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Fantozzi PM, Anil A, McHugh S, Srsich AR, Zope M, Parish-Morris J, Schultz RT, Herrington J, Hocking MC. Social impairment in survivors of pediatric brain tumors via reduced social attention and emotion-specific facial expression recognition. Pediatr Blood Cancer 2024; 71:e30943. [PMID: 38470289 PMCID: PMC11039359 DOI: 10.1002/pbc.30943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/05/2024] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND/OBJECTIVES Survivors of pediatric brain tumors (SPBT) experience significant social challenges, including fewer friends and greater isolation than peers. Difficulties in face processing and visual social attention have been implicated in these outcomes. This study evaluated facial expression recognition (FER), social attention, and their associations with social impairments in SPBT. METHODS SPBT (N = 54; ages 7-16) at least 2 years post treatment completed a measure of FER, while parents completed measures of social impairment. A subset (N = 30) completed a social attention assessment that recorded eye gaze patterns while watching videos depicting pairs of children engaged in joint play. Social Prioritization scores were calculated, with higher scores indicating more face looking. Correlations and regression analyses evaluated associations between variables, while a path analysis modeling tool (PROCESS) evaluated the indirect effects of Social Prioritization on social impairments through emotion-specific FER. RESULTS Poorer recognition of angry and sad facial expressions was significantly correlated with greater social impairment. Social Prioritization was positively correlated with angry FER but no other emotions. Social Prioritization had significant indirect effects on social impairments through angry FER. CONCLUSION Findings suggest interventions aimed at improving recognition of specific emotions may mitigate social impairments in SPBT. Further, reduced social attention (i.e., diminished face looking) could be a factor in reduced face processing ability, which may result in social impairments. Longitudinal research is needed to elucidate temporal associations between social attention, face processing, and social impairments.
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Affiliation(s)
| | - Ashley Anil
- The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Sean McHugh
- The Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - Manali Zope
- The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Julia Parish-Morris
- The Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Robert T. Schultz
- The Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - John Herrington
- The Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Matthew C. Hocking
- The Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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2
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Adamski J, Langford V, Finlay JL. Approaches to Minimise the Neurodevelopmental Impact of Choroid Plexus Carcinoma and Its Treatment. Life (Basel) 2023; 13:1855. [PMID: 37763259 PMCID: PMC10533047 DOI: 10.3390/life13091855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 09/29/2023] Open
Abstract
Choroid plexus carcinomas (CPC) are rare aggressive tumours that primarily affect very young children. Treatment for CPC typically involves a combination of surgery, chemotherapy, and radiation therapy. Whilst considered necessary for a cure, these therapies have significant neurocognitive consequences for patients, negatively impacting cognitive function including memory, attention, executive functioning, and full-scale intelligence quotients (FSIQ). These challenges significantly impact the quality of life and ultimately socioeconomic parameters such as the level of educational attainment, marital status, and socioeconomic status. This review looks at the tumour- and treatment-related causes of neurocognitive damage in CPC patients and the progress made in finding strategies to reduce these. Opportunities to mitigate the neurodevelopmental consequences of surgery, chemotherapy, and radiation therapy are explored in the context of CPC treatment. Evaluation of the pathological and biological mechanisms of injury has identified innovative approaches to neurocognitive protection and neurorehabilitation, which aim to limit the neurocognitive damage. This review aims to highlight multiple approaches physicians can use when treating young children with CPC, to focus on neurocognitive outcomes as a measure of success.
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Affiliation(s)
- Jenny Adamski
- Birmingham Women’s and Children’s Hospital NHS Foundation Trust, Birmingham B4 6NH, UK;
| | - Vikki Langford
- Birmingham Women’s and Children’s Hospital NHS Foundation Trust, Birmingham B4 6NH, UK;
| | - Jonathan L. Finlay
- Ohio State University College of Medicine, The Ohio State University, Columbus, OH 43210, USA;
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3
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Strauser DR, Shen S, Brehmer CE, Fine E, Liptak C. Barriers to employment for young adult central nervous system tumor survivors: The role of career readiness and core self-evaluations. JVR 2023. [DOI: 10.3233/jvr-230008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND: Although the majority of childhood cancer survivors make successful transitions to adulthood, research suggests that a significant group experiences ongoing medical concerns, such as psychological distress, that significantly impact the achievement of crucial social roles including employment. OBJECTIVE: The purpose of this study was to examine the relationship between career decision making, core self-evaluations, and perceived internal and external barriers to employment in a sample of young adult central nervous system tumor survivors. METHOD: A sample of 110 young adult survivors of pediatric central nervous system tumors was surveyed. Mediation analysis with structural equational modeling was used to correlate a number of different measures (Career Decision Making [CTI], Perceived Employment Barriers [PEB], and Core-Self Evaluations [CSE]). RESULTS: The presence of both significant direct and indirect effects of career decision making on perceived employment barriers implied that there was a partial mediating effect of core self-evaluations on the association between career readiness and employment barriers. CONCLUSION: Career decision-making is a robust construct that can be applied to young adult central nervous system tumor survivors in effort to gain more insight into the vocational psychological factors that impact career development and employment in this group. Core self-evaluations was found to be a mediator between career decision making and perceived career barriers.
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Affiliation(s)
- David R. Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
- National Changhua University of Education, Changhua City, Taiwan
| | - Sa Shen
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | - Elizabeth Fine
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, USA
| | - Cori Liptak
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, USA
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Kumar S, Islim AI, Moon R, Millward CP, Hennigan D, Thorpe A, Foster M, Pizer B, Mallucci CL, Jenkinson MD. Long term quality of life outcomes following surgical resection alone for benign paediatric intracranial tumours. J Neurooncol 2023; 161:77-84. [PMID: 36592264 DOI: 10.1007/s11060-022-04208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/04/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Survivors of paediatric intracranial tumours are at increased risk of psychosocial, neuro-developmental, and functional impairment. This study aimed to evaluate long-term health-related quality-of-life (HRQOL) outcomes in patients with benign paediatric brain tumours treated curatively with surgical resection alone. METHODOLOGY This was a cross-sectional study of patients with benign paediatric intracranial tumours managed with surgery alone between 2000 and 2015. Eligible patients with a minimum of 5-years follow-up after surgery were identified. Validated health-related quality of life (HRQOL) questionnaires were administered: SF-36, QLQ-BN20, QLQ-C30 and PedsQL™. RESULTS Twenty-three patients participated (median age at surgery 13 years; range 1-18; 12 male). The most common diagnosis was pilocytic astrocytoma (n = 15). Median time from surgery to participation was 11 years(range 6-19). Fourteen patients achieved A-level qualifications and two obtained an undergraduate degree. Twelve patients were employed, eight were studying and three were unemployed or volunteering. HRQOL outcomes demonstrated significant limitation from social functioning (p = 0.03) and cognitive functioning (p = 0.023) compared to the general population. Patients also experienced higher rates of loss of appetite (p = 0.009) and nausea and vomiting (p = 0.031). Ten patients were under transitional teenager and young-adult (TYA) clinic follow-up. TYA patients achieved higher levels of education (p = 0.014), were more likely to hold a driver's license (p = 0.041) compared to patients not followed-up through these services. CONCLUSIONS Childhood brain-tumour survivors have a greater risk of developing psychological, neuro-cognitive and physical impairment. Early comprehensive assessment, specialist healthcare and TYA services are vital to support these patients.
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Affiliation(s)
- Siddhant Kumar
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, L9 7LJ, UK. .,Institute of Systems, Molecular and Integrative Biology, The University of Liverpool, Liverpool, UK.
| | - Abdurrahman I Islim
- Department of Neurosurgery, Salford Royal Hospital Foundation Trust, Manchester, UK.,Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Richard Moon
- Department of Neurosurgery, North Bristol NHS Trust, Bristol, UK
| | - Christopher P Millward
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, L9 7LJ, UK.,Institute of Systems, Molecular and Integrative Biology, The University of Liverpool, Liverpool, UK
| | - Dawn Hennigan
- Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Antonia Thorpe
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, L9 7LJ, UK
| | - Mitchell Foster
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, L9 7LJ, UK
| | - Barry Pizer
- Department of Paediatric Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Conor L Mallucci
- Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, L9 7LJ, UK.,Institute of Systems, Molecular and Integrative Biology, The University of Liverpool, Liverpool, UK
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Albee M, Allende S, Cosgrove V, Hocking MC. A prospective study of social competence in survivors of pediatric brain and solid tumors. Pediatr Blood Cancer 2022; 69:e29670. [PMID: 35312152 DOI: 10.1002/pbc.29670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES Survivors of pediatric brain tumors are at increased risk for difficulties with social competence, including poor social information processing (SIP) and peer relationships. Improved survival rates heighten the need to better understand these challenges and if they are specific to survivors of pediatric brain tumors versus survivors of other childhood cancers. METHODS Fifty-one survivors of pediatric brain tumors and 34 survivors of pediatric solid tumors completed evaluations of SIP and peer relationship quality within six months of completing treatment and one year later. Caregivers completed a measure of social skills. Linear mixed models evaluated differences between survivors of pediatric brain and solid tumors on SIP and social skills and how indices of SIP were associated with peer relationships over time. RESULTS The two groups did not differ on indices of SIP or social skills over time. A three-way interaction between measures of SIP, group, and time predicted peer relationships. Survivors of pediatric solid tumors showed a positive association between baseline social skills and theory of mind and peer relationships over time, whereas survivors of pediatric brain tumors showed an inverse association between baseline social skills and theory of mind and peer relationships over time. CONCLUSION Findings revealed unanticipated associations between baseline SIP and social skills and peer relationships over time among survivors of pediatric brain tumors. Additional research is needed to elucidate the factors most influential on peer relationships in this group to inform interventions.
