond, Richmond, VA 23298, USA,Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Robyn Dillon
- Children’s Hospital of Richmond, Richmond, VA 23298, USA,Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Jeanne Harvey
- Cardinal Glennon Children’s Medical Center, St. Louis, MO, USA
| | - Kevin Krull
- Departments of Epidemiology & Cancer Control and Psychology
| | - James L. Klosky
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis TN, USA
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23
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Kostak MA, Avci G. Hopelessness and depression levels of parents of children with cancer. Asian Pac J Cancer Prev 2014; 14:6833-8. [PMID: 24377613 DOI: 10.7314/apjcp.2013.14.11.6833] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The purpose of this descriptive study was to determine the hopelessness and depression levels of parents of children diagnosed with cancer and undergoing cancer treatment and factors affecting these levels. The study was carried out with parents of 44 children receiving treatment in a paediatric haematology clinic of a university hospital. Data were collected using a survey form, the Beck Hopelessness Scale (BHS) and the Beck Depression Scale (BDS). The mean BDS score of the mothers and fathers was 18.3 ± 11.30 and 15.2 ± 11.33, respectively. The mean BHS score of the mothers was 6.45 ± 4.40, whereas the mean BHS score of the fathers was 5.88 ± 4.27. The results showed that the levels of hopelessness and depression among the mothers were higher than among the fathers (p<0.001). There was a positive relationship between the hopelessness and depression scores of the mothers and the fathers (p<0.05), and the levels of hopelessness and depression scores of the fathers increased as those of the mothers increased. A weak financial situation of the family increased the hopelessness and depression levels of the fathers. The hopelessness and depression levels of the mothers who were supported by their families and relatives were decreased compared to those without such support (p<0.05). The results show that the parents of children with cancer face many psychosocial and spiritual problems. Using simple screening tools, nurses can identify at-risk parents and direct them to support services. We conclude that actively encouraging families to avail themselves of support resources and supporting them financially would positively affect the levels of depression and hopelessness of parents of children with cancer.
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Affiliation(s)
- Melahat Akgun Kostak
- Department of Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey E-mail :
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24
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Ljungman L, Cernvall M, Grönqvist H, Ljótsson B, Ljungman G, von Essen L. Long-term positive and negative psychological late effects for parents of childhood cancer survivors: a systematic review. PLoS One 2014; 9:e103340. [PMID: 25058607 PMCID: PMC4110004 DOI: 10.1371/journal.pone.0103340] [Citation(s) in RCA: 147] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 06/28/2014] [Indexed: 01/07/2023] Open
Abstract
Increasing survival rates in childhood cancer have yielded a growing population of parents of childhood cancer survivors (CCSs). This systematic review compiles the literature on positive and negative long-term psychological late effects for parents of CCSs, reported at least five years after the child's diagnosis and/or two years after the end of the child's treatment. Systematic searches were made in the databases CINAHL, EMBASE, PsycINFO, and PubMed. Fifteen studies, published between 1988 and 2010, from 12 projects were included. Thirteen studies used quantitative methodology, one quantitative and qualitative methodology, and one qualitative methodology. A total of 1045 parents participated in the reviewed studies. Mean scores were within normal ranges for general psychological distress, coping, and family functioning. However, a substantial subgroup reported a clinical level of general psychological distress, and 21–44% reported a severe level of posttraumatic stress symptoms. Worry, disease-related thoughts and feelings, marital strains, as well as posttraumatic growth was reported. Several factors were associated with the long-term late effects, such as parents' maladaptive coping during earlier stages of the childs disease trajectory and children's current poor adjustment. Quality assessments of reviewed studies and clinical implications of findings are discussed and recommendations for future research are presented.
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Affiliation(s)
- Lisa Ljungman
- Psychosocial Oncology and Supportive Care, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Martin Cernvall
- Psychosocial Oncology and Supportive Care, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Psychosocial Oncology and Supportive Care, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Gustaf Ljungman
- Department of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden
| | - Louise von Essen
- Psychosocial Oncology and Supportive Care, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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25
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Kasparian NA, Rutstein A, Sansom-Daly UM, Mireskandari S, Tyler J, Duffy J, Tucker KM. Through the looking glass: an exploratory study of the lived experiences and unmet needs of families affected by Von Hippel-Lindau disease. Eur J Hum Genet 2014; 23:34-40. [PMID: 24690678 DOI: 10.1038/ejhg.2014.44] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 01/27/2014] [Accepted: 02/13/2014] [Indexed: 12/31/2022] Open
Abstract
Despite well-established protocols for the medical management of Von Hippel-Lindau disease (VHL), families affected by this rare tumour syndrome continue to face numerous psychological, social, and practical challenges. To our knowledge, this is one of the first qualitative studies to explore the psychosocial difficulties experienced by families affected by VHL. A semi-structured interview was developed to explore patients' and carers' experiences of VHL along several life domains, including: self-identity and self-esteem, interpersonal relationships, education and career opportunities, family communication, physical health and emotional well-being, and supportive care needs. Quantitative measures were also used to examine the prevalence of anxiety, depression, and disease-specific distress in this sample. Participants were recruited via the Hereditary Cancer Clinic at the Prince of Wales Hospital in Sydney, Australia. A total of 23 individual telephone interviews were conducted (15 patients, 8 carers), yielding a response rate of 75%. A diverse range of experiences were reported, including: sustained uncertainty about future tumour development, frustration regarding the need for lifelong medical screening, strained family relationships, difficulties communicating with others about VHL, perceived social isolation and limited career opportunities, financial and care-giving burdens, complex decisions in relation to childbearing, and difficulties accessing expert medical and psychosocial care. Participants also provided examples of psychological growth and resilience, and voiced support for continued efforts to improve supportive care services. More sophisticated systems for connecting VHL patients and their families with holistic, empathic, and person-centred medical and psychosocial care are urgently needed.
