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Pletschko T, Knasmüller S, Schwarzinger A, Weiler-Wichtl L, Slavc I, Deimann P, Kastner-Koller U, Hansl R, Leiss U. Assessment of Participation in Pediatric Neuropsychology. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2022. [DOI: 10.1024/1016-264x/a000367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract: Pediatric patients with chronic health conditions often suffer from social and academic exclusion. Since disease-centered assessments do not allow for differentiated biopsychosocial profiling, this study aims to evaluate the psychometric quality of “The School Participation Scales 24/7,” a novel ICF-CY-based assessment tool. Results show high fit indices for most subscales, signifying structural equality between the tool and the ICF-CY. Acceptable criterion validity is given for established neuropsychological tests. Internal consistency and retest analyses revealed that most subscales reliably and stably measure the intended domains. Finally, the tool was standardized using a representative healthy sample. In summary, the S-PS 24/7 represents a useful tool for measuring school participation in pediatric patients, thereby building a profound basis for effective interventions.
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Affiliation(s)
- Thomas Pletschko
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Stephanie Knasmüller
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Agathe Schwarzinger
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Liesa Weiler-Wichtl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Pia Deimann
- Faculty of Psychology, University of Vienna, Austria
| | | | - Rita Hansl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Ulrike Leiss
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
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Barrios P, Enesco I, Varea E. Emotional Experience and Type of Communication in Oncological Children and Their Mothers: Hearing Their Testimonies Through Interviews. Front Psychol 2022; 13:834312. [PMID: 35686067 PMCID: PMC9171433 DOI: 10.3389/fpsyg.2022.834312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
The emotional experience and the type of communication about cancer within the family are important factors for successful coping with pediatric oncology. The main purpose is to study mother’s and children’s emotional experiences concerning cancer, whether they communicate openly about the disease, and relationships between the type of communication and the different emotions expressed by the children. Fifty-two cancer patients aged 6–14 years and their mothers were interviewed in separate sessions about the two central themes of the study: emotional experiences and type of communication. Analyses of response categories were performed to subsequently compare the age-groups and the mother–child responses. According to the results, mothers expressed emotions such as fear, sadness, or anxiety, while children report sadness, pain, but also happiness. Significant positive correlations were observed between mothers’ sadness and older children’s sadness, mothers’ anxiety and children’s fear, and mothers’ anxiety and children’s happiness. Regarding communication type, mothers tend to hide information about the disease from younger children and to provide direct information to the older children. Children usually prefer to communicate their concerns to parents; however, children whose mothers convey anxiety are more likely to prefer to communicate with others. These results support the idea that parents should talk honestly with their children, explaining their illness in an age-appropriate way, and encouraging them to share their emotional experiences. Further studies are needed from a developmental perspective to understand the disease management of children and families.
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Affiliation(s)
- Paula Barrios
- Departamento de Investigación y Psicología en Educación, Complutense University of Madrid, Madrid, Spain
| | - Ileana Enesco
- Departamento de Investigación y Psicología en Educación, Complutense University of Madrid, Madrid, Spain
| | - Elena Varea
- Departamento de Investigación y Psicología en Educación, Complutense University of Madrid, Madrid, Spain
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Khattak H, Malhas R, Craciunas L, Afifi Y, Amorim CA, Fishel S, Silber S, Gook D, Demeestere I, Bystrova O, Lisyanskaya A, Manikhas G, Lotz L, Dittrich R, Colmorn LB, Macklon KT, Hjorth IMD, Kristensen SG, Gallos I, Coomarasamy A. Fresh and cryopreserved ovarian tissue transplantation for preserving reproductive and endocrine function: a systematic review and individual patient data meta-analysis. Hum Reprod Update 2022; 28:400-416. [PMID: 35199164 PMCID: PMC9733829 DOI: 10.1093/humupd/dmac003] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 12/29/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Ovarian tissue cryopreservation involves freezing and storing of surgically retrieved ovarian tissue in liquid or vapour nitrogen below -190°C. The tissue can be thawed and transplanted back with the aim of restoring fertility or ovarian endocrine function. The techniques for human ovarian tissue freezing and transplantation have evolved over the last 20 years, particularly in the context of fertility preservation in pre-pubertal cancer patients. Fresh ovarian tissue transplantation, using an autograft or donor tissue, is a more recent development; it has the potential to preserve fertility and hormonal function in women who have their ovaries removed for benign gynaecological conditions. The techniques of ovarian tissue cryopreservation and transplantation have progressed rapidly since inception; however, the evidence on the success of this intervention is largely based on case reports and case series. OBJECTIVE AND RATIONALE The aim of this study was to systematically review the current evidence by incorporating study-level and individual patient-level meta-analyses of women who received ovarian transplants, including frozen-thawed transplant, fresh or donor graft. SEARCH METHODS The review protocol was registered with PROSPERO (CRD42018115233). A comprehensive literature search was performed using MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials from database inception to October 2020. Authors were also contacted for individual patient data if relevant outcomes were not reported in the published manuscripts. Meta-analysis was performed using inverse-variance weighting to calculate summary estimates using a fixed-effects model. OUTCOMES The review included 87 studies (735 women). Twenty studies reported on ≥5 cases of ovarian transplants and were included in the meta-analysis (568 women). Fertility outcomes included pregnancy, live birth and miscarriage rates, and endocrine outcomes included oestrogen, FSH and LH levels. The pooled rates were 37% (95% CI: 32-43%) for pregnancy, 28% (95% CI: 24-34%) for live birth and 37% (95% CI: 30-46%) for miscarriage following frozen ovarian tissue transplantation. Pooled mean for pre-transplant oestrogen was 101.6 pmol/l (95% CI: 47.9-155.3), which increased post-transplant to 522.4 pmol/l (95% CI: 315.4-729; mean difference: 228.24; 95% CI: 180.5-276). Pooled mean of pre-transplant FSH was 66.4 IU/l (95% CI: 52.8-84), which decreased post-transplant to 14.1 IU/l (95% CI: 10.9-17.3; mean difference 61.8; 95% CI: 57-66.6). The median time to return of FSH to a value <25 IU/l was 19 weeks (interquartile range: 15-26 weeks; range: 0.4-208 weeks). The median duration of graft function was 2.5 years (interquartile range: 1.4-3.4 years; range: 0.7-5 years). The analysis demonstrated that ovarian tissue cryopreservation and transplantation could restore reproductive and hormonal functions in women. Further studies with larger samples of well-characterized populations are required to define the optimal retrieval, cryopreservation and transplantation processes. WIDER IMPLICATIONS Ovarian tissue cryopreservation and transplantation may not only be effective in restoring fertility but also the return of reproductive endocrine function. Although this technology was developed as a fertility preservation option, it may have the scope to be considered for endocrine function preservation.
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Affiliation(s)
- Hajra Khattak
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and
Systems Research, University of Birmingham, Birmingham, UK,Correspondence address. Clinical Research Fellow Tommy’s National
Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University
of Birmingham, Birmingham B15 2 TT, UK. E-mail:
https://orcid.org/0000-0002-7330-3825
| | - Rosamund Malhas
- Birmingham Women’s and Children’s NHS Foundation Trust,
Birmingham, UK
| | - Laurentiu Craciunas
- Population Health Sciences Institute, Newcastle University, Newcastle upon
Tyne, UK
| | - Yousri Afifi
- Birmingham Women’s and Children’s NHS Foundation Trust,
Birmingham, UK
| | - Christiani A Amorim
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et
Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Simon Fishel
- CARE Fertility Group, Nottingham, UK,School of Pharmacy and Biomolecular Sciences, Liverpool John Moores
University, Liverpool, UK
| | | | - Debra Gook
- Reproductive Services/Melbourne IVF, The Royal Women’s Hospital,
Parkville, VIC, Australia
| | - Isabelle Demeestere
- Research Laboratory on Human Reproduction, Faculty of Medicine, Université
Libre de Bruxelles (ULB), Brussels, Belgium
| | - Olga Bystrova
- AVA-PETER Fertility Clinic, Saint-Petersburg, Russia
| | - Alla Lisyanskaya
- Division of Gynecologic Oncology, Saint-Petersburg City Oncology
Clinic, Saint-Petersburg, Russia
| | - Georgy Manikhas
- Department of Oncology of the First Pavlov State Medical University of
Saint-Petersburg, Saint-Petersburg, Russia
| | - Laura Lotz
- Department of Obstetrics and Gynecology, Erlangen University Hospital,
Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ralf Dittrich
- Department of Obstetrics and Gynecology, Erlangen University Hospital,
Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Lotte Berdiin Colmorn
- The Fertility Clinic, University Hospital of Copenhagen,
Rigshospitalet, Copenhagen, Denmark
| | - Kirsten Tryde Macklon
- The Fertility Clinic, University Hospital of Copenhagen,
Rigshospitalet, Copenhagen, Denmark
| | | | - Stine Gry Kristensen
- Laboratory of Reproductive Biology, The Juliane Marie Centre for Women,
Children and Reproduction, University Hospital of Copenhagen,
Rigshospitalet, Copenhagen, Denmark
| | - Ioannis Gallos
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and
Systems Research, University of Birmingham, Birmingham, UK
| | - Arri Coomarasamy
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and
Systems Research, University of Birmingham, Birmingham, UK
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Sawyer JL, Mishna F, Bouffet E, Saini M, Zlotnik-Shaul R. Bridging the Gap: Exploring the Impact of Hospital Isolation on Peer Relationships Among Children and Adolescents with a Malignant Brain Tumor. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2021; 40:91-105. [PMID: 34025015 PMCID: PMC8130807 DOI: 10.1007/s10560-021-00764-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/24/2021] [Indexed: 06/12/2023]
Abstract
Children and adolescents with complex medical conditions are often uprooted from their environments and isolated in hospital while undergoing treatment. Little is known about how they perceive this isolation and its subsequent impact on their relationships with peers, both during and after isolation for treatment. This study describes the experience of hospital isolation from the perspectives of children and adolescents with a malignant brain tumor. The use and impact of information and communication technologies (ICT) as a possible bridge for contact is also explored. Following a qualitative approach utilizing interpretive phenomenological analysis, in-depth interviews were conducted with eight youth participants who had undergone treatment for medulloblastoma. Data analysis generated three main themes: (1) transforming children and relationships, (2) hospitalization in a digital world, and (3) ICTs as a promising bridge back to school. Study findings provide insight into the experience of hospital isolation for children and adolescents, while highlighting the positive social as well as academic outcomes of frequent, open ended ICT use throughout hospital isolation. This is timely, given the context of the COVID-19 pandemic and its resulting isolation. Considerations for hospital social workers to promote relationships and connection, while facilitating a smooth transition as these children return to school are included.