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Affiliation(s)
- May Albee
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | - Matthew C Hocking
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Verity SJ, Bell L, Ryles J, Hill RM. "I Feel Happy Again": Methylphenidate Supports Health-Related Quality of Life in Survivors of Pediatric Brain Tumor. Children (Basel) 2022; 9:1058. [PMID: 35884042 PMCID: PMC9322883 DOI: 10.3390/children9071058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/24/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The deleterious impact upon the cognitive development of survivors of pediatric brain tumors (PBT) is well documented. Impairment in cognitive function is associated with reduced health-related quality of life (HRQoL), such that survivors of PBT report difficulties in multiple distinct domains and an overall reduced quality of life. Studies of the use of methylphenidate in survivors of PBT to alleviate impairment in cognitive functions have shown some success. The current study aimed to explore the impact upon HRQoL in survivors of PBT of a trial of psychostimulant medication. METHOD Data were collected from 12 pediatric neuro-oncology patients aged 7-17 years receiving methylphenidate treatment. HRQoL was measured using the PEDS QL quality of life self-report measure and a semi-structured questionnaire-based interview. RESULTS Analyses of data demonstrates benefit to five domains associated with HRQoL: social, emotional, academic, physical, and cognition. CONCLUSION Survivors of PBT reported favorable views as to the subjective benefit of methylphenidate on post-treatment impairment of HRQoL. This medication may offer the potential for restoration of a sense of 'normality' of function following cancer treatment in this clinical population.
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Affiliation(s)
- Sarah J. Verity
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne NE1 4LP, UK; (J.R.); (R.M.H.)
- Northern Institute of Cancer Research, Newcastle University, Newcastle Upon Tyne NE1 4LP, UK
| | - Lauren Bell
- Cumbria, Northumberland Tyne and Wear NHS Foundation Trust, Hopewood Park Hospital, Sunderland SR2 0NB, UK;
| | - Jade Ryles
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne NE1 4LP, UK; (J.R.); (R.M.H.)
| | - Rebecca M. Hill
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne NE1 4LP, UK; (J.R.); (R.M.H.)
- Wolfson Childhood Cancer Research Centre, Newcastle University Centre for Cancer, Newcastle upon Tyne NE1 8QB, UK
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7
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Wang Y, Liu APY, Lee TM, Wong WHS, Fong DYT, Leung LK, Shing MMK, Ku DT, Chan GC, Tso WW. Neurobehavioral Impairment in Pediatric Brain Tumor Survivors: A Meta-Analysis. Cancers (Basel) 2022; 14. [PMID: 35805042 DOI: 10.3390/cancers14133269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose: The neurocognitive outcomes of pediatric brain tumor survivors have been extensively studied but the risk and predictors for neurobehavioral impairment are less clearly defined. We systematically analyzed the rates of emotional, psychosocial, and attention problems in pediatric brain tumor survivors. Methods: PubMed, Web of Science, Embase, Scopus, and Cochrane were searched for articles published between January 2012 to April 2022. Eligible studies reported neurobehavioral outcomes for PBTS aged 2 to <23 years with a brain tumor diagnosis before 18 years of age. A random-effect meta-analysis was performed in R. Results: The search yielded 1187 unique publications, of which 50 were included in the quantitative analysis. The estimated risk of having emotional, psychosocial, and attention problems were 15% (95%CI 10−20%), 12% (95%CI 9−16%), and 12% (95%CI 9−16%), respectively. PBTS were more likely to have emotional difficulties (Hedge’s g = 0.43 [95%CI 0.34−0.52]), psychosocial problems (Hedge’s g = 0.46 [95%CI 0.33−0.58]), and attention problems (Hedge’s g = 0.48 [95%CI 0.34−0.63]) compared to normal/healthy control subjects. There was no significant difference in the rates of neurobehavioral impairment between children with and without history of cranial radiotherapy. Conclusions: PBTS are at elevated risk of neurobehavioral impairment. Neurobehavioral monitoring should be considered as the standard of care for PBTS.
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Maurice-Stam H, van Erp LME, Maas A, van Oers HA, Kremer LCM, van Dulmen-den Broeder E, Tissing WJE, Loonen JJ, van der Pal HJH, Beek LR, de Vries ACH, van den Heuvel-Eibrink MM, Ronckers CM, Bresters D, Louwerens M, van der Heiden-van der Loo M, Huizinga GA, Grootenhuis MA. Psychosocial developmental milestones of young adult survivors of childhood cancer. Support Care Cancer 2022; 30:6839-6849. [PMID: 35538326 PMCID: PMC9213344 DOI: 10.1007/s00520-022-07113-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/02/2022] [Indexed: 11/26/2022]
Abstract
Purpose The study aimed to compare the psychosocial development of young adult survivors of childhood cancer (YACCS) with a norm group of young adults from the general population. Methods From 2017 to 2020, 558 YACCS (18–30 years, 51% female, 10.9% CNS cancer) who participated in the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort (diagnosed 1963–2001) part 2 completed the Course of Life Questionnaire (CoLQ), assessing the achievement of milestones. Items were grouped into the scales autonomy, psychosexual, and social development. Differences between YACCS and norm group were examined with ANOVA and Cohen’s d (CoLQ scales) and with logistic regression analysis and odds ratio (OR) (CoLQ items), for the total group and YACCS of CNS cancer. Results The total group of YACCS did not report a less favorable psychosocial development than the norm group. YACCS of CNS cancer scored lower than the norm group (p < 0.001) on the scales autonomy (d = − 0.36) and psychosexual (d = − 0.46). Additionally, on half of the items of autonomy (0.25 ≤ OR ≤ 0.34), psychosexual (0.30 ≤ OR ≤ 0.48), and social (0.23 ≤ OR ≤ 0.47) development, YACCS of CNS cancer were less likely (p < 0.01) than the norm group to have achieved the milestones. Conclusion Overall, psychosocial development of YACCS was as favorable as the norm, but YACCS of CNS cancer were at risk of an unfavorable psychosocial development in all domains. Monitoring psychosocial development should be included in the standards of psychosocial care, especially for CNS cancer patients and survivors, to be able to trace delay. Personalized interventions should be offered to improve the psychosocial development in an early stage.
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Affiliation(s)
- Heleen Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
| | - Loes M E van Erp
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Anne Maas
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Hedy A van Oers
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | | | - Helena J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Laura R Beek
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cécile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Willem Alexander Children's Hospital/Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Gea A Huizinga
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
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Gordon ML, Means B, Jurbergs N, Conklin HM, Gajjar A, Willard VW. Social Problem Solving in Survivors of Pediatric Brain Tumor. J Pediatr Psychol 2022; 47:929-938. [PMID: 35286389 DOI: 10.1093/jpepsy/jsac022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Psychosocial late effects among survivors of pediatric brain tumors are common. For school-aged survivors, social skills deficits and isolation present a particular challenge. Social problem-solving is a social skill that is an important determinant of social outcomes and may yield a potential target for intervention. METHODS School-aged youth (N = 65) 8-12 years of age (10.59 ± 1.36 years; 55.4% female, 86.2% white) who were 5.23 (SD = 2.44, range 2-10.9) years post-treatment for a brain tumor completed the Attributions and Coping Questionnaire, a measure of social problem-solving that uses vignettes to assess attribution of intent, subsequent emotional response, and imagined behavioral response to an interpersonal problem. Youth also completed self-reports of social functioning (PROMIS Peer Relationships, Self-Perception Profile). A caregiver completed additional measures of child social functioning (NIH Toolbox-Emotion Measures). RESULTS Survivors attributed unpleasant situations to accidental causes (neutral attribution) and responded in ways that prioritized the friendship (appeasement) or relied on adult intervention. Self-reported social functioning was higher among those who were less likely to avoid challenging social problem-solving situations. CONCLUSIONS Findings identified characteristic social problem-solving approaches among survivors, including a tendency to attribute ambiguous situations to accidental causes and to request adult assistance and/or maintain social relationships. This may indicate a possible avenue for intervention, with a focus on increasing survivors' understanding of the causes of potentially negative peer interactions and reducing their reliance on adults.
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Affiliation(s)
- Mallorie L Gordon
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Bethany Means
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Niki Jurbergs
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Heather M Conklin
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, USA
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Björklund AC, Granlund M, Santacroce SJ, Enskär K, Carlstein S, Björk M. Using ICF to Describe Problems With Functioning in Everyday Life for Children Who Completed Treatment for Brain Tumor: An Analysis Based on Professionals' Documentation. Front Rehabilit Sci 2021; 2:708265. [PMID: 36188761 PMCID: PMC9397836 DOI: 10.3389/fresc.2021.708265] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/25/2021] [Indexed: 01/13/2023]
Abstract
Background: Children treated for brain tumors often experience persistent problems affecting their activity performance and participation in everyday life, especially in school. Linking these problems to the International Classification of Functioning, Disability and Health (ICF) classification system can be described as affecting body function, activity performance, and/or participation. Services involved in the everyday life of the child have different focus and goals when meeting the child in context, which advantage the use of ICF to overcome this impediment to follow-up and provide comprehensive support for children who have completed treatment for a brain tumor. Aim: The aim of the study was to use the ICF classification system to describe how professionals in healthcare, habilitation, and school document problems with everyday life functioning at body, activity, and participation levels for children who completed treatment for a brain tumor. Materials and Methods: A retrospective review of records from healthcare, habilitation, and school concerning nine children completed treatment for brain tumor was implemented. Identified problems in everyday life were linked to ICF codes. Descriptive statistics of ICF-linked code frequency supplemented by network visualization diagrams viewing the co-occurrence between codes within the body, activity participation, and environmental components were performed. Results: Most documented problems were found in healthcare records, whereas the documentation in habilitation and school was sparse. The frequently occurring codes, independent of record source, were linked to the body function component, and ICF-linked problems in habilitation and school were salient in the activity and participation component. To gain a holistic picture of relations between ICF codes and problems, network visualization diagrams were used to illustrate clusters of problems. Conclusion: Code prevalence likely reflects where healthcare professionals and educators focus their attention when meeting the needs of children treated for a brain tumor in context. To maximize the comprehensive view of functioning and participation of children in everyday life, the full range of difficulties regarding body impairments, activity limitations, and participation restrictions must be identified and linked to each other in patterns of co-occurrence, which the ICF facilitate. However, ICF provides no guidance on how to identify networks of problems within the body, activity, and participation. Identifying such networks is important for building comprehensive interventions for children.
