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Sievers Y, Roser K, Scheinemann K, Michel G, Ilic A. The information needs of relatives of childhood cancer patients and survivors: A systematic review of quantitative evidence. PATIENT EDUCATION AND COUNSELING 2024; 126:108316. [PMID: 38788309 DOI: 10.1016/j.pec.2024.108316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/04/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE We aimed to: (1) summarize the quantitative evidence on the information needs of relatives of childhood cancer patients, survivors, and children deceased from cancer; and (2) identify factors associated with these needs. METHODS PubMed, PsycINFO, Scopus, and CINAHL were systematically searched. The methodological quality of all included publications was assessed, and the extracted data were analyzed using narrative synthesis. RESULTS Of 5810 identified articles, 45 were included. Information needs were classified as unmet, met (satisfied), and unspecified and categorized into five domains: medical information, cancer-related consequences, lifestyle, family, and support. Most unmet information needs concerned cancer-related consequences (e.g., late effects), while information needs on support were generally met. Migrant background and higher education were associated with higher information needs among parents. Siblings had lower information needs than parents. CONCLUSION This systematic review provides a comprehensive overview of the information needs of relatives in the context of childhood cancer, showing that information on cancer-related consequences is needed most often. The socioeconomic background of the relatives needs continued consideration throughout the cancer trajectory. PRACTICE IMPLICATIONS Our findings suggest the need for personalized information. Healthcare professionals should adapt their communication strategies to respond to the different and evolving needs of all affected relatives.
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Affiliation(s)
- Yara Sievers
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Division of Hematology and Oncology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland; Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Anica Ilic
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Zahid N, Enam SA, Mårtensson T, Azam I, Mushtaq N, Moochhala M, Kausar F, Hassan A, Kamran Bakhshi S, Javed F, Rehman L, Mughal MN, Altaf S, Kirmani S, Brown N. Factors associated with changes in the quality of life and family functioning scores of primary caregivers of children and young people with primary brain tumors in Karachi, Pakistan: a prospective cohort study. BMC Pediatr 2024; 24:389. [PMID: 38851708 PMCID: PMC11161978 DOI: 10.1186/s12887-024-04867-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND There are limited data available, particularly in low- and middle-income countries (LMICs), on the long-term quality of life (QoL) and family functioning of primary caregivers of children and young people (CYPs) affected by primary brain tumors (PBTs). This study aimed to assess the factors associated with the mean change in QoL and family functioning scores of primary caregivers of CYP patients with PBTs 12 months posttreatment. METHODS This prospective cohort study enrolled CYPs aged 5-21 years with newly diagnosed PBTs and their primary caregivers. The study was carried out between November 2020 and July 2023. The primary caregivers of CYPs were recruited from two major tertiary care centers in Karachi, Pakistan. The primary caregivers QoL were assessed by the Pediatric Quality of Life Inventory (PedsQL) Family Impact Module. The assessment was undertaken by a psychologist at the time of diagnosis and 12 months posttreatment. The data were analyzed with STATA version 12. RESULTS Forty-eight CYPs with newly diagnosed PBTs and their primary caregivers (46 mothers and 2 fathers) were enrolled. At 12 months posttreatment, 25 (52%) CYPs and their primary caregivers (mothers) were reassessed, and 23 (48%) were lost to follow-up. On multivariable analysis, a significant decrease in mothers' mean 12-month posttreatment QoL and family functioning scores was associated with CYP having posttreatment seizures (beta= -10.2; 95% CI: -18.4 to -2.0) and with the financial burden associated with the CYP's illness (beta= -0