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Affiliation(s)
- Nadine A Kasparian
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Alison Rutstein
- 1] Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia [2] Psychosocial Research Group, Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Ursula M Sansom-Daly
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Shab Mireskandari
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Janet Tyler
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Jessica Duffy
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Katherine M Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW, Australia
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Kim MA, Yi J. Psychological distress in adolescent and young adult survivors of childhood cancer in Korea. J Pediatr Oncol Nurs 2013; 30:99-108. [PMID: 23508241 DOI: 10.1177/1043454213478469] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study examined psychological distress levels, their differences across groups based on sociodemographic and medical variables, and risk factors for significant distress in adolescent and young adult childhood cancer survivors in Korea. Participants consisted of 223 Korean survivors of childhood cancer between 15 and 39 years of age. Psychological distress was measured using the Brief Symptom Inventory-18. A series of t tests, binomial proportion tests, analysis of variance, and univariable and multivariable logistic regressions were used. One fifth of the participants were classified as psychologically distressed. Significant levels of psychological distress were associated with age, economic status, and time since diagnosis. The results indicate a greater need for monitoring and follow-up care related to psychological health in childhood cancer survivors. Outreach and collaboration with health care professionals to increase mental health referrals could provide opportunities to address the needs of childhood cancer survivors in terms of their psychological well-being.
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Affiliation(s)
- Min Ah Kim
- University of Southern California, Los Angeles, CA, USA.
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Wesley KM, Zelikovsky N, Schwartz LA. Physical symptoms, perceived social support, and affect in adolescents with cancer. J Psychosoc Oncol 2013; 31:451-67. [PMID: 23844924 PMCID: PMC4479176 DOI: 10.1080/07347332.2013.798761] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Treatment for cancer among adolescents is often more intense and lasts longer than treatment for older or younger patients. It typically causes pain, fatigue, and nausea and affects social and emotional well-being. This study examined the relationships among demographics, physical symptoms, perceived social support from friends and family, and affect (positive and negative) in 102 adolescents (age 13-19) with cancer using correlational analyses. Additionally, perceived social support was explored as a mediator and moderator of the relationship between physical symptoms and affect using regression. Females reported significantly lower friend support and higher negative affect compared to males. Minority participants were more likely to endorse physical symptoms and less negative affect compared to White respondents. Higher report of physical symptoms was significantly related to greater negative affect, whereas higher perceived social support from friends was related to higher positive affect. Adolescents consistently reported high levels of social support from family and friends. Additionally, adolescents tended to report average levels of positive affect and low levels of negative affect compared to healthy populations. No significant mediation or moderation effects were found. This research highlights that females and minorities, and those with greater physical symptoms, may be more vulnerable to poor adjustment to cancer during adolescence. However, overall this study lends support to the notion that adolescents with cancer are an especially resilient population, as these patients endorsed generally high levels of social support and positive affect, with low levels of negative affect.
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Affiliation(s)
- Kimberly M Wesley
- Department of Psychology, La Salle University, Philadelphia, PA 19141, USA.
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28
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Morgan G, Johnsen J. Might salicylate exert benefits against childhood cancer? Ecancermedicalscience 2010; 4:156. [PMID: 22276025 PMCID: PMC3234022 DOI: 10.3332/ecancer.2010.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2009] [Indexed: 11/06/2022] Open
Abstract
Childhood cancers are a broad range of diseases. Research on the chemopreventive potential of non-steroidal anti-inflammatory drugs, such as aspirin (acetylsalicylate) has yet to be fully directed towards childhood cancers. A prima facie hypothesis on salicylate and childhood cancer would therefore be based on several factors. Firstly, salicylate inhibits the production of inflammatory prostaglandins, which have been shown to stimulate the growth of cancer cells. Secondly, salicylate inhibits the growth of cancer cells in pre-clinical models. Thirdly, salicylate is a natural component of fruits and vegetables so it is consumed within the diet. Further research, of which some possibilities are identified, is recommended.
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Affiliation(s)
- G Morgan
- Fellow of the Royal Institute for Public Health, National Health Service for Wales, Wales, UK
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