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Affiliation(s)
- Ann-Christin Björklund
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Pediatric Hematology and Oncology, Uppsala University Hospital, Uppsala, Sweden
- *Correspondence: Ann-Christin Björklund
| | - Mats Granlund
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Sheila Judge Santacroce
- School of Nursing and Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Karin Enskär
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
| | - Stefan Carlstein
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maria Björk
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Hocking MC, Albee M, Brodsky C, Shabason E, Wang L, Schultz RT, Herrington J. Face Processing and Social Functioning in Pediatric Brain Tumor Survivors. J Pediatr Psychol 2021; 46:1267-1275. [PMID: 34313751 DOI: 10.1093/jpepsy/jsab067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Pediatric brain tumor survivors (PBTS) experience deficits in social functioning. Facial expression and identity recognition are key components of social information processing and are widely studied as an index of social difficulties in youth with autism spectrum disorder (ASD) and other neurodevelopmental conditions. This study evaluated facial expression and identity recognition among PBTS, youth with ASD, and typically developing (TD) youth, and the associations between these face processing skills and social impairments. METHODS PBTS (N = 54; ages 7-16) who completed treatment at least 2 years prior were matched with TD (N = 43) youth and youth with ASD (N = 55) based on sex and IQ. Parents completed a measure of social impairments and youth completed a measure of facial expression and identity recognition. RESULTS Groups significantly differed on social impairments (p < .001), with youth with ASD scoring highest followed by PBTS and lastly TD youth. Youth with ASD performed significantly worse on the two measures of facial processing, while TD youth and PBTS were not statistically different. The association of facial expression recognition and social impairments was moderated by group, such that PBTS with higher levels of social impairment performed worse on the expression task compared to TD and ASD groups (p < .01, η2 = 0.07). CONCLUSIONS Variability in face processing may be uniquely important to the social challenges of PBTS compared to other neurodevelopmental populations. Future directions include prospectively examining associations between facial expression recognition and social difficulties in PBTS and face processing training as an intervention for PBTS.
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Affiliation(s)
- Matthew C Hocking
- Children's Hospital of Philadelphia and The University of Pennsylvania
| | | | | | | | - Leah Wang
- Children's Hospital of Philadelphia and The University of Pennsylvania
| | - Robert T Schultz
- Children's Hospital of Philadelphia and The University of Pennsylvania
| | - John Herrington
- Children's Hospital of Philadelphia and The University of Pennsylvania
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12
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Gilleland Marchak J, Devine KA, Hudson MM, Jacobson LA, Michel G, Peterson SR, Schulte F, Wakefield CE, Sands SA. Systematic Review of Educational Supports of Pediatric Cancer Survivors: Current Approaches and Future Directions. J Clin Oncol 2021; 39:1813-1823. [PMID: 33886350 DOI: 10.1200/jco.20.02471] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Jordan Gilleland Marchak
- Emory University, Atlanta, GA.,Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA
| | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - Lisa A Jacobson
- Kennedy Krieger Institute and Johns Hopkins School of Medicine, Baltimore, MD
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,School of Women's and Children's Health, UNSW Sydney, Sydney, NSW, Australia
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13
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Willard VW, Gordon ML, Means B, Brennan RC, Conklin HM, Merchant TE, Vinitsky A, Harman JL. Social–Emotional Functioning in Preschool-Aged Children With Cancer: Comparisons Between Children With Brain and Non-CNS Solid Tumors. J Pediatr Psychol 2021; 46:790-800. [DOI: 10.1093/jpepsy/jsab018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/31/2022] Open
Abstract
Abstract
Objectives
The preschool years (ages 4–6) are essential for the development of social–emotional skills, such as problem solving, emotion regulation, and conflict resolution. For children with cancer treated during this period, especially those with brain tumors, there are questions regarding the consequences of missed normative social experiences. The objective of this pilot study was to explore the social–emotional functioning of young children with brain tumors, as compared to those with non-CNS solid tumors, who have recently completed treatment.
Methods
Children with brain (n = 23) or solid tumors (n = 20) 4–6 years of age (5.42 ± 0.73 years; 60.5% male, 65.1% white) who were 8.21 (SD = 2.42) months post-treatment completed objective measures (Challenging Situations Task, NEPSY-II) of social functioning while a caregiver completed questionnaires (e.g., BASC-3, NIH Toolbox Emotion Measures).
Results
A large portion of the sample (brain tumor: 65.2%, solid tumor: 44.4%) fell in the clinical range on parent-report measures of peer interaction. There were no statistically significant differences between patient groups across measures, but effect sizes suggest youth with brain tumors potentially experienced more difficulties on some indices. All children were more likely to choose prosocial responses when presented with a challenging social situation where they were physically provoked (e.g., hit) versus socially provoked (e.g., left out).
Conclusions
Preschool-aged children with cancer may experience weaknesses in social functioning shortly after treatment, with youth with brain tumors potentially demonstrating greater concerns. Emphasizing social interaction is critical to ensure young children have the opportunity to develop critical social–emotional skills.
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Affiliation(s)
- Victoria W Willard
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Mallorie L Gordon
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Bethany Means
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Rachel C Brennan
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Heather M Conklin
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Thomas E Merchant
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Anna Vinitsky
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Jennifer L Harman
- Departments of Psychology, Oncology, & Radiation Oncology, St Jude Children’s Research Hospital, Memphis, TN
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14
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Hocking MC, Noll RB, Kazak AE, Brodsky C, Phillips P, Barakat LP. Friendships in Pediatric Brain Tumor Survivors and Non-Central Nervous System Tumor Survivors. J Pediatr Psychol 2020; 45:194-202. [PMID: 31925436 DOI: 10.1093/jpepsy/jsz101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/06/2019] [Accepted: 12/09/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Brain tumors during childhood may disrupt the development and maintenance of friendships due to the impact of disease- and treatment-related factors on functioning. The goal of this study was to determine if children treated for either a brain tumor or a non-central nervous system (CNS) solid tumor could name a friend and to evaluate the social information processes associated with the ability to name a friend. METHOD Youth (ages 7-14) treated for either a brain tumor (n = 47; mean age = 10.51 years) or a non-CNS solid tumor (n = 34; mean age = 11.29) completed an assessment within 6 months of the conclusion of treatment that included asking participants to name a friend and completing measures of social information processing (SIP). Rates of self-reported friendship were compared between groups and correlates of being able to name a friend were evaluated. RESULTS Youth treated for a brain tumor (61.7%) were significantly less likely to name a friend compared with youth treated for a non-CNS solid tumor (85.3%). Diagnosis type (brain vs. non-CNS), relapse status, attribution style, and facial affect recognition were significant predictors of being able to name a friend or not in a logistic regression model. CONCLUSIONS Youth treated for a brain tumor and those who experienced a disease relapse are at risk for impairments in friendships; difficulties with SIP may increase this risk. Targeted screening and intervention efforts for children diagnosed with brain tumors and those who have relapsed could address difficulties with peers.
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Affiliation(s)
| | | | - Anne E Kazak
- Nemours Children's Health System.,Thomas Jefferson University
| | | | - Peter Phillips
- Children's Hospital of Philadelphia.,The University of Pennsylvania
| | - Lamia P Barakat
- Children's Hospital of Philadelphia.,The University of Pennsylvania
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15
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Christen S, Roser K, Mulder RL, Ilic A, Lie HC, Loonen JJ, Mellblom AV, Kremer LCM, Hudson MM, Constine LS, Skinner R, Scheinemann K, Gilleland Marchak J, Michel G; IGHG psychological late effects group. Recommendations for the surveillance of cancer-related fatigue in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. J Cancer Surviv 2020; 14:923-38. [PMID: 32839902 DOI: 10.1007/s11764-020-00904-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/03/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) negatively affects the lives of childhood, adolescent, and young adult (CAYA) cancer survivors. We aimed to provide an evidence-based clinical practice guideline (CPG) with internationally harmonized CRF surveillance recommendations for CAYA cancer survivors diagnosed < 30 years. METHODS This CPG was developed by a multidisciplinary panel under the umbrella of the International Late Effects of Childhood Cancer Guideline Harmonization Group. After evaluating concordances and discordances of four existing CPGs, we performed systematic literature searches. We screened articles for eligibility, assessed quality, extracted, and summarized the data from included articles. We formulated recommendations based on the evidence and clinical judgment. RESULTS Of 3647 articles identified, 70 articles from 14 countries were included. The prevalence of CRF in CAYA cancer survivors ranged from 10-85%. We recommend that healthcare providers are aware of the risk of CRF, implement regular screening with validated measures, and recommend effective interventions to fatigued survivors. CONCLUSIONS A considerable proportion of CAYA cancer survivors suffers from CRF even years after the end of treatment. IMPLICATIONS FOR CANCER SURVIVORS We recommend that healthcare providers adopt regular screening to detect and treat CRF early and positively influence survivors' health and quality of life.