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Affiliation(s)
- Jami-Leigh Sawyer
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S1V4 Canada
| | - Faye Mishna
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S1V4 Canada
| | - Eric Bouffet
- The Hospital for Sick Children, Toronto, ON Canada
- Department of Paediatrics, University of Toronto, Toronto, ON Canada
| | - Michael Saini
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S1V4 Canada
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Willard VW, Tillery R, Harman JL, Long A, Phipps S. The Influence of Early Childhood Temperament on Later Social-Emotional Functioning in Youth with Cancer. J Pediatr Psychol 2021; 46:433-442. [PMID: 33355354 DOI: 10.1093/jpepsy/jsaa120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/20/2020] [Accepted: 11/18/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE One of the peak incidences of childhood cancer is during the early childhood years. This is also an important time for psychosocial and personality development, and it is well known that early childhood temperament influences later psychosocial functioning. However, this association has not been examined in young children with cancer. METHODS Parents of children with cancer (N = 39) and healthy comparisons (N = 35) completed an indicator of temperament (Children's Behavior Questionnaire) when children were young (Mage=4.99 ± 1.05 years). Five years later, parents and youth completed measures of psychosocial functioning (Mage=10.15 ± 1.10 years; Behavior Assessment Scale for Children, 2nd edition and Social Emotional Assets and Resilience Scale). RESULTS Parents of healthy comparisons reported that their children demonstrated greater surgency than youth with cancer; there were no differences in negative affect or effortful control. Children with cancer and healthy comparisons were rated similarly on measures of psychosocial functioning. Health status was not a significant predictor of later functioning, but socioeconomic status and temperament were. The influence of temperament was stronger for strengths-based functioning (e.g., social competence, adaptive functioning) versus distress (internalizing and externalizing problems). CONCLUSIONS Early childhood temperament is a strong predictor of later psychosocial functioning, regardless of health status. Findings highlight the need to consider temperament in the clinical assessment of psychosocial functioning in children with cancer. Additional research is needed to specifically assess how a diagnosis of cancer in early childhood influences temperament over time.
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Affiliation(s)
| | - Rachel Tillery
- Department of Psychology, St. Jude Children's Research Hospital
| | | | - Alanna Long
- Department of Psychology, St. Jude Children's Research Hospital
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital
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Okado Y, Long A, Phipps S. Profiles and predictors of resilient functioning in youths with pediatric cancer history. J Psychosoc Oncol 2021; 39:493-508. [PMID: 33480312 DOI: 10.1080/07347332.2020.1844843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify and predict resilient functioning over time among youths with pediatric cancer experience (YPCE). DESIGN YPCE aged 8-17 years (N = 231) were followed prospectively for 3 years. Their psychosocial adjustment was assessed using self-report and parent-report at 1 year (T2) and 3 years (T3) post-baseline. METHODS Latent profile analysis identified subgroups of YPCE with different patterns of adjustment over time. Self-reported factors from baseline and T2 were examined as predictors of subgroup membership. FINDINGS Three subgroups of youths were found. Two exhibited average (52.5% of the sample) to better-than-average (41.3%) functioning. One subgroup (6.2%) exhibited subclinical but at-risk range of adjustment. Low optimism and low connectedness to parents and school predicted membership in this group. CONCLUSIONS Most YPCE exhibit resilient functioning across time. However, approximately 6% report persistent maladjustment. IMPLICATIONS Most YPCE are well-adjusted, but those with low optimism and poor connection to parents or school may require monitoring for psychosocial difficulties.
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Affiliation(s)
- Yuko Okado
- Department of Psychology, California State University, Fullerton, California, USA
| | - Alanna Long
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Psychological Outcomes, Health-Related Quality of Life, and Neurocognitive Functioning in Survivors of Childhood Cancer and Their Parents. Pediatr Clin North Am 2020; 67:1103-1134. [PMID: 33131537 DOI: 10.1016/j.pcl.2020.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood cancer disrupts the lives of patients and their families and affects acute and long-term psychological health. This article summarizes (1) psychological challenges, including depression, anxiety, worries, and posttraumatic stress, as well as positive outcomes such as benefit finding and posttraumatic growth in young survivors and parents; (2) health-related quality of life; (3) interventions to support survivors and parents with psychological difficulties; and (4) neurocognitive problems and interventions to help alleviate them. Although many survivors and parents fare well in the long term, many survivors may benefit from interventions. Interventions should be further evaluated and integrated into routine clinical care.
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8
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Barone R, Gulisano M, Cannata E, Padalino S, Saia F, Maugeri N, Pettinato F, Lo Nigro L, Casabona A, Russo G, Di Cataldo A, Rizzo R. Self- and Parent-Reported Psychological Symptoms in Young Cancer Survivors and Control Peers: Results from a Clinical Center. J Clin Med 2020; 9:jcm9113444. [PMID: 33120900 PMCID: PMC7693519 DOI: 10.3390/jcm9113444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022] Open
Abstract
Pediatric cancer survivors are at increased risk for psychological distress. We sought to understand the severity and symptoms' co-occurrence among pediatric survivors compared to controls by rating both self- and parent-reported symptomatology. Forty survivors (22 males; mean age at study time: 12.9 years) participated in the study. Most survivors (85%) had a diagnosis of acute lymphoblastic leukemia. Seventy-nine healthy controls with the same age and gender distribution as the patients were included. A standardized assessment of psychological functioning was conducted by self- and parent-reported symptoms evaluations. The self-reported anxious symptom severity was significantly higher in survivors. A significantly higher proportion of survivors compared to controls had clinically significant anxiety, depression, and combined anxiety symptoms (i.e., social anxiety, separation anxiety, or physical symptoms). In both study groups, the self-reported emotional and somatic symptoms were significantly associated. The multi-informant assessments of the psychological symptoms revealed distinct associations between the child- and parent-reported symptoms in the survivors' group: the survivors' self-reports of depressive symptoms, somatic symptoms, and functional impairment were significantly correlated with the parent reports of child behavioral concerns, somatic complaints, and functional impairment, respectively. Conclusion: Self-reported symptoms showed similar comorbidity profiles in survivors and control peers. The multi-informant assessments detected differences in the association of self- and parent-reported symptoms between the survivor and control groups. The present study showed that multi-informant assessment is critical to understanding symptom profiles and to informing intervention with particular regard to parental participation and support.
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Affiliation(s)
- Rita Barone
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
- Correspondence: ; Tel.: +39-095-378-2898
| | - Mariangela Gulisano
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Emanuela Cannata
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Sara Padalino
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Federica Saia
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Nicoletta Maugeri
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Fabio Pettinato
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
| | - Luca Lo Nigro
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Antonino Casabona
- Department of Biomedical and Biotechnological Sciences, Section of Physiology, School of Medicine, University of Catania, 95123 Catania, Italy;
| | - Giovanna Russo
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Andrea Di Cataldo
- Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (E.C.); (L.L.N.); (G.R.); (A.D.C.)
| | - Renata Rizzo
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy; (M.G.); (S.P.); (F.S.); (N.M.); (F.P.); (R.R.)