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16
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Strauser DR, Rumrill SP, Rumrill PD, Greco CE, Wagner S. The Work Experience Survey: An on-the-job needs assessment tool to promote successful career outcomes for young adult central nervous system cancer survivors. JVR 2020. [DOI: 10.3233/jvr-191070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David R. Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
- National Changhua University of Education, Changhua City, Taiwan
| | | | - Phillip D. Rumrill
- University of Kentucky, Human Development Institute and Rehabilitation Counseling Program, Lexington, KY, USA
| | | | - Stacia Wagner
- Children’s Brain Tumor Foundation, New York, NY, USA
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17
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Abstract
BACKGROUND Treatment strategies for childhood cancer are improving, resulting in higher survival rates. However, the consequences of childhood cancer do not end with the successful completion of cancer treatment. Most patients will develop late effects after cessation of treatment. Severe fatigue is seen as a common and debilitating late effect in cancer survivors. Although most research on fatigue has been performed in patients after adult-onset cancer, our review focuses on fatigue after childhood cancer. OBJECTIVES To estimate the prevalence of severe fatigue after treatment for childhood cancer. Secondary objectives are to describe the course of severe fatigue following cancer treatment and to examine risk factors for fatigue, or factors associated with it. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (the Cochrane Library 2019; issue 8 March 2019), MEDLINE/PubMed (from 1945 to 8 March 2019), Embase/Ovid (from 1947 to 8 March 2019), reference lists of included articles and several conference proceedings from 2011 to 2018. SELECTION CRITERIA Observational studies, randomised controlled trials and controlled clinical trials reporting on fatigue in participants after treatment for childhood cancer. Case series and case reports were not eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risks of bias. If the publication did not present the prevalence of severe fatigue, we contacted study authors for additional information. MAIN RESULTS We included 30 studies (18,682 participants in total). Eighteen studies contributed to the main objective and 22 studies contributed to the secondary objectives. We found substantial differences between studies in cancer diagnosis, cancer treatment, age of participants, questionnaires used to assess fatigue, and sample size. All included studies scored at least one 'Risk of bias' item as unclear or high risk. We identified both clinical and statistical heterogeneity and therefore could not pool results, so we present them descriptively. Eighteen studies (describing 14,573 survivors) reported the prevalence of severe fatigue, which ranged from 0% to 61.7%. In a subgroup of three studies including children aged up to 18 years at fatigue assessment (268 survivors), prevalence rates ranged from 6.7% to 12.5%. In comparison, in a subgroup of 12 studies including participants aged 16 and over (13,952 survivors), prevalence rates ranged from 4.4% to 61.7%. The prevalence of severe fatigue in a subgroup of survivors of haematological cancer was presented in seven studies and ranged from 1.8% to 35.9% (1907 survivors). Prevalence of severe fatigue in brain cancer survivors was presented in two studies (252 survivors) and was 14.6% and 21.1% respectively. One study presented a prevalence for bone cancer survivors of 0.0% (17 survivors). Four studies provided prevalence rates of severe fatigue in control groups of siblings or population-based controls, which ranged from 3.1% to 10.3%. In these four studies, survivors were more often fatigued than controls, but this difference was statistically significant in only two studies. Studies assessing risk and associated factors for fatigue were heterogeneous, and definitions of the factors under study were often inconsistent, with results therefore presented descriptively. They found that depression might be associated with fatigue. In contrast, age at diagnosis and education level did not seem to be associated with fatigue. We were unable to calculate any overall risk estimate for any of the reported risks and associated factors, because we could not conduct meta-analysis. One study provided information about the course of fatigue over time, and found that over the course of 2.7 years, 32 of the 102 participants (31.4%) reported persistent severe fatigue. AUTHORS' CONCLUSIONS It is unclear how many childhood cancer survivors suffer from severe fatigue. This review encountered several difficulties. We found statistical and clinical heterogeneity and great variation in the reporting of possible risk and associated factors. The evidence in this review is therefore weak, and the exact prevalence of severe fatigue after treatment for childhood cancer remains to be determined. This is also the case for the course of severe fatigue following treatment and the strength of the relationship between fatigue and associated and risk factors. Despite these limitations, our review does provide a comprehensive overview of the existing literature about severe fatigue after treatment for childhood cancer.
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Affiliation(s)
- Sylvia van Deuren
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
| | - Amilie Boonstra
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
| | - Eline van Dulmen‐den Broeder
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatrics, Division of Oncology/HematologyPO Box 7057AmsterdamNetherlands1007 MB
| | - Nicole Blijlevens
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
| | - Hans Knoop
- Amsterdam UMC, University of AmsterdamDepartment of Medical PsychologyMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - Jacqueline Loonen
- Radboud University Medical CenterDepartment of HematologyGeert Grooteplein Zuid 8NijmegenNetherlands6500 HB
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18
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Jones RM, Pattwell SS. Future considerations for pediatric cancer survivorship: Translational perspectives from developmental neuroscience. Dev Cogn Neurosci 2019; 38:100657. [PMID: 31158802 PMCID: PMC6697051 DOI: 10.1016/j.dcn.2019.100657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 04/26/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023] Open
Abstract
Breakthroughs in modern medicine have increased pediatric cancer survival rates throughout the last several decades. Despite enhanced cure rates, a subset of pediatric cancer survivors exhibit life-long psychological side effects. A large body of work has addressed potential mechanisms for secondary symptoms of anxiety, post-traumatic stress, impaired emotion regulation and cognitive deficits in adults. Yet, absent from many studies are the ways in which cancer treatment can impact the developing brain. Additionally, it remains less known whether typical neurobiological changes during adolescence and early adulthood may potentially buffer or exacerbate some of the known negative cancer survivorship outcomes. This review highlights genetic, animal, and human neuroimaging research across development. We focus on the neural circuitry associated with aversive learning, which matures throughout childhood, adolescence and early adulthood. We argue that along with other individual differences, the precise timing of oncological treatment insults on such neural circuitry may expose particular vulnerabilities for pediatric cancer patients. We also explore other moderators of treatment outcomes, including genetic polymorphisms and neural mechanisms underlying memory and cognitive control. We discuss how neural maturation extending into young adulthood may also provide a sensitive period for intervention to improve psychological and cognitive outcomes in pediatric cancer survivors.
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Affiliation(s)
- Rebecca M Jones
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, United States
| | - Siobhan S Pattwell
- Human Biology Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Mailstop C3-168, Seattle, WA 98109, United States.
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19
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Coça KL, Bergmann A, Carrara de Angelis E, Ferman S, Ribeiro MG. Health‐related quality of life of Brazilian children and adolescents with benign and malignant solid tumours: A prospective cohort study during the first year after hospital admission. Eur J Cancer Care (Engl) 2019; 28:e13102. [DOI: 10.1111/ecc.13102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 03/08/2019] [Accepted: 04/08/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Kaliani Lima Coça
- Section of Speech‐language Pathology Instituto Nacional de Câncer (INCA) Rio de Janeiro Brazil
| | - Anke Bergmann
- Molecular Carcinogenesis Program Instituto Nacional de Câncer (INCA) Rio de Janeiro Brazil
| | | | - Sima Ferman
- Pediatric Oncology Service Instituto Nacional de Câncer (INCA) Rio de Janeiro Brazil
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20
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Willard VW, Russell KM, Long A, Phipps S. The impact of connectedness on social functioning in youth with brain tumors. Pediatr Blood Cancer 2019; 66:e27607. [PMID: 30614197 PMCID: PMC6428615 DOI: 10.1002/pbc.27607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE Children with brain tumors (BT) are at risk for difficulties with social functioning. Research to date has focused on deficits, with no studies identifying areas of strength or resilience. Our objective was to assess the potential influence of connectedness on social functioning in youth with BT as compared with children with other cancers. METHODS Children with cancer (20 with BT, 33 with other diagnoses) were enrolled on a longitudinal study of psychosocial functioning. The current study included measures from time 2 (+1 year after enrollment; Mage = 13.11 ± 2.31, Mtimesincediagnosis = 4.95 ± 3.74 years) and time 3 (+3 years after enrollment; Mage = 14.98 ± 2.36, Mtimesincediagnosis = 6.82 ± 3.81 years). Youth completed the Hemingway Measure of Adolescent Connectedness (HMAC) at time 2. Two years later, social functioning was assessed by the self- and proxy-report versions of the Social-Emotional Assets and Resilience Scale (SEARS). RESULTS Youth with BT perceived that they were less connected to friends (t(50) = -2.13, P = 0.04), but similarly connected to peers as youth with other cancers. Youth with BT also demonstrated lower social functioning by self- and parent report. Connectedness to friends significantly mediated the relationship between diagnostic category and self-reported social functioning, such that youth with BT who reported being more connected to friends also indicated greater social functioning. Analyses using connectedness to peers and/or parent-reported social functioning were nonsignificant. CONCLUSIONS Perceiving a connection to a friend may be a protective factor that could mitigate deficits in social functioning in youth with BT. Additional research is needed to further assess the potential benefits of this construct.