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Alba-Suarez J, Davidson SL, Priebe C, Patel P, Greenspahn E, Boucher L, Rodríguez EM. Patient and sibling adjustment to pediatric cancer: the roles of parental relationship adjustment and depressive symptoms. J Psychosoc Oncol 2020; 39:613-628. [PMID: 32942948 DOI: 10.1080/07347332.2020.1819932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Pediatric cancer may impact parents' partner relationship and increase patient, parent, and sibling distress. This study examined parents' reports of their relationship adjustment and depressive symptoms and their association with their ratings of patients' and siblings' emotional/behavioral problems in families of recently diagnosed pediatric cancer patients. DESIGN Cross-sectional questionnaire study. SAMPLE A total of 31 parents (87% female; 71% Latino) of pediatric cancer patients. METHODS Parents reported on their relationship adjustment, depressive symptoms, and the patients' and siblings' emotional/behavioral problems. FINDINGS Poorer relationship adjustment was correlated with more parent depressive symptoms and patient emotional/behavioral problems. Parent depressive symptoms were positively correlated with emotional/behavioral problems in patients and siblings. After accounting for child age and parent depressive symptoms, relationship adjustment remained significantly associated with patient, but not sibling, problems. CONCLUSIONS When parents have poorer relationship adjustment following diagnosis, children with cancer may be at increased risk for emotional/behavioral problems. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS OR POLICY Interventions targeting the partner relationship may be relevant to supporting family adjustment following diagnosis.
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Affiliation(s)
- Juliana Alba-Suarez
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Savannah L Davidson
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Courtney Priebe
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Puja Patel
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA.,Dell Children's Medical Center, Austin, Texas, USA.,Dell Medical School, Austin, Texas, USA
| | - Emily Greenspahn
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA.,Dell Children's Medical Center, Austin, Texas, USA.,Dell Medical School, Austin, Texas, USA
| | - Lori Boucher
- Dell Children's Medical Center, Austin, Texas, USA
| | - Erin M Rodríguez
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA
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Zając-Spychała O, Pieczonka A, Barańska M, Wachowiak J. Long-Term Recipient Health-Related Quality of Life and Donor-Recipient Relationship following Sibling Pediatric Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2019; 26:401-406. [PMID: 31622770 DOI: 10.1016/j.bbmt.2019.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/03/2019] [Accepted: 10/08/2019] [Indexed: 01/13/2023]
Abstract
Despite the fact that the choice of donors and the number of sources of hematopoietic stem cells have increased, a sibling remains a preferred donor for allogeneic hematopoietic stem cell transplantation (HSCT). Transplant donation between siblings is a unique life experience that may have an impact on their future relationship. The aim of the study was to quantitatively measure the quality of life (QoL) in patients who underwent transplant and to describe the relationship between a recipient and a sibling donor after HSCT. We identified and invited 82 adults aged 18.0 to 38.7 years (median, 23.6) who underwent HSCT in our center and their sibling donors to participate in this survey. Forty-five patients (54.9%) and their siblings consented to take part in the study. The studied group consisted of 45 matched siblings donor (MSD)-HSCT recipients (19 women and 26 men) aged 18.0 to 36.2 (median, 28.5) years, who underwent MSD-HSCT at the age of 5.8 to 16.3 (median, 11.9) years, and their sibling donors aged 21.0 to 36.0 (median, 31.0) years, who were aged 11.2 to 20.2 (median, 15.5) years at bone marrow harvesting. For QoL and sibling relationship assessment, we used the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) and the Adult Sibling Relationship Questionnaire (ASQR). Higher scores indicate better quality of life in each scale of the FACT-BMT and the more significant is the factor in a sibling relationship measured by the ASQR. The questionnaires were given to both subgroups, HSCT recipients and donors, and the results were compared with each other. The overall result of the FACT-BMT questionnaire was 117 ± 35.0. The highest QoL was found in the functional (25.0 ± 3.5) and social well-being (25.0 ± 3.5) subscales, whereas the worst was in the emotional well-being (18.0 ± 9.5) subscale. Statistically, the QoL score was not influenced by current age (P = .378), age at the moment of HSCT (P = .256), and sex (P = .117). Being a recipient or a donor of HSCT was not a significant factor associated with warmth (2.6 ± 0.5 versus 3.1 ± 0.5; P = .830) and conflict (2.0 ± 0.7 versus 2.1 ± 1.2; P = .886) within the sibling relationship, whereas recipients scored significantly lower in rivalry within the sibling relationship compared with HSCT donors (0.8 ± 0.3 versus 1.2 ± 0.2; P = .012). The FACT Treatment Outcome Index remained the only significant predictor of warmth in the sibling relationship between HSCT recipient and donor. QoL in adult patients after HSCT in childhood was good. Sibling donor-recipient relationship is unbalanced, with a higher level of rivalry presented among donors. Further multicenter studies based on a larger cohort of patients are necessary to assess all aspects of the sibling relationship after transplantation experience.
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Affiliation(s)
- Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Anna Pieczonka
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Barańska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
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Peterson RK, Ashford JM, Scott SM, Wang F, Zhang H, Bradley JA, Merchant TE, Conklin HM. Predicting parental distress among children newly diagnosed with craniopharyngioma. Pediatr Blood Cancer 2018; 65:e27287. [PMID: 29932288 PMCID: PMC6107393 DOI: 10.1002/pbc.27287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Childhood brain tumor diagnoses are stressful for families. Children diagnosed with craniopharyngioma (Cp) present with particularly challenging medical and cognitive problems due to tumor location and associated biophysiologic comorbidities. This study examined parental distress in a sample of families of patients with Cp treated with proton beam therapy to identify factors for targeting psychological intervention. PROCEDURE Prior to (n = 96) and 1 year after (n = 73) proton therapy, parents of children diagnosed with Cp (9.81 ± 4.42 years at baseline; 49% male) completed a self-report measure of distress, the Brief Symptom Inventory (BSI). Children completed cognitive assessment measures at baseline; medical variables were extracted from the study database. RESULTS At baseline, t-tests revealed parents reported higher levels of distress than normative expectations on Anxiety, Depression, Global Severity, and Positive Symptom Distress BSI scales (P < 0.05). Linear mixed effects models revealed parent report measures of child executive dysfunction and behavioral issues were more predictive of parental distress than patients' cognitive performance or medical status (P < 0.05). Models also revealed a significant reduction only in Anxiety over time (t = -2.19, P < 0.05). Extensive hypothalamic involvement at baseline predicted this reduction (P < 0.05). CONCLUSION Parents experience significant distress before their child begins adjuvant therapy for Cp, though parental distress appears largely unrelated to medical complications and more related to parent perceptions of child cognitive difficulties (vs. child performance). Importantly, this may be explained by a negative parent reporting style among distressed parents. Knowledge of socio-emotional functioning in parents related to patient characteristics is important for optimization of psychological intervention.
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Affiliation(s)
- Rachel K. Peterson
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Jason M. Ashford
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Sarah M. Scott
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Fang Wang
- Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN
| | - Hui Zhang
- Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN
| | - Julie A. Bradley
- University of Florida Health Proton Therapy Institute, 2015 North Jefferson Street, Jacksonville, FL 32206
| | - Thomas E. Merchant
- Department of Radiation Oncology, St. Jude Children’s Research Hospital Memphis, TN
| | - Heather M. Conklin
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
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12
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Van Schoors M, Caes L, Alderfer MA, Goubert L, Verhofstadt L. Couple functioning after pediatric cancer diagnosis: a systematic review. Psychooncology 2016; 26:608-616. [DOI: 10.1002/pon.4204] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/10/2016] [Accepted: 06/24/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology; Ghent University; Ghent Belgium
| | - Line Caes
- School of Psychology and Centre for Pain Research; National University of Ireland Galway; Galway Ireland
| | - Melissa A. Alderfer
- Center for Healthcare Delivery Science; Nemours Children's Health System; Wilmington Delaware
- Department of Pediatrics, Sidney Kimmel Medical College; Thomas Jefferson University; Philadelphia Pennsylvania
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology; Ghent University; Ghent Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology; Ghent University; Ghent Belgium
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Okado Y, Howard Sharp KM, Tillery R, Long AM, Phipps S. Profiles of Dispositional Expectancies and Affectivity Predict Later Psychosocial Functioning in Children and Adolescents With Cancer. J Pediatr Psychol 2015; 41:298-308. [PMID: 26476282 DOI: 10.1093/jpepsy/jsv096] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/19/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Examined how individual differences in disposition among pediatric cancer patients predict their later psychosocial functioning. METHODS Patients aged 8-17 years (N = 223) reported on their disposition at baseline. One and three years later, self-reports and parent reports of patient psychosocial functioning were obtained. Latent profile analysis was used to identify subgroups that differed on baseline disposition and to compare them on later outcomes. ESULTS Three groups were identified: The "Positive" group (59%) had high optimism and positive affectivity and low pessimism and negative affectivity; the "Moderate" group (39%) had a similar profile, with less exaggerated scores; a small, "Negative" group (2%) had the opposite profile (low optimism/positive affectivity; high pessimism/negative affectivity). These groups differed in psychosocial functioning at follow-up, generally in expected directions. CONCLUSIONS Most patients have a disposition that may be protective. A small minority at high risk for maladjustment is distinguished by their disposition.