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Affiliation(s)
- Victoria W. Willard
- Department of PsychologySt. Jude Children's Research Hospital Memphis Tennessee
| | - Kathryn M. Russell
- Department of PsychologySt. Jude Children's Research Hospital Memphis Tennessee
| | - Alanna Long
- Department of PsychologySt. Jude Children's Research Hospital Memphis Tennessee
| | - Sean Phipps
- Department of PsychologySt. Jude Children's Research Hospital Memphis Tennessee
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21
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Shabason EK, Brodsky C, Baran J, Isaac L, Minturn JE, Ginsberg JP, Hobbie W, Fisher M, Blum N, Hocking MC. Clinical diagnosis of attention-deficit/hyperactivity disorder in survivors of pediatric brain tumors. J Neurooncol 2019; 143:305-12. [DOI: 10.1007/s11060-019-03165-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
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22
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Desjardins L, Barrera M, Chung J, Cataudella D, Janzen L, Bartels U, Downie A, Fairclough D. Are we friends? Best friend nominations in pediatric brain tumor survivors and associated factors. Support Care Cancer 2019; 27:4237-44. [PMID: 30847703 DOI: 10.1007/s00520-019-04706-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Pediatric brain tumor survivors (PBTSs) are at risk of impairments in social competence. Limited information is available regarding nominations and reciprocated nominations of PBTSs as best friends and factors which may predict these. PROCEDURE Caregivers of children (n = 32) aged 8-16 (38% low-grade glioma, 34% medulloblastoma, 28% other) completed ratings of child adjustment at baseline (T1) and PBTSs and classmates completed the Three Best Friends measure approximately 12 months later (T2). Sociometric data yielded ratings of best friend nominations and reciprocated best friend nominations. RESULTS Nominations of PBTSs as best friends were not significantly different than controls, but PBTSs had fewer reciprocated best friend nominations than controls. Approximately half of PBTSs in this study did not have any reciprocated best friend nominations and 25% were not nominated by any peer as a best friend. Greater symptoms of depression and lower social skills in PBTSs were associated with fewer nominations as a best friend by peers and a greater likelihood of no reciprocal best friend nominations. Greater difficulties in emotional control were associated with fewer nominations as a best friend by peers. CONCLUSIONS The discrepancy between reciprocated best friend nominations and best friend nominations highlights a need to attend to reciprocal friendships in PBTSs and further understand social information processes in this population. Longitudinal analyses illustrate the impact of emotional adjustment on PBTS friendships.
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23
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Desjardins L, Barrera M, Schulte F, Chung J, Cataudella D, Janzen L, Bartels U, Downie A. Predicting social withdrawal, anxiety and depression symptoms in pediatric brain tumor survivors. J Psychosoc Oncol 2019; 37:22-36. [DOI: 10.1080/07347332.2018.1535531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Leandra Desjardins
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Maru Barrera
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Fiona Schulte
- Department of Psychology, Division of Hematology/Oncology, Alberta Children’s Hospital, Calgary, Canada
| | - Joanna Chung
- Department of Psychology, Division of Hematology/Oncology, BC Children’s Hospital, Vancouver, Canada
| | - Danielle Cataudella
- Department of Psychology, Division of Hematology/Oncology, London Health Sciences Centre, London, Canada
| | - Laura Janzen
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Ute Bartels
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Andrea Downie
- Department of Psychology, Division of Hematology/Oncology, London Health Sciences Centre, London, Canada
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24
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Willard VW. Social skills interventions for survivors of pediatric brain tumors: A review and reformulation. Pediatr Blood Cancer 2018; 65:e27434. [PMID: 30160028 DOI: 10.1002/pbc.27434] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/18/2018] [Accepted: 08/03/2018] [Indexed: 11/10/2022]
Abstract
Youth with brain tumors are at risk for late effects. Families report that survivors' difficulties with peer relationships are among the most distressing and impactful on quality of life. As such, interventions have been designed to improve social functioning. The objective was to review the nine published social skills intervention studies for survivors of brain tumors with regard to study design, participation rates, skills targeted, assessment measures, and outcomes. Results of this review were used to discuss future directions, with a focus on alternative approaches to inclusion criteria (including developmental considerations and screening for weaknesses), intervention timing and modality.
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25
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Strauser DR, Chan F, Fine E, Iwanaga K, Greco C, Liptak C. Development of the perceived barriers scale: a new instrument identifying barriers to career development and employment for young adult survivors of pediatric CNS tumors. J Cancer Surviv 2018; 13:1-9. [PMID: 30357721 DOI: 10.1007/s11764-018-0722-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Given the significant employment disparities for survivors of pediatric brain tumors, there is increased need to conduct vocational and career research with this group. The purpose of the present study was to construct an instrument, the Perceived Barriers Scale, that is psychometrically sound and has both clinical and research application related to career and employment issues of pediatric brain tumor survivors. METHOD The participants consisted of 110 young adult central nervous system survivors of childhood cancer aged between 18 and 30 years old (M = 23.05, SD = 3.36) who were identified by the DFCI Pediatric Brain Tumor Clinic. The 12-item Perceived Barriers Scale was developed from a comprehensive literature review, clinical interviews conducted with survivors of pediatric brain tumors, and feedback from multidisciplinary providers. Exploratory factor analysis and correlations were completed to examine the initial psychometric properties of the scale. RESULTS Exploratory factors analysis identified two factors that accounted for 57.92% with the two factors labeled as internal barriers and external barriers. All factors loaded significantly onto their respective factors (.48 to .88). The results of the correlational analysis found significant relationships between both internal barrier and external barrier subscales and CSE and WHODAS-2 providing initial support for the construct validity of the Perceived Barriers Scale. CONCLUSIONS Overall, the study findings indicate good psychometrics with the brevity of the scale increasing potential application and utilization in both research and clinical settings. IMPLICATIONS FOR CANCER SURVIVORS Identification of employment barriers for brain tumor survivors provides opportunity for more targeted vocational intervention.
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Affiliation(s)
- David R Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA. .,Work and Disability Lab, Department of Kinesiology And Community Health, 213A Huff Hall, 1206 South Fourth Street, Champaign, IL, 61820, USA.
| | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Elizabeth Fine
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, 02115, USA
| | | | - Chelsea Greco
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Cori Liptak
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, 02115, USA
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Bell H, Ownsworth T, Lloyd O, Sheeran N, Chambers S. A systematic review of factors related to children's quality of life and mental health after brain tumor. Psychooncology 2018; 27:2317-2326. [PMID: 30071150 DOI: 10.1002/pon.4850] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Brain tumor has been found to have a major impact on children's quality of life (QOL); yet, the subjective impact of the illness is still not well understood. This review aimed to investigate factors related to children's subjective well-being (SWB), or self-reported QOL and mental health after brain tumor. A further aim was to determine the consistency between child and parent-proxy ratings of children's SWB and common factors associated with both child and parent-proxy ratings. METHODS A systematic search of PsycINFO, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, and Scopus was conducted from 1980 to May 2018 to identify eligible studies. Methodological quality of these studies was assessed by 2 independent reviewers. RESULTS Twenty studies investigated factors related to children's self-reported mental health or QOL. Fourteen studies examined these factors from the perspectives of both children and their parents. Overall, risk factors for poor QOL included infratentorial tumors, radiation, hydrocephalus, lower IQ, and behavioral problems. Only 5 studies examined mental health outcomes, the findings of which were mixed. Relatively few studies examined psychosocial variables related to children's SWB. CONCLUSIONS Although several risk factors for poor QOL were identified, further research investigating mental health outcomes and the influence of psychosocial factors on children's SWB is needed to guide support interventions for pediatric brain tumor.
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Affiliation(s)
- Hayley Bell
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Owen Lloyd
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.,Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.,School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Nicola Sheeran
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Suzanne Chambers
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.,Cancer Council Queensland, Brisbane, Queensland, Australia
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Wade SL, Bedell G, King JA, Jacquin M, Turkstra LS, Haarbauer-Krupa J, Johnson J, Salloum R, Narad ME. Social Participation and Navigation (SPAN) program for adolescents with acquired brain injury: Pilot findings. Rehabil Psychol 2018; 63:327-337. [PMID: 30024207 PMCID: PMC6198824 DOI: 10.1037/rep0000187] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE/OBJECTIVE Our goal was to examine the feasibility and preliminary efficacy of an app-based coaching intervention (Social Participation and Navigation; SPAN) to help survivors of acquired brain injury attain social participation goals. Research Method/Design: This is a nonrandomized pilot trial of SPAN, including 15 adolescents (9 with traumatic brain injury, 6 with brain tumor) between the ages of 14-22. The SPAN intervention consisted of a mobile app to support the development and implementation of social participation goals, weekly video-conference coaching sessions to identify goals and step-by-step action plans, and online didactic materials. Assessments were completed pre- and postintervention. Satisfaction with the intervention, confidence in the adolescents' ability to participate in and plan social activities and manage their emotions and behaviors, and frequency and satisfaction with social participation were assessed via self- and parent-report questionnaires developed for this project. Behavior problems, social competence, and social problems were measured by using the Child Behavior Checklist and the Youth Self-Report. RESULTS High levels of participant and parent satisfaction were reported. Increases in parent-reported frequency of social participation and teen-reported confidence in their ability to participate and develop social participation goals and plans were observed. A decline in parent-reported total problems, internalizing problems, externalizing problems, and social problems was noted. CONCLUSION/IMPLICATIONS Results support the feasibility of the program, because participants were able to successfully meet with their coaches and use the app to develop and accomplish social participation goals. Further research will be needed to refine the app and program, particularly when reaching out to populations beyond traumatic brain injury. (PsycINFO Database Record
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Schulte F, Brinkman TM, Li C, Fay-McClymont T, Srivastava DK, Ness KK, Howell RM, Mueller S, Wells E, Strother D, Lafay-Cousin L, Leisenring W, Robison LL, Armstrong GT, Krull KR. Social adjustment in adolescent survivors of pediatric central nervous system tumors: A report from the Childhood Cancer Survivor Study. Cancer 2018; 124:3596-3608. [PMID: 30067866 DOI: 10.1002/cncr.31593] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/25/2018] [Accepted: 05/10/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to examine the prevalence and predictors of social difficulties in adolescent survivors of central nervous system (CNS) tumors. METHODS Six hundred sixty-five survivors of CNS tumors (53.8% male and 51.7% treated with cranial radiation therapy [CRT]), who had a current median age of 15.0 years (range, 2.0-17.0 years) and were a median of 12.1 years (range, 8.0-17.7 years) from their diagnosis, were compared with 1376 survivors of solid tumors (50.4% male), who had a median age of 15.0 years (range, 12.0-17.0 years) and were a median of 13.2 years (range, 8.3-17.9 years) from their diagnosis, and 726 siblings (52.2% male), who had a median age of 15.0 years (range, 12.0-17.0 years). Social adjustment was measured with parent-proxy responses to the Behavior Problems Index. Latent profile analysis defined social classes. Multinomial logistic regression, adjusted for age, sex, and age at diagnosis, identified predictors of class membership. Path analyses tested mediating effects of physical limitations, sensory loss, and cognitive impairment on social outcomes. RESULTS Caregivers reported that survivors of CNS tumors were more likely to have 0 friends (15.3%) and to interact with friends less than once per week (41.0%) in comparison with survivors of solid tumors (2.9% and 13.6%, respectively) and siblings (2.3% and 8.7%, respectively). Latent profile analysis identified 3 social classes for survivors of CNS tumors: well-adjusted (53.4%), social deficits (16.2%), and poor peer relationships (30.4%). However, 2 classes were identified for survivors of solid tumors and siblings: well-adjusted (86.2% and 91.1%, respectively) and social deficits (13.8% and 8.9%, respectively). CRT predicted class membership for CNS survivors (odds ratio [OR] for poor peer relationships, 1.16/10 Gy; 95% confidence interval [CI], 1.08-1.25; OR for social deficits 1.14/10 Gy; 95% CI, 1.04-1.25; reference, well-adjusted). Cognitive impairment mediated the association between all social outcomes and CRT (P values < .001). CONCLUSION Almost 50% of survivors of CNS tumors experience social difficulties; the pattern is unique in comparison with solid tumor and sibling groups. Cognitive impairment is associated with increased risk, and this highlights the need for multitargeted interventions.
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Affiliation(s)
- Fiona Schulte
- University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | - Chenghong Li
- St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Taryn Fay-McClymont
- University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | - Kirsten K Ness
- St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Rebecca M Howell
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sabine Mueller
- University of California San Francisco, San Francisco, California
| | - Elizabeth Wells
- Children's National Medical Center, Washington, District of Columbia
| | - Douglas Strother
- University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Lucie Lafay-Cousin
- University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | | | | | - Kevin R Krull
- St. Jude Children's Research Hospital, Memphis, Tennessee
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Paltin I, Schofield HL, Baran J. Rehabilitation and Pediatric Oncology: Supporting Patients and Families During and After Treatment. Curr Phys Med Rehabil Rep 2018. [DOI: 10.1007/s40141-018-0181-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Schulte F, Wurz A, Russell KB, Reynolds K, Strother D, Dewey D. Social adjustment and repressive adaptive style in survivors of pediatric cancer. J Psychosoc Oncol 2018; 36:274-286. [PMID: 29452053 DOI: 10.1080/07347332.2018.1431754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of the study was to explore the relationship between repressive adaptive style and self-reports of social adjustment in survivors of pediatric cancer compared to their siblings. We hypothesized that there would be a greater proportion of repressors among survivors of pediatric cancer compared to siblings, and that repressive adaptive style would be significantly associated with more positive self-reports of social adjustment. METHODS We utilized a cross-sectional approach. Seventy-seven families participated. Survivors of pediatric cancer (n = 77, 48% male; 8-18 years of age) and one sibling (n = 50, 48% male; 8-18 years of age) completed measures assessing repressive adaptive style and social adjustment. As well, one parent from each family completed a socio-demographic questionnaire. Questionnaire packages were mailed to eligible families who agreed to participate, and were mailed back to investigators in a pre-addressed, pre-stamped envelope. RESULTS Chi-square analyses revealed there was no significant difference in the proportion of repressors among survivors and siblings. Social adjustment scores were subjected to a two (group: survivor, sibling) by two (repressor, nonrepressor) ANCOVA with gender and age as covariates. There was a significant main effect of repressive adaptive style (F = 5.69, p < .05, η2 = 0.05) with a modest effect. Survivors and siblings with a repressive style reported significantly higher social adjustment scores (M = 106.91, SD = 11.69) compared to nonrepressors (M = 99.57, SD = 13.45). CONCLUSIONS Repressive adaptive style explains some of the variance in survivors and siblings' self-reports of social adjustment. Future research should aim to better understand the role of the repressive adaptive style in survivors and siblings of children with cancer.
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Affiliation(s)
- Fiona Schulte
- a Department of Oncology, Division of Psychosocial Oncology , Cumming School of Medicine and Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary , Alberta , Canada
| | - Amanda Wurz
- b School of Human Kinetics, University of Ottawa , Ottawa , Ontario , Canada
| | - K Brooke Russell
- c Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Departments of Psychology and Oncology , Cumming School of Medicine, University of Calgary , Calgary , Alberta , Canada
| | - Kathleen Reynolds
- d Long Term Survivor Clinic, Alberta Children's Hospital, Clinical Lecturer, Department of Family Medicine , University of Calgary , Calgary , Alberta , Canada
| | - Douglas Strother
- e Departments of Oncology, Pediatrics , University of Calgary, Division of Hematology Oncology Bone Marrow Transplantation, Alberta Children's Hospital , Calgary , Alberta , Canada
| | - Deborah Dewey
- f Departments of Pediatrics & Community Health Sciences , University of Calgary, Director, Behavioural Research Unit , Calgary , Alberta , Canada
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Tsimicalis A, Genest L, Stevens B, Ungar WJ, Barr R. The Impact of a Childhood Cancer Diagnosis on the Children and Siblings’ School Attendance, Performance, and Activities: A Qualitative Descriptive Study. J Pediatr Oncol Nurs 2017; 35:118-131. [DOI: 10.1177/1043454217741875] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Families of children with cancer are confronted with unexpected out-of-pocket expenses and productivity costs associated with the diagnosis. One productivity cost that falls on children is the impact of cancer on children’s school attendance, performance, and activities (eg, play, friendships, and socialization). Nested within the Childhood Cancer Cost Study, this qualitative descriptive study used convenience sampling to recruit and interview parents of children newly diagnosed with cancer. Content analysis techniques were used to inductively descriptive the semistructured interview data. Sixty-six parents of 65 children with cancer and of 73 siblings participated. The most commonly reported productivity loss in children with cancer was school absenteeism mainly due to cancer treatment. Children fell behind their classmates academically and lost important social time with peers. A few siblings also fell behind their peers primarily due to limited parental attention. Parents adopted various strategies to lessen the impact of the diagnosis on their children’s school attendance, performance, and activities. Providing parents with additional resources and support may optimize their children’s academic and social reintegration into school.
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Affiliation(s)
- Argerie Tsimicalis
- McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children–Canada, Montreal, Quebec, Canada
| | | | - Bonnie Stevens
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wendy J. Ungar
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald Barr
- Pediatric Oncology Group of Ontario (POGO), Toronto, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
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Sargın Yıldırım N, Demirkaya M, Sevinir BB, Güler S, Vural AP, Demiröz C, Çırpan Kantarcıoğlu A. A prospective follow-up of quality of life, depression, and anxiety in children with lymphoma and solid tumors. Turk J Med Sci 2017; 47:1078-1088. [PMID: 29153555 DOI: 10.3906/sag-1510-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: The aim of this study was the determination and prospective follow-up of quality of life, depression, and anxiety in pediatric patients with cancer under chemotherapy, as well as the evaluation of related factors. Materials and methods: Fifty newly diagnosed pediatric cancer patients and their parents were prospectively monitored before, during, and after therapy, and tests were used. Results: Significantly lower quality of life scores were recorded during treatment, in the group with CNS tumors, in the group receiving chemotherapy plus radiotherapy plus surgery, in the inpatient-only treatment group, in the group receiving treatment for longer than 6 months, and in the group of patients whose diagnosis was delayed for more than 3 months. Total quality of life scores for children and their parents were 82.95 ± 14.59 vs. 83.61 ± 14.60 before, 54.69 ± 16.51 vs. 55.78 ± 16.05 during, and 83.88 ± 12.44 vs. 84.19 ± 13.22 at the end of treatment (P < 0.05). Anxiety and depression scores were significantly higher during treatment, in patients whose diagnoses were delayed for more than 3 months, and among inpatients. Conclusion: The quality of life of a majority of our patients was severely affected, and depression and anxiety were more frequently seen especially during treatment.
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Hobbie WL, Ogle S, Reilly M, Barakat L, Lucas MS, Ginsberg JP, Fisher MJ, Volpe EM, Deatrick JA. Adolescent and Young Adult Survivors of Childhood Brain Tumors: Life After Treatment in Their Own Words. Cancer Nurs 2016; 39:134-43. [PMID: 25950583 DOI: 10.1097/NCC.0000000000000266] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To date, there are few studies that examine the perspectives of older survivors of childhood brain tumors who are living with their families in terms of their sense of self and their role in their families. OBJECTIVE The aim of this study was to describe how adolescent and young adult survivors of childhood brain tumors describe their health-related quality of life, that is, their physical, emotional, and social functioning. METHODS This qualitative descriptive study included a purposive sample of 41 adolescent and young adult survivors of a childhood brain tumor who live with their families. Home interviews were conducted using a semistructured interview guide. Directed content analytic techniques were used to analyze data using health-related quality of life as a framework. RESULTS This group of brain tumor survivors described their everyday lives in terms of their physical health, neurocognitive functioning, emotional health, social functioning, and self-care abilities. Overall, survivors struggle for normalcy in the face of changed functioning due to their cancer and the (late) effects of their treatment. CONCLUSIONS Neurocognitive issues seemed most compelling in the narratives. The importance of families went beyond the resources, structure, and support for functioning. Their families provided the recognition that they were important beings and their existence mattered to someone. IMPLICATIONS FOR PRACTICE The value and complexity of care coordination were highlighted by the multifaceted needs of the survivors. Advocacy for appropriate and timely educational, vocational, and social support is critical as part of comprehensive cancer survivorship care.