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Affiliation(s)
- Yuko Okado
- Department of Psychology, California State University, Fullerton, Department of Psychology, St. Jude Children's Research Hospital
| | - Katianne M Howard Sharp
- Department of Psychology, St. Jude Children's Research Hospital, Department of Psychology, University of Memphis, and Department of Psychiatry, University of Mississippi Medical Center
| | - Rachel Tillery
- Department of Psychology, St. Jude Children's Research Hospital, Department of Psychology, University of Memphis, and
| | - Alanna M Long
- Department of Psychology, St. Jude Children's Research Hospital
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital,
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14
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Van Schoors M, Caes L, Verhofstadt LL, Goubert L, Alderfer MA. Systematic Review: Family Resilience After Pediatric Cancer Diagnosis: Figure 1. J Pediatr Psychol 2015; 40:856-68. [DOI: 10.1093/jpepsy/jsv055] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/18/2015] [Indexed: 11/12/2022] Open
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15
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Bagur J, Massoubre C, Casagranda L, Faure-Conter C, Trombert-Paviot B, Berger C. Psychiatric disorders in 130 survivors of childhood cancer: preliminary results of a semi-standardized interview. Pediatr Blood Cancer 2015; 62:847-53. [PMID: 25683046 DOI: 10.1002/pbc.25425] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 12/15/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although psychological sequelae are well known among survivors of childhood cancer, psychiatric sequelae remain inadequately explored. Long-term psychiatric sequelae and their main risk factors in this population were evaluated. PROCEDURE Initially, 483 survivors of childhood cancer, except leukemia, were invited to complete a questionnaire assessing their health and quality of life. Of them, 130 completed the survey, subsequently consulted with a pediatric oncologist and an internist, and met with a psychologist for a semi-standardized interview based on the Mini International Neuropsychiatric Interview (MINI), which allowed diagnosis of DSM-IV Axis 1 psychiatric disorders. The collected data were compared with those of the French general population. RESULTS Seventy-three of the 130 survivors (56.2%) who completed the MINI interview reported experiencing at least one psychiatric disorder since cancer diagnosis, mostly anxiety (39.2%), mood (27.7%), or major depressive (24.6%) disorders; 46 reported at least one current disorder (35.4%). Agoraphobia (P = 0.02) and psychotic disorders were more common (P = 0.003) and general anxiety disorder less common (P < 0.001) among survivors than the general population. Most disorders correlated significantly with survivors' ratings of lower quality of life. Smoking, cancer type, and treatments significantly influenced the prevalence of psychiatric disorders. CONCLUSIONS Results were consistent between the self-questionnaire and MINI interview responses, though time may have biased memory. Vulnerability to and high risk for developing DSM-IV Axis 1 psychiatric disorders of childhood cancer survivors can persist long after diagnosis and treatment. Thus, systematic and general psychological screening of survivors may facilitate long-term psychological restoration.
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Affiliation(s)
- J Bagur
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
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16
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Takei Y, Ogata A, Ozawa M, Moritake H, Hirai K, Manabe A, Suzuki SI. Psychosocial difficulties in adolescent and young adult survivors of childhood cancer. Pediatr Int 2015; 57:239-46. [PMID: 25203461 DOI: 10.1111/ped.12495] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 07/20/2014] [Accepted: 08/21/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND With a large number of children surviving cancer worldwide, numerous investigations have assessed psychological and social adjustment among childhood cancer survivors. According to these studies, it is unclear whether childhood cancer survivors successfully adjust to daily life after being discharged from hospital, especially for adolescent and young adult survivors who have unique needs and concerns. The primary aim of this study was to identify the factors underlying psychosocial difficulties faced by adolescent and young adult survivors in their day-to-day lives after being discharged from hospital. METHODS Semi-structured interviews were conducted. Twenty-five childhood cancer survivors were recruited from two regional cancer institutions in Japan. Content analysis was applied to the responses. RESULTS Nineteen attributes were extracted and classified into four categories as follows: physical difficulties, interpersonal difficulties, behavioral difficulties, and uncertainty about the future. The attributes indicated by >50% of the participants were "I am worried about not feeling well," "I have difficulty continuing treatment in daily life," "I have difficulty moving my body," "I have to be absent from school or work because of illness," and "I am left behind academically." CONCLUSIONS This study identified important factors of psychosocial day-to-day difficulties. Clinically, these results suggest that it is important to watch for these signs and to provide early support to survivors so that their daily life and development are not hindered by the treatment and its side-effects, and to offer long-term support focusing on individual patient characteristics such as sex, age, and cancer history.
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Affiliation(s)
- Yuko Takei
- Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
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17
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Okado Y, Tillery R, Sharp KH, Long AM, Phipps S. Effects of Time since Diagnosis on the Association between Parent and Child Distress in Families with Pediatric Cancer. CHILDRENS HEALTH CARE 2015; 45:303-322. [PMID: 27630380 DOI: 10.1080/02739615.2014.996883] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although parental distress and child distress have been linked in families of children with cancer, how these associations change over time is unknown. The present study examined how the amount of time elapsed since the child's diagnosis moderates the associations between self-reported parent and child symptoms of depression, anxiety, and post-traumatic stress in 255 parent-child dyads. Time since diagnosis moderated the associations between parental symptoms and child-reported anxiety and post-traumatic stress. Dyads farther out from diagnosis exhibited stronger associations between parental and child symptoms. Findings suggest the importance of monitoring the psychological adjustment of parents and children over time.
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18
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Castellano-Tejedor C, Pérez-Campdepadrós M, Capdevila L, Blasco-Blasco T. Surviving cancer: The psychosocial outcomes of childhood cancer survivors and its correlates. J Health Psychol 2014; 21:1491-502. [DOI: 10.1177/1359105314557503] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.
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19
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Measuring anxiety in children: a methodological review of the literature. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 3:49-62. [PMID: 25030332 DOI: 10.1016/s1976-1317(09)60016-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 03/17/2009] [Accepted: 04/27/2009] [Indexed: 11/22/2022] Open
Abstract
This paper provides a comprehensive methodological review of the literature concerning anxiety measurement in children. Initially, a conceptual basis for anxiety measures is introduced, followed by specific approaches to measuring childhood anxiety based on 14 original articles. In particular, a variety of strategies that have been used in previous research are discussed in detail with theoretical underpinnings. Common approaches to measure anxiety such as self-reported instruments, observational ratings, and behavioral checklists are reviewed one by one with a critical look at the strengths and weaknesses of each of these approaches. While multiple measures of anxiety are available to assess the level of anxiety in children, selection of measurement approach should be an iterative process based on rigorous evaluation of evidence of reliability and cross-validation of the tool across different age groups of children.
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20
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Beek L, Schappin R, Gooskens R, Huisman J, Jongmans M. Surviving a brain tumor in childhood: impact on family functioning in adolescence. Psychooncology 2014; 24:89-94. [DOI: 10.1002/pon.3599] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 05/15/2014] [Accepted: 05/19/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Laura Beek
- Department of Medical Psychology and Social Work; Wilhelmina Children's Hospital, UMC Utrecht; The Netherlands
| | - Renske Schappin
- Department of Medical Psychology and Social Work; Wilhelmina Children's Hospital, UMC Utrecht; The Netherlands
| | - Rob Gooskens
- Department of Neurology; Wilhelmina Children's Hospital, UMC Utrecht; The Netherlands
| | - Jaap Huisman
- Department of Medical Psychology and Social Work; Wilhelmina Children's Hospital, UMC Utrecht; The Netherlands
| | - Marian Jongmans
- Department of Special Education, Faculty of Social and Behavioral Sciences; Utrecht University; The Netherlands
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21
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Pérez-Campdepadrós M, Castellano-Tejedor C, Sábado-Álvarez C, Gros-Subías L, Capdevila L, Blasco-Blasco T. Type of tumour, gender and time since diagnosis affect differently health-related quality of life in adolescent survivors. Eur J Cancer Care (Engl) 2014; 24:635-41. [DOI: 10.1111/ecc.12215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 11/29/2022]
Affiliation(s)
- M. Pérez-Campdepadrós
- Department of Pediatric Oncology and Hematology; Hospital Universitari Vall d'Hebron; Barcelona Spain
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
| | - C. Castellano-Tejedor
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
- Departament of Psychiatry; Hospital Universitari Vall d'Hebron-Fundació Institut de Recerca; Barcelona Spain
| | - C. Sábado-Álvarez
- Department of Pediatric Oncology and Hematology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - L. Gros-Subías
- Department of Pediatric Oncology and Hematology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - L. Capdevila
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
| | - T. Blasco-Blasco
- Department of Basic Psychology; Universitat Autònoma de Barcelona; Bellaterra Spain
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22
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Impact of psychological and cancer-related factors on HRQoL for Korean childhood cancer survivors. Qual Life Res 2014; 23:2603-12. [DOI: 10.1007/s11136-014-0709-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2014] [Indexed: 10/25/2022]
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23
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Canning S, Bunton P, Talbot Robinson L. Psychological, demographic, illness and treatment risk factors for emotional distress amongst paediatric oncology patients prior to reaching 5-year survivorship status. Psychooncology 2014; 23:1283-91. [DOI: 10.1002/pon.3563] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 03/23/2014] [Accepted: 04/07/2014] [Indexed: 11/07/2022]
Affiliation(s)
- S. Canning
- Division of Clinical Psychology; University of Manchester, UK
| | - P. Bunton
- Division of Clinical Psychology; University of Manchester, UK
| | - L. Talbot Robinson
- Paediatric Psychosocial Service; Royal Manchester Children's Hospital; Harrington Building UK
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24
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Surviving Childhood Cancer: Relationship between Exercise and Coping on Quality of Life. SPANISH JOURNAL OF PSYCHOLOGY 2013; 16:E1. [DOI: 10.1017/sjp.2013.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThis research assesses Health-Related Quality of Life (HRQoL) in a Spanish sample of adolescent cancer survivors, and analyzes the relationship between HRQoL, coping styles and physical exercise. Forty-two survivors (12–19 years), who were ≥ 1 year of remission, completed standardized measures of HRQoL (CHIP-AE), coping strategies (ACS) and physical exercise (AECEF). Mean scores in all HRQoL domains were within normative values. Multiple regression analysis revealed that physical exercise and productive coping were related to higher HRQoL, whereas non-productive coping was related to lower HRQoL. This sample of survivors reported good levels of HRQoL, which are mediated by coping styles and physical exercise.
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25
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Thompson AL, Long KA, Marsland AL. Impact of Childhood Cancer on Emerging Adult Survivors' Romantic Relationships: A Qualitative Account. J Sex Med 2013; 10 Suppl 1:65-73. [DOI: 10.1111/j.1743-6109.2012.02950.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Life satisfaction in young adults 10 or more years after hematopoietic stem cell transplantation for childhood malignant and nonmalignant diseases does not show significant impairment compared with healthy controls: a case-matched study. Biol Blood Marrow Transplant 2012; 18:1759-64. [PMID: 22766222 DOI: 10.1016/j.bbmt.2012.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 06/20/2012] [Indexed: 11/24/2022]
Abstract
Patients undergoing hematopoietic stem cell transplantation (HSCT) may experience physical and psychological deterioration that impairs their life satisfaction (LS). This study focused on LS in long-term survivors at 10 or more years after HSCT. Fifty-five patients (39 males, median age 25 years) undergoing allogeneic HSCT for childhood malignant (n = 52) or nonmalignant diseases (n = 3) were enrolled. A control group of 98 young adults (59 males, median age 24 years) was considered. A questionnaire with a modified Satisfaction Life Domain Scale was administered. We assessed such domains as education, employment, leisure time, social relationships, and perception of physical status with a 30-item questionnaire. To investigate the association between the domains and the probability of diminished LS, we performed a logistical procedure using the maximum likelihood method. Predictive factors of LS were adjusted for sociodemographic variables. In the multivariate analysis, the participant's level of LS was not significantly correlated with sociodemographic factors or with HSCT status. The same analysis showed a slight trend in favor of the control group (P = .06) for body perception. Our data suggest that the patients who undergo HSCT in childhood have no significant difference in long-term LS compared with healthy controls.
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27
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Kahalley LS, Wilson SJ, Tyc VL, Conklin HM, Hudson MM, Wu S, Xiong X, Stancel HH, Hinds PS. Are the psychological needs of adolescent survivors of pediatric cancer adequately identified and treated? Psychooncology 2012; 22:447-58. [PMID: 22278930 DOI: 10.1002/pon.3021] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 11/16/2011] [Accepted: 11/26/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES To describe the psychological needs of adolescent survivors of acute lymphoblastic leukemia (ALL) or brain tumor (BT), we examined the following: (i) the occurrence of cognitive, behavioral, and emotional concerns identified during a comprehensive psychological evaluation and (ii) the frequency of referrals for psychological follow-up services to address identified concerns. METHODS Psychological concerns were identified on measures according to predetermined criteria for 100 adolescent survivors. Referrals for psychological follow-up services were made for concerns previously unidentified in formal assessment or not adequately addressed by current services. RESULTS Most survivors (82%) exhibited at least one concern across domains: behavioral (76%), cognitive (47%), and emotional (19%). Behavioral concerns emerged most often on scales associated with executive dysfunction, inattention, learning, and peer difficulties. Cranial radiation therapy was associated with cognitive concerns, χ(2) (1, N = 100) = 5.63, p < 0.05. Lower income was associated with more cognitive concerns for ALL survivors, t(47) = 3.28, p < 0.01, and more behavioral concerns for BT survivors, t(48) = 2.93, p < 0.01. Of the survivors with concerns, 38% were referred for psychological follow-up services. Lower-income ALL survivors received more referrals for follow-up, χ(2) (1, N = 41) = 8.05, p < 0.01. Referred survivors had more concerns across domains than non-referred survivors, ALL: t(39) = 2.96, p < 0.01; BT: t(39) = 3.52, p < 0.01. Trends suggest ALL survivors may be at risk for experiencing unaddressed cognitive needs. CONCLUSIONS Many adolescent survivors of cancer experience psychological difficulties that are not adequately managed by current services, underscoring the need for long-term surveillance. In addition to prescribing regular psychological evaluations, clinicians should closely monitor whether current support services appropriately meet survivors' needs, particularly for lower-income survivors and those treated with cranial radiation therapy.
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Affiliation(s)
- Lisa S Kahalley
- Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston, TX, USA.
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28
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Jóhannsdóttir IM, Moum T, Hjermstad MJ, Wesenberg F, Hjorth L, Schrøder H, Lähteenmäki PM, Jónmundsson G, Loge JH. Emotional Functioning and School Contentment in Adolescent Survivors of Acute Myeloid Leukemia, Infratentorial Astrocytoma, and Wilms Tumor. J Adolesc Young Adult Oncol 2011; 1:133-139. [PMID: 23610734 DOI: 10.1089/jayao.2011.0019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: Cancer in childhood may disrupt normal developmental processes and cause psychosocial problems in adolescent survivors of childhood cancers (ACCSs). Previous studies report inconsistent findings. Study aims were to assess subjective well-being (SWB), psychological distress, and school contentment in survivors of three dissimilar childhood cancers. Patients and methods: Nordic patients treated for acute myeloid leukemia (AML), infratentorial astrocytoma (IA), and Wilms tumor (WT) in childhood from 1985 to 2001, aged ≥1 year at diagnosis, and aged 13-18 years at the time of study were eligible for this questionnaire-based survey that included items on SWB, psychological distress, school contentment, self-esteem, and personality traits; 65% (151/231) responded. An age-equivalent group from a Norwegian health survey (n=7910) served as controls. Results: The median age of ACCSs was 16 years; 52% were males. ACCSs reported better SWB (p=0.004) and self-esteem (p<0.001). They had fewer social problems in school (p=0.004) and their school contentment tended to be higher than controls. SWB and school contentment were positively influenced by self-esteem. However, ACCSs reported higher levels of psychological distress (p=0.002), mostly attributable to general worrying. No significant differences in outcomes were found across diagnoses, and time since diagnosis did not significantly affect the results. Conclusion: The overall emotional functioning of ACCSs was good, possibly due to changes in their perception of well-being after having survived a life-threatening disease. However, they seemed more worried than their peers. This may cause an additional strain at a vulnerable period in life.
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Affiliation(s)
- Inga M Jóhannsdóttir
- National Resource Center for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital , Radiumhospitalet, Oslo, Norway
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김민희, 신윤정, 원성철, Chuhl Joo Lyu, Kyong-Mee Chung, 이명아. Discrepancy between Parent and Child Report on Quality of Life and Behavioral Problems in Child and Adolescent cancer survivors and Healthy Control Group. ACTA ACUST UNITED AC 2011. [DOI: 10.17315/kjhp.2011.16.3.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Smorti M. Adolescents' struggle against bone cancer: an explorative study on optimistic expectations of the future, resiliency and coping strategies. Eur J Cancer Care (Engl) 2011; 21:251-8. [PMID: 21812846 DOI: 10.1111/j.1365-2354.2011.01271.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The present study aims to assess adolescents' expectations of the future after bone cancer treatment and to investigate in greater depth the relationship between expectations of the future, resilience and coping strategies. Thirty-two adolescents with cancer experience (11-20 years old), who had a complete first remission at least 1 month after the end of successful treatment, were requested to respond to the Expectations for Future Scale, the Ego-Resiliency Scale and Coping Strategy Indicators. Forty-eight gender- and age-matched control adolescents were randomly selected from a normative sample (NORMs). Adolescents with cancer experience had more optimistic expectations of the future and were less open to experience compared to NORMs. They had lower global ego-resiliency, higher impulse control and tended to use more avoidance strategies than NORMs. In adolescents with cancer experience, expectations of the future were negatively related to global ego-resiliency and positively related to impulse control and avoidance. Expectations of the future were positively correlated with global ego-resiliency and openness to new experience and negatively correlated with impulse control in NORMs. Patients' positive expectations of the future may relate to positive adjustment to cancer events; however, they could also express unrealistic optimism.