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Gerhardt CA. Commentary: Dennis D. Drotar Distinguished Research Award: Academic and Personal Reflections on Childhood Cancer Research Across the Illness Spectrum. J Pediatr Psychol 2016; 41:1045-1052. [PMID: 27680081 PMCID: PMC5061976 DOI: 10.1093/jpepsy/jsw076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 08/16/2016] [Accepted: 08/17/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- Cynthia A Gerhardt
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital Department of Pediatrics and Psychology, The Ohio State University
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Abstract
Brain tumors are the most common solid tumor in childhood, yet outcomes vary dramatically. High-grade gliomas have dismal outcomes with poor survival. By contrast, low-grade gliomas, have high survival rates, but children suffer from morbidity of tumor burden and therapy-associated side effects. In this article, we discuss how current trial designs often miss the opportunity to include end points beyond tumor response and thus fail to offer complete assessments of therapeutic approaches. Quality of life, neurocognitive function and neurofunctional deficits need to be considered when assessing overall success of a therapy. Herein, we identify specific end points that should be included in the interpretation of clinical trial results and accordingly, offer a more comprehensive approach to treatment decision-making.
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Affiliation(s)
- Lennox Byer
- School of Medicine, University of California, San Francisco (UCSF), 513 Parnassus Ave, San Francisco, CA 94143, USA
| | - Cassie Kline
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of California, San Francisco, 550 16th Street, 4th Floor, San Francisco, CA 94158, USA
| | - Sabine Mueller
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of California, San Francisco, 550 16th Street, 4th Floor, San Francisco, CA 94158, USA.,Department of Neurology & Neurosurgery San Francisco, University of California, 625 Nelson Rising Lane, 4th Floor, San Francisco, CA 94158, USA
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36
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Liptak C, Brinkman T, Bronson A, Delaney B, Chordas C, Brand S, Patenaude AF, Muriel AC, Manley P. A social program for adolescent and young adult survivors of pediatric brain tumors: The power of a shared medical experience. J Psychosoc Oncol 2016; 34:493-511. [DOI: 10.1080/07347332.2016.1225146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Brinkman TM, Li C, Vannatta K, Marchak JG, Lai JS, Prasad PK, Kimberg C, Vuotto S, Di C, Srivastava D, Robison LL, Armstrong GT, Krull KR. Behavioral, Social, and Emotional Symptom Comorbidities and Profiles in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol 2016; 34:3417-25. [PMID: 27432919 DOI: 10.1200/jco.2016.66.4789] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In the general population, psychological symptoms frequently co-occur; however, profiles of symptom comorbidities have not been examined among adolescent survivors of childhood cancer. PATIENTS AND METHODS Parents of 3,893 5-year survivors of childhood cancer who were treated between 1970 and 1999 and who were assessed in adolescence (age 12 to 17 years) completed the Behavior Problems Index. Age- and sex-standardized z scores were calculated for symptom domains by using the Childhood Cancer Survivor Study sibling cohort. Latent profile analysis identified profiles of comorbid symptoms, and multivariable multinomial logistic regression modeling examined associations between cancer treatment exposures and physical late effects and identified symptom profiles. Odds ratios (ORs) and 95% CIs for latent class membership were estimated and analyses were stratified by cranial radiation therapy (CRT; CRT or no CRT). RESULTS Four symptoms profiles were identified: no significant symptoms (CRT, 63%; no CRT, 70%); elevated anxiety and/or depression, social withdrawal, and attention problems (internalizing; CRT, 31%; no CRT, 16%); elevated headstrong behavior and attention problems (externalizing; CRT, no observed; no CRT, 9%); and elevated internalizing and externalizing symptoms (global symptoms; CRT, 6%; no CRT, 5%). Treatment with ≥ 30 Gy CRT conferred greater risk of internalizing (OR, 1.7; 95% CI, 1.0 to 2.8) and global symptoms (OR, 3.2; 95% CI, 1.2 to 8.4). Among the no CRT group, corticosteroid treatment was associated with externalizing symptoms (OR, 1.9; 95% CI, 1.2 to 2.8) and ≥ 4.3 g/m(2) intravenous methotrexate exposure was associated with global symptoms (OR, 1.5; 95% CI, 0.9 to 2.4). Treatment late effects, including obesity, cancer-related pain, and sensory impairments, were significantly associated with increased risk of comorbid symptoms. CONCLUSION Behavioral, emotional, and social symptoms frequently co-occur in adolescent survivors of childhood cancer and are associated with treatment exposures and physical late effects. Assessment and consideration of symptom profiles are essential for directing appropriate mental health treatment for adolescent survivors.
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Affiliation(s)
- Tara M Brinkman
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA.
| | - Chenghong Li
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kathryn Vannatta
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jordan G Marchak
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jin-Shei Lai
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Pinki K Prasad
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Cara Kimberg
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Stefanie Vuotto
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Chongzhi Di
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Deokumar Srivastava
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Leslie L Robison
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Gregory T Armstrong
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kevin R Krull
- Tara M. Brinkman, Chenghong Li, Cara Kimberg, Stefanie Vuotto, Deokumar Srivastava, Leslie L. Robison, Gregory T. Armstrong, and Kevin R. Krull, St. Jude Children's Research Hospital, Memphis, TN; Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Jordan G. Marchak, Emory University School of Medicine, Atlanta, GA; Jin-Shei Lai, Northwestern University Feinberg School of Medicine, Chicago, IL; Pinki K. Prasad, Louisiana State University, Baton Rouge, LA; and Chongzhi Di, Fred Hutchinson Cancer Research Center, Seattle, WA
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Suzuki LK, Kato PM. Psychosocial Support for Patients in Pediatric Oncology: The Influences of Parents, Schools, Peers, and Technology. J Pediatr Oncol Nurs 2016; 20:159-74. [PMID: 14567564 DOI: 10.1177/1043454203254039] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The diagnosis and treatment of pediatric cancer can be associated with profound psychosocial changes in the life of young patients. Although nurses, physicians, and other health care professionals are important sources of support, psychosocial support is also available through parents, schools, and peers. This article presents a review of the literature on how parents, schools, and peers affect the coping and adjustment of young patients with cancer and critically reviews interventions directed at improving functioning in these areas. Special attention is paid to recent interventions that exploit technology such as video games, CD-ROMs, and the Internet to provide creative new forms of support for patients in pediatric oncology. Existing research on both technological and interpersonal forms of intervention and support shows promising results, and suggestions for further study are provided.
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Fischer C, Petriccione M, Donzelli M, Pottenger E. Improving Care in Pediatric Neuro-oncology Patients: An Overview of the Unique Needs of Children With Brain Tumors. J Child Neurol 2016; 31:488-505. [PMID: 26245798 PMCID: PMC5032907 DOI: 10.1177/0883073815597756] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 06/29/2015] [Indexed: 02/06/2023]
Abstract
Brain tumors represent the most common solid tumors in childhood, accounting for almost 25% of all childhood cancer, second only to leukemia. Pediatric central nervous system tumors encompass a wide variety of diagnoses, from benign to malignant. Any brain tumor can be associated with significant morbidity, even when low grade, and mortality from pediatric central nervous system tumors is disproportionately high compared to other childhood malignancies. Management of children with central nervous system tumors requires knowledge of the unique aspects of care associated with this particular patient population, beyond general oncology care. Pediatric brain tumor patients have unique needs during treatment, as cancer survivors, and at end of life. A multidisciplinary team approach, including advanced practice nurses with a specialty in neuro-oncology, allows for better supportive care. Knowledge of the unique aspects of care for children with brain tumors, and the appropriate interventions required, allows for improved quality of life.
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Affiliation(s)
- Cheryl Fischer
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mary Petriccione
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria Donzelli
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elaine Pottenger
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Abstract
PURPOSE OF REVIEW The purpose of this article is to review the literature in the area of social competence in pediatric brain tumor survivors published in the last year. RECENT FINDINGS Research published over the past year examining the social competence of pediatric brain tumor survivors has seen the consistent application of a comprehensive conceptual framework that pertains specifically to children with brain disorders. Subsequent to the application of a comprehensive conceptual framework, more sophisticated research approaches have begun to advance our understanding of deficits among this population. Specifically, operationalization of social competence is evolving. SUMMARY Continued application of a conceptual framework and investigation into the components that comprise the framework will enhance the depth of our understanding of social competence deficits among this population. Research must continue to use innovative approaches to measuring social competence. Considerable gaps still exist with respect to identifying risk and resilience factors for social competence deficits.