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Affiliation(s)
- M Smorti
- Faculty of Education, Free University of Bozen, Viale Ratisbona 16, Bressanone, Italy.
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31
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Maurice-Stam H, Broek A, Kolk AMM, Vrijmoet-Wiersma JMJ, Meijer-van den Bergh E, van Dijk EM, Phipps S, Grootenhuis MA. Measuring perceived benefit and disease-related burden in young cancer survivors: validation of the Benefit and Burden Scale for Children (BBSC) in The Netherlands. Support Care Cancer 2011; 19:1249-53. [PMID: 21667049 PMCID: PMC3128272 DOI: 10.1007/s00520-011-1206-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 05/30/2011] [Indexed: 11/26/2022]
Abstract
PURPOSE Perceiving favourable changes from one's illness may go hand in hand with experiencing harmful psychosocial effects. Each of these constructs should be considered when examining children's levels of psychological adjustment following stressful life events. A paediatric instrument that accounts for both positive and negative impact of stressful events has not been investigated in The Netherlands before. The aim of the study was to investigate psychometric properties of the Dutch version of the Benefit and Burden Scale for Children (BBSC), a 20-item questionnaire that intends to measure potential benefit and burden of illness in children. METHODS Dutch paediatric survivors of childhood cancer aged 8-18 (N = 77) completed the BBSC and other psychological questionnaires: Pediatric Quality of Life Inventory (health-related quality of life), State-Trait Anxiety Inventory for Children (anxiety), Children's Revised Impact of Event Scale (posttraumatic stress) and Strengths and Difficulties Questionnaire (behavioural functioning). Reliability and validity were evaluated. RESULTS Internal consistency (Cronbach's alpha, benefit 0.84, burden 0.72), test-retest reliability (benefit r = 0.74, burden r = 0.78) and homogeneity (mean inter-item correlation, benefit r = 0.34, burden r = 0.22) were satisfactory. Burden was associated with HRQoL (-), anxiety (+), posttraumatic stress symptoms (+) and behavioural problems. Benefit did not correlate with the psychological outcomes. CONCLUSIONS The Dutch version of the BBSC shows promising psychometric properties. Perceived benefit and disease-related burden are distinct constructs; both should be considered when examining children's psychological adjustment to potentially traumatic experiences. The BBSC may be useful as monitoring and screening instrument.
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Affiliation(s)
- Heleen Maurice-Stam
- Paediatric Psychosocial Department, Emma Children's Hospital Academic Medical Centre, Amsterdam, The Netherlands.
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Schulte F, Bartels U, Bouffet E, Janzen L, Hamilton J, Barrera M. Body weight, social competence, and cognitive functioning in survivors of childhood brain tumors. Pediatr Blood Cancer 2010; 55:532-9. [PMID: 20658626 DOI: 10.1002/pbc.22543] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of the following article was to examine: (a) body mass index (BMI) in survivors of childhood brain tumors; (b) the association of BMI with social competence and cognitive functioning; and (c) congruency in reporting of survivors' social competence by the survivors, parents, and teachers. PROCEDURE Fifty-four survivors of childhood brain tumors (32 males) 8-18 years participated. BMI-for-age percentiles and BMI Z-scores (SDS) were calculated and survivors were categorized as underweight, normal, overweight, or obese, using established criteria. Informants completed measures of social competence and internalizing behaviors. Survivors also completed a test of self-perception and cognitive functioning (IQ). RESULTS Survivors were more underweight (15% vs. 4%), and less overweight (17% vs. 31%) than population norms (chi(2) = 38.62, P < 0.001). Parents perceived lower social competence in survivors that were underweight, had lower verbal IQ, and higher internalizing behaviors (P < 0.05). A significant interaction between BMI-for-age and IQ on self-perception of close friendships suggested that survivors with lower weight and lower IQ perceived having fewer close friendships (P < 0.05). Congruency among the three informants was moderate. CONCLUSIONS Survivors of childhood brain tumors are at increased risk for underweight. Underweight status is related to lower parent reported social competence and survivors' self-perception of fewer close friendships in the presence of low IQ.
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Affiliation(s)
- Fiona Schulte
- Hematology/Oncology/Transplant Program Department of Oncology, Alberta Children's Hospital, Calgary, Alberta, Canada.
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Latham GJ, Greenberg RS. Anesthetic considerations for the pediatric oncology patient--part 3: pain, cognitive dysfunction, and preoperative evaluation. Paediatr Anaesth 2010; 20:479-89. [PMID: 20337952 DOI: 10.1111/j.1460-9592.2010.03261.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In part three of this three-part review, we continue with discussion of the effects of tumor and its therapy as they impact neurocognitive functioning, psychosocial issues of the patient and family, and the mechanisms and experience of pain in the child with cancer. A discussion of preanesthetic testing and evaluation in this patient population is next presented for the reader, focusing on the factors which pose the commonest and greatest risks to the child undergoing surgery. Lastly, an algorithmic approach to evaluating and managing key components of the medical history of pediatric patients is presented.
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Affiliation(s)
- Gregory J Latham
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA 98105, USA.
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Latham GJ, Greenberg RS. Anesthetic considerations for the pediatric oncology patient--part 2: systems-based approach to anesthesia. Paediatr Anaesth 2010; 20:396-420. [PMID: 20199611 DOI: 10.1111/j.1460-9592.2010.03260.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
One of the prices paid for chemo- and radiotherapy of cancer in children is damage to the vulnerable and developing healthy tissues of the body. Such damage can exist clinically or subclinically and can become apparent during active antineoplastic treatment or during remission decades later. Furthermore, effects of the tumor itself can significantly impact the physiologic state of the child. The anesthesiologist who cares for children with cancer or for survivors of childhood cancer should understand what effects cancer and its therapy can have on various organ systems. In part two of this three-part review, we review the anesthetic issues associated with childhood cancer. Specifically, this review presents a systems-based approach to the impact from both tumor and its treatment in children, followed by a discussion of the relevant anesthetic considerations.
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Affiliation(s)
- Gregory J Latham
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way N.E., Seattle, WA 98105, USA.
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Aspects of quality of life, anxiety, and depression among persons diagnosed with cancer during adolescence: A long-term follow-up study. Eur J Cancer 2010; 46:1062-8. [DOI: 10.1016/j.ejca.2010.01.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 12/04/2009] [Accepted: 01/15/2010] [Indexed: 11/17/2022]
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van Dijk J, Grootenhuis MA, Imhof SM, Cohen-Kettenis PT, Moll AC, Huisman J. Coping strategies of retinoblastoma survivors in relation to behavioural problems. Psychooncology 2009; 18:1281-9. [DOI: 10.1002/pon.1507] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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MAURICE-STAM H, OORT F, LAST B, BRONS P, CARON H, GROOTENHUIS M. School-aged children after the end of successful treatment of non-central nervous system cancer: longitudinal assessment of health-related quality of life, anxiety and coping. Eur J Cancer Care (Engl) 2009; 18:401-10. [DOI: 10.1111/j.1365-2354.2008.01041.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McDougall J, Tsonis M. Quality of life in survivors of childhood cancer: a systematic review of the literature (2001-2008). Support Care Cancer 2009; 17:1231-46. [PMID: 19488790 DOI: 10.1007/s00520-009-0660-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 05/13/2009] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this paper was to provide a comprehensive, contemporary systematic review of studies that have examined the quality of life (QOL) of survivors of childhood cancer in order to extend upon the findings of earlier reviews. MATERIALS AND METHODS A review was conducted that used the databases MEDLINE, PubMed, PsycINFO, and CINAHL. Articles were included that were published in English between 2001 and 2008 and used quantitative measures and statistical tests to compare health-related quality of life (HRQL) or QOL of childhood cancer survivors with population norms or matched comparison groups. RESULTS Thirteen studies were identified. Findings were contradictory across studies, yet by and large, reflected those of past reviews. In general, survivors' scores on subscales representing physical, psychological, and social domains of HRQL/QOL were similar to comparisons, with the greatest differences being in physical well-being. Key personal and environmental factors were negatively correlated with the three domains across studies for survivors including: older age at diagnosis, longer time since diagnosis, certain cancer and treatment types, female gender, and a number of socioeconomic factors. CONCLUSIONS Lack of comparability across studies remains a problem due to wide variation in study focus and designs. Conceptual and methodological issues include: use of numerous HRQOL and QOL measures, lack of distinction between conceptualization and measurement of HRQL and QOL, lack of initial qualitative input from survivors about QOL, little examination of the influence of environmental factors on QOL, little attention to survivors' satisfaction with life quality, use of small heterogeneous samples, and need for population-based longitudinal studies.
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Affiliation(s)
- Janette McDougall
- Thames Valley Children's Centre, 779 Base Line Road East, London, Ontario, Canada.
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Maurice-Stam H, Oort FJ, Last BF, Grootenhuis MA. A predictive model of health-related quality of life in young adult survivors of childhood cancer. Eur J Cancer Care (Engl) 2009; 18:339-49. [PMID: 19486128 DOI: 10.1111/j.1365-2354.2007.00916.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A predictive model of health-related quality of life in young adult survivors of childhood cancerThis study aimed to examine factors that affect survivors' health-related quality of life (HRQoL), using a theoretical model in which demographic and medical characteristics explain HRQoL mediated by course of life, coping and social support. In a cross-sectional design, 353 survivors aged 18-30 years completed questionnaires. Structural equation modelling was performed to investigate the relationships among the variables in the model and to test whether the model fitted the data. The model fitted the data closely: chi(2)(14) = 21.61, P = 0.087; root mean square error of approximation = 0.039, 90% confidence interval [0.00; 0.070]. The effect of medical and demographic characteristics on HRQoL was mediated by coping. Survivors having been treated with both chemotherapy and radiotherapy were most at risk for worse HRQoL because they suffer more from current health complaints and were less inclined to predictive and active coping. Screening survivors medically as well as psychosocially could help to identify patients with the greatest needs and direct interventions by which the follow-up care could be improved.
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Affiliation(s)
- H Maurice-Stam
- Pediatric Psychosocial Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, the Netherlands.
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Faugli A, Bjørnland K, Emblem R, Nøvik TS, Diseth TH. Mental health and psychosocial functioning in adolescents with esophageal atresia. J Pediatr Surg 2009; 44:729-37. [PMID: 19361632 DOI: 10.1016/j.jpedsurg.2008.09.027] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Revised: 09/06/2008] [Accepted: 09/29/2008] [Indexed: 11/17/2022]
Abstract
PURPOSE We examined mental health and psychosocial functioning in adolescents with esophageal atresia (EA) and searched for predictors of impaired outcome. METHODS The study group comprised 21 adolescents with EA and 1 or both parents. A comparison group comprised 36 adolescents from the general population. Mental health, self-esteem, psychosocial functioning, and parental/family functioning were assessed by standardized questionnaires and semistructured interviews. Physical health was assessed by growth and clinical symptoms. RESULTS Mental health and psychosocial functioning did not differ from the comparison group. Seven of 21 EA adolescents had special education. Dilatations of esophagus, birth weight, well-being, and maternal psychological distress were prognostic factors predicting mental health. Height, birth weight, well-being, dissociative symptoms, and family strain were prognostic factors predicting psychosocial functioning. CONCLUSION Adolescents with EA adjusted well, and mental health and psychosocial functioning did not differ from controls. Dilatations of esophagus and birth weight were significant predictors of mental health and psychosocial functioning.
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Affiliation(s)
- Anne Faugli
- Institute of Psychiatry, University of Oslo, Norway.
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Maurice-Stam H, Oort FJ, Last BF, Brons PPT, Caron HN, Grootenhuis MA. Longitudinal assessment of health-related quality of life in preschool children with non-CNS cancer after the end of successful treatment. Pediatr Blood Cancer 2008; 50:1047-51. [PMID: 17914734 DOI: 10.1002/pbc.21374] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The aim of the study was to access Health Related Quality of Life (HRQoL) in preschool cancer survivors during the first 3 years of continuous remission after the end of successful treatment, and to identify predictors of HRQoL. PROCEDURE Parent-reported HRQoL was assessed in 53 preschool children treated successfully for cancer, using the TAPQOL and compared with norm data. Longitudinal mixed models analyses were performed to investigate to what extent demographic and medical variables and parental psychological distress were predictive of HRQoL over time. RESULTS Two months after the end of successful cancer treatment, survivors showed significantly (P < 0.01) more problem behavior and anxiety, and scored significantly worse (P < 0.01) on sleeping, motor functioning, positive mood and liveliness than the norm. One year after the end of treatment survivors still showed significantly (P < 0.01) more anxiety and worse motor functioning. The level of HRQoL in survivors had normalized 2 and 3 years after the end of treatment. Longer duration of treatment, bad prognosis and greater parental psychological distress were associated with worse scores on the Physical Component Score of the TAPQOL. Medical variables and parental psychological distress were not associated with the Mental Component Score. CONCLUSIONS Survivors adjusted well to the cancer experience and HRQoL improved with time. Despite overall resilience in survivors over time, physical as well as psychosocial monitoring in follow-up is recommended. Standard aftercare should preferably include psychosocial screening, education, and counseling directed at both survivors and parents.
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Affiliation(s)
- Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Educational and occupational outcomes among survivors of childhood cancer during the transition to emerging adulthood. J Dev Behav Pediatr 2007; 28:448-55. [PMID: 18091089 DOI: 10.1097/dbp.0b013e31811ff8e1] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine educational and occupational outcomes among survivors of childhood cancer and peers during the transition from adolescence to emerging adulthood. METHODS Families were recruited when children with cancer were 8 to 15 years old and receiving initial treatment for a malignancy that did not primarily affect the central nervous system (CNS). At that time, each child with cancer was matched to a classmate of similar age, gender, and race for inclusion in a comparison group. For the current follow-up (7.29 years postdiagnosis), 56 survivors, 60 peers, and their parents completed questionnaires soon after the youth's 18th birthday. Severity of treatment and late effects were rated by healthcare providers. RESULTS Survivors and peers were similar on a variety of outcomes, including family background, scholastic and occupational self-concept, and academic competence. However, survivors were more likely to report repeating a grade and having more school absences. The proportion of participants who graduated from high school, were working, and expressed plans to attend postsecondary education or seek employment were similar between groups. Initial treatment intensity, time since diagnosis, and severity of late effects were associated with several indices of educational and occupational attainment. CONCLUSIONS Despite being more likely to repeat a grade and miss school, survivors of nonCNS cancer were similar to peers on most educational and occupational outcomes during the transition from adolescence to emerging adulthood. Interventions to assist academic or occupational functioning may not be necessary for all survivors, but additional research is needed to identify subgroups at risk for difficulties.
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Liang HF, Chiang YC, Chien LY, Yeh CH. A comparison of emotional/behavioural problems between Taiwanese children with cancer and healthy controls. J Clin Nurs 2007; 17:304-11. [PMID: 17931378 DOI: 10.1111/j.1365-2702.2006.01925.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS The purpose of this study was to compare children, diagnosed with cancer, who were attending school, with their healthy peers on emotional and behavioural problems. BACKGROUND Children who suffer from cancer experience severe side effects from their treatment protocols and from the uncertainty associated with their disease. We were seeking to find out if these children subsequently experienced more emotional and behavioural problems than their healthy peers. METHODS Parents and teachers of paediatric oncology patients and their healthy schoolmates were recruited. The ratio was one patient to two schoolmates. The Child Behaviour Checklist (CBCL) was used to collect data from the parents and teachers of 23 paediatric cancer patients and 46 healthy controls. Children were matched on enrollment in the same grade and socioeconomic status of their families. Paired-t tests were used to compare the differences between the emotional/behavioural scores of both groups of children. RESULTS The findings of the study indicated that children with cancer had statistically higher scores on the following items of the CBCL: withdrawn/depressed, somatic complaints, social problems, thought problems, hyperactivity/impulsivity, rule-breaking behaviours and aggressive behaviours. CONCLUSIONS School children with cancer in Taiwan did have more emotional/behavioural problems than their peers. Findings from this study suggest that Taiwanese paediatric oncology patients who are able to return to school and their families may need more psychosocial care. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals may need to extend their professional services to school settings to decrease long-term emotional and behavioural problems in children with cancer.
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Affiliation(s)
- Hwey-Fang Liang
- Department of Nursing, Chang Gung Institute of Technology, Pu-Tz, Chia-Yi, Taiwan
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Affiliation(s)
- Krister K Boman
- Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden.
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Maurice-Stam H, Grootenhuis MA, Brons PPT, Caron HN, Last BF. Psychosocial indicators of health-related quality of life in children with cancer 2 months after end of successful treatment. J Pediatr Hematol Oncol 2007; 29:540-50. [PMID: 17762495 DOI: 10.1097/mph.0b013e3181256b66] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of the study was to identify psychosocial correlates of Health-Related Quality of Life (HRQoL) in pediatric cancer patients after completion of cancer treatment. Multiple regression analyses were performed to predict self-reported HRQoL of 52 patients aged 8 to 15 years, and parent-reported HRQoL of 54 patients aged 1 to 5 years. Cognitive coping, family functioning, parental emotional reactions, communication about the disease, and several medical variables were included in the regression models. Better HRQoL was especially associated with more positive expectations of the further course of the disease and less frequent parental asking after disease-related emotions of the child. Interventions should include "positive thinking" as a coping strategy. Several other psychosocial variables were indicative of better HRQoL but further research is needed to confirm and to understand the relationship between psychosocial variables and HRQoL.