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Devine KA, Bukowski WM, Sahler OJ, Ohman-Strickland P, Smith TH, Lown EA, Patenaude AF, Korones DN, Noll RB. Social Competence in Childhood Brain Tumor Survivors: Feasibility and Preliminary Outcomes of a Peer-Mediated Intervention. J Dev Behav Pediatr 2016; 37:475-82. [PMID: 27355881 DOI: 10.1097/DBP.0000000000000315] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Evaluate the acceptability, feasibility, and preliminary outcomes of a peer-mediated intervention to improve social competence of brain tumor survivors and classmates. METHOD Twelve childhood brain tumor survivors and 217 classroom peers in intervention (n = 8) or comparison (n = 4) classrooms completed measures of social acceptance and reputation at 2 time points in the year. The intervention (5-8 sessions over 4-6 weeks) taught peer leaders skills for engaging classmates. Individual and classroom outcomes were analyzed with analysis of covariance. RESULTS Recruitment rates of families of brain tumor survivors (81%) and schools (100%) were adequate. Peer leaders reported satisfaction with the intervention. Preliminary outcome data trended toward some benefit in increasing the number of friend nominations for survivors of brain tumors but no changes in other peer-reported metrics. Preliminary results also suggested some positive effects on classroom levels of victimization and rejection. CONCLUSION A peer-mediated intervention was acceptable to families of brain tumor survivors and feasible to implement in schools. Findings warrant a larger trial to evaluate improvements for children with brain tumors and their peers.
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Willard VW, Allen TM, Hardy KK, Bonner MJ. Social functioning in survivors of pediatric brain tumors: Contribution of neurocognitive and social-cognitive skills. Children's Health Care 2015. [DOI: 10.1080/02739615.2015.1124769] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Thompson AL, Christiansen HL, Elam M, Hoag J, Irwin MK, Pao M, Voll M, Noll RB, Kelly KP. Academic Continuity and School Reentry Support as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S805-17. [PMID: 26700927 PMCID: PMC5198902 DOI: 10.1002/pbc.25760] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/20/2015] [Indexed: 11/09/2022]
Abstract
Clinicians agree that return to school after diagnosis promotes the positive adjustment of children and adolescents with cancer; however, the school reentry process can present challenges. The aim of this review was to critically evaluate the literature on school reentry support for youth with cancer. Seventeen publications were identified. School reentry services were well-received by families and educators; increased teacher and peer knowledge about childhood cancer; influenced peer and educator attitudes toward the patient; and improved communication and collaboration between patients/families, school, and the healthcare team. Evidence supports a strong recommendation for school reentry support for youth with cancer.
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Affiliation(s)
- Amanda L. Thompson
- Center for Cancer and Blood Disorders, Children’s National Health System, Washington, DC
| | | | - Megan Elam
- Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Jennifer Hoag
- Department of Pediatric Hematology/Oncology/BMT, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mary Kay Irwin
- School Health Services, Nationwide Children’s Hospital, Columbus, Ohio
| | - Maryland Pao
- National Institute of Mental Health, Bethesda, Maryland
| | - Megan Voll
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Robert B. Noll
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Katherine Patterson Kelly
- Department of Nursing Research and Quality Outcomes, Children’s National Health System, Washington, DC
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Hocking MC, McCurdy M, Turner E, Kazak AE, Noll RB, Phillips P, Barakat LP. Social competence in pediatric brain tumor survivors: application of a model from social neuroscience and developmental psychology. Pediatr Blood Cancer 2015; 62:375-84. [PMID: 25382825 PMCID: PMC4304946 DOI: 10.1002/pbc.25300] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/16/2014] [Indexed: 12/21/2022]
Abstract
Pediatric brain tumor (BT) survivors are at risk for psychosocial late effects across many domains of functioning, including neurocognitive and social. The literature on the social competence of pediatric BT survivors is still developing and future research is needed that integrates developmental and cognitive neuroscience research methodologies to identify predictors of survivor social adjustment and interventions to ameliorate problems. This review discusses the current literature on survivor social functioning through a model of social competence in childhood brain disorder and suggests future directions based on this model. Interventions pursuing change in survivor social adjustment should consider targeting social ecological factors.
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Affiliation(s)
| | - Mark McCurdy
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Psychology, Drexel University
| | - Elise Turner
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Psychology, Drexel University
| | - Anne E. Kazak
- Center for Healthcare Delivery Science, Nemours Children’s Health System
- Department of Pediatrics, Sidney Kimmel School of Medicine at Thomas Jefferson University
| | | | - Peter Phillips
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania
| | - Lamia P. Barakat
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania
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Zwiers A, Campbell C, Evans M, Kirkwood K. Constructing the Meaning of Survivor With Former Pediatric Brain Tumor Patients. J Pediatr Oncol Nurs 2014; 32:143-52. [DOI: 10.1177/1043454214553708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although the term survivor is frequently used in cancer discourse, the meaning of survivor and how people identify with this term can be difficult to understand. The purpose of this qualitative study is to explore the meaning of the term survivor from the perspective of young adults who have experienced a pediatric brain tumor (PBT). A constructivist grounded theory was utilized in this study with 6 young adults who had a PBT. This study also used semistructured interviews with participants who also completed reflective journals, which were focused on the survivor concept. Data were analyzed through coding strategies and constant comparative methods. Findings present 4 major themes of process: ( a) reviewing the illness experience, ( b) qualifying as a survivor, ( c) thinking positive, and ( d) being changed. These themes are important to consider in the construction, interpretation, and understanding of how the majority of this population do not identify with the current social use of the term survivor. Clearly, there is a need for a clearer understanding of survivor and how it specifically applies to those who have had a PBT. Everyone should remain conscious and consider how a broad, generalizing term such as survivor may influence a person’s attitude and advocacy toward their health.
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Salley CG, Gerhardt CA, Fairclough DL, Patenaude AF, Kupst MJ, Barrera M, Vannatta K. Social self-perception among pediatric brain tumor survivors compared with peers. J Dev Behav Pediatr 2014; 35:427-34. [PMID: 25127341 DOI: 10.1097/DBP.0000000000000077] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess self-perceptions of social behavior among children treated for a brain tumor and comparison children. To investigate group differences in the accuracy of children's self-perceptions as measured by discrepancies between self and peer reports of social behavior and to understand if these phenomena differ by gender. METHOD Self and peer reports of social behavior were obtained in the classrooms of 116 children who were treated for an intracranial tumor. Social behaviors were assessed using the Revised Class Play, which generates indices for 5 behavioral subscales: Leadership-popularity, Prosocial, Aggressive-disruptive, Sensitive-isolated, and Victimization. A child matched for gender, race, and age was selected from each survivor's classroom to serve as a comparison. Abbreviated IQ scores were obtained in participants' homes. RESULTS Relative to comparison children, those who had undergone treatment for a brain tumor overestimated their level of Leadership-popularity and underestimated levels of Sensitive-isolated behaviors and Victimization by peers. Female survivors were more likely than male survivors to underestimate Sensitive-isolated behaviors and Victimization. CONCLUSION Following treatment for a brain tumor, children (particularly girls) may be more likely than healthy children to underestimate peer relationship difficulties. These discrepancies should be considered when obtaining self-report from survivors and developing interventions to improve social functioning.
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Hoag J, Kupst MJ, Briere ME, Mabbott D, Elkin TD, Trask CL, Isenberg J, Holm S, Ambler C, Strother DR. Feasibility of conducting long-term follow-up of children and infants treated for CNS tumors on the same cooperative group clinical trial protocol. J Clin Psychol Med Settings 2014; 21:136-43. [PMID: 24668336 DOI: 10.1007/s10880-014-9391-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Given the barriers to conducting long-term assessment of neurocognitive and psychosocial functioning of those treated in infancy for central nervous system (CNS) tumors, a multi-site feasibility study was conducted. The primary objective was to demonstrate that it is feasible to identify, locate and assess the functioning of children treated on the same protocol 10-years post-treatment. Six sites obtained institutional approval, identified and recruited subjects, and obtained comprehensive neurocognitive and psychosocial data. All feasibility objectives were met. Barriers to participation included length of time for Institutional Review Board submission and review, clinical demands, limited eligible participants at individual institutions, difficulty locating long-term subjects and stipend/reimbursement concerns. Results indicate that long-term studies are feasible and essential given the need to address long-term issues of children treated at a young age for CNS tumors, especially as they relate to later academic and vocational planning, but require significant coordination and commitment of cooperative group and institutional resources.
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Howard AF, Hasan H, Bobinski MA, Nurcombe W, Olson R, Parkinson M, Goddard K. Parents’ perspectives of life challenges experienced by long-term paediatric brain tumour survivors: work and finances, daily and social functioning, and legal difficulties. J Cancer Surviv 2014; 8:372-83. [DOI: 10.1007/s11764-013-0331-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 11/23/2013] [Indexed: 11/27/2022]
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Abstract
Background: Childhood cancer is a stressful experience and may cause a change in the child's perception of himself/ herself, the family and the world around him/ her. Aims: This study sought to (a) explore the self-perception of children; and (b) examine the relation of children with others. Materials and Methods: The total population of the study consisted of all the children, undergoing cancer treatment at Children Cancer Hospital, located in Karachi. The participants were asked to draw a drawing on self and others. Through qualitative approach (phenomenology), themes and sub-themes were derived. Results: Using purposive sampling, the total sample size drawn for this study was 78 children aged 7-12, receiving treatment for cancer (1st stage) at the Children Cancer Hospital, Karachi, Pakistan. The drawings of the children were categorized into facial expressions, self images and family ties. Within each category, there were sub-categories. Under facial expressions, the common emotions reflected were sadness, seriousness, anger; and pain. The self-image pictures uniformly reflected low self-esteem, especially focusing on hair loss, missing body parts. Under the category of family ties, most of the children's drawings reflected their isolation or emotional detachment from or abandonment by their family members. Conclusions: The study concludes that the self- image of most of the participants is deteriorated and they are socially isolated. Social and moral support can bring positive emotional development and helps to correct their self-perception.
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Affiliation(s)
- Munir Moosa Sadruddin
- Department of Education, Sindh Madressatul Islam University, Aiwan-e-Tijarat Road, Karachi, Pakistan
| | - M Hameed-Ur-Rehman
- Hamdard Institute of Education and Social Sciences, Hamdard University, Karachi, Pakistan
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