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Affiliation(s)
- Heleen Maurice-Stam
- Pediatric Psychosocial Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, The Netherlands.
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Jörngården A, Mattsson E, von Essen L. Health-related quality of life, anxiety and depression among adolescents and young adults with cancer: a prospective longitudinal study. Eur J Cancer 2007; 43:1952-8. [PMID: 17624761 DOI: 10.1016/j.ejca.2007.05.031] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Revised: 04/24/2007] [Accepted: 05/29/2007] [Indexed: 11/19/2022]
Abstract
The present study sets out to add to knowledge about the development over time of health-related quality of life (HRQL), anxiety and depression among survivors of adolescent cancer. The aim was to investigate if and how the HRQL, anxiety and depression of a group of adolescents with cancer differ from those of a reference group shortly after diagnosis, and subsequently at 6, 12 and 18 months after diagnosis. Adolescents diagnosed with cancer and a reference group randomised from the general population completed the Hospital Anxiety and Depression Scale (HADS) and the two subscales Mental Health and Vitality in the Short Form 36 (SF-36) in telephone interviews. The results indicate a steady increase in psychological well-being from the time of diagnosis, when the cancer patients' ratings were significantly worse than those of the general population, and onwards. The differences gradually disappeared and then were reversed, resulting in the cancer group reporting significantly better HRQL and lower levels of anxiety and depression than the reference group when 1.5 years had passed since diagnosis. The adolescents faced with cancer show signs of adaptation to trauma, which can be understood in relation to the theoretical framework of posttraumatic growth as well as response shift. Future research should continue to follow this development over time, to investigate if the positive effects of the cancer experience will wear off, or if it has facilitated a permanent positive outcome.
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Affiliation(s)
- Anna Jörngården
- Department of Public Health and Caring Sciences, Psychosocial Oncology, Uppsala University, Uppsala Science Park, Dag Hammarskjölds väg 10 B, S-751 83 Uppsala, Sweden
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Servitzoglou M, Papadatou D, Tsiantis I, Vasilatou-Kosmidis H. Psychosocial functioning of young adolescent and adult survivors of childhood cancer. Support Care Cancer 2007; 16:29-36. [PMID: 17562085 DOI: 10.1007/s00520-007-0278-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Accepted: 05/16/2007] [Indexed: 10/23/2022]
Abstract
GOALS OF WORK The present study aimed to assess the psychosocial well-being of Greek adolescent and young adult survivors of childhood cancer and, in particular, self-esteem, anxiety, coping strategies, and social functioning. PATIENTS AND METHODS The sample comprised 103 Greek childhood cancer survivors and 135 healthy controls. The Battle Culture-free Self-esteem Inventory (BCSEI), the Spielberger State-Trait Anxiety Inventory (STAI), the Lazarus and Folkman Ways of Coping, and 36-item short-form instruments were used along with The Questionnaire for the Quality of Life. MAIN RESULTS Survivors scored higher than controls on all STAI subscales, but on State, the difference was statistically significant only for female adults, while on the Trait subscale, for the entire group. Survivors scored lower on Personal and higher on Lie subscale of BCSEI, by comparison to controls. When coping with stressful events, the use of self-blame strategies and wishful thinking were more frequent among controls, while distancing strategies more common among survivors. CONCLUSIONS The long-term psychological functioning of Greek survivors of childhood cancer is satisfactory, with emotional difficulties, such as increased anxiety and lower self-esteem, receding over time. Survivors experience personal growth and mature through trauma as they develop a positive view of the impact that the cancer experience has upon their life.
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Affiliation(s)
- Marina Servitzoglou
- Haematology/Oncology, Great Ormond Street Hospital for Children, Great Osmond Street, London, UK.
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Gerhardt CA, Vannatta K, Valerius KS, Correll J, Noll RB. Social and romantic outcomes in emerging adulthood among survivors of childhood cancer. J Adolesc Health 2007; 40:462.e9-15. [PMID: 17448406 DOI: 10.1016/j.jadohealth.2006.12.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2006] [Accepted: 12/05/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine social and romantic outcomes among survivors of childhood cancer and comparison peers during the transition from adolescence to emerging adulthood. METHODS Families were recruited when the children with cancer were 8-15-years-old and on initial treatment for a malignancy that did not primarily affect the central nervous system (i.e., non-CNS). At that time, each child with cancer was matched to a classmate of similar age, gender, and race for inclusion in a comparison group. For the current follow-up (7.29 years post-diagnosis), 56 survivors, 60 comparison peers, and their parents completed questionnaires after the youth's 18th birthday. Severity of treatment and late effects were rated by health care providers. RESULTS Survivors and comparison peers were similar on a variety of outcomes, including family background, social self-concept, social competence, family relationships, friendships, and romantic relationships. Mothers reported that survivors engaged in fewer activities than comparison peers. The proportion of participants who lived with their parents, were dating, and expressed plans to marry or have children was similar between groups. Initial treatment intensity, time since diagnosis, and severity of late effects were associated with some indices of social adjustment. CONCLUSIONS The social and romantic outcomes of survivors of non-CNS cancer were similar to comparison peers during the transition from adolescence to emerging adulthood. Disease and treatment factors had limited associations with outcomes. Clinical interventions to assist social development may not be necessary for all survivors, but additional research is needed to identify subgroups at risk for difficulties.
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Affiliation(s)
- Cynthia A Gerhardt
- Center for Biobehavioral Health, Columbus Children's Research Institute and The Ohio State University, Columbus, Ohio 43205-2696, USA.
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Wallace ML, Harcourt D, Rumsey N, Foot A. Managing appearance changes resulting from cancer treatment: resilience in adolescent females. Psychooncology 2007; 16:1019-27. [PMID: 17328096 DOI: 10.1002/pon.1176] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Typically, adolescence is marked by cognitive and physical developments impacting on self-esteem, independence and sexual awareness, often resulting in increased appearance awareness and dissatisfaction. Adolescents with cancer have the additional burden of illness, treatments and resultant appearance changes. This study aimed to explore the impact of these changes on adolescents who have had cancer. In depth, semi-structured interviews were conducted with six females between 14 and 19 years who had completed treatment within the previous two years, and analysed using Interpretative Phenomenological Analysis (IPA). Concerns around an altered appearance were significant during treatment, serving as a constant reminder of 'difference' and a marker of illness. However, since treatment, participants expressed an apparent shift in views and expectations of their appearance, as well as the value placed on it -- expressing increased satisfaction with their own appearance and a decrease in its importance. While important to acknowledge the distress and challenges experienced by participants, results highlight the need for research and care to focus on positive experiences of patients, rather than simply maladjustment. Explanations for the findings are explored, including the temporary nature of many appearance changes and the life-threatening nature of cancer.
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Affiliation(s)
- Melissa L Wallace
- Centre for Appearance Research, University of the West of England, Bristol, UK.
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Stam H, Grootenhuis MA, Brons PPT, Caron HN, Last BF. Health-related quality of life in children and emotional reactions of parents following completion of cancer treatment. Pediatr Blood Cancer 2006; 47:312-9. [PMID: 16261599 DOI: 10.1002/pbc.20661] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Completing therapy is one of the major transitions in care in the practice of pediatric oncology and, therefore, deserves special consideration. The purpose of the study was to investigate health-related quality of life (HRQOL) of pediatric patients, and emotional reactions of their parents, shortly after the end of successful treatment. METHODS HRQOL of 126 patients, aged 1-15 years, on average 2 months after the end of successful treatment, was assessed with the TNO-AZL Pre-school Quality of life Questionnaire and the TNO-AZL Children's Quality of life Questionnaire. Emotional adjustment of 124 mothers and 111 fathers was assessed with the General Health Questionnaire and the Situation Specific Emotional Reaction Questionnaire. The outcomes of the patients and parents were compared with norm data by means of one sample t-tests, one sample sign-tests or binomial tests. RESULTS All age groups, except patients aged 8-11 years, experienced worse HRQOL than the norm with respect to motor functioning. In addition, pre-school patients were rated worse on sleeping, appetite, stomach, skin, problem behavior, anxiety, and liveliness, and patients aged 6-7 years on autonomy and cognitive functioning. Parents reported more psychological distress than the norm. Compared to parents whose children were 1-5 years after cancer treatment, they suffered more from feelings of loneliness, helplessness, and uncertainty. CONCLUSIONS A few months after the end of successful cancer treatment, both patients and parents appeared to experience worse well-being than the norm to a clinically relevant extent. Supporting patients and parents should not stop when treatment ends.
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Affiliation(s)
- Heleen Stam
- Pediatric Psychosocial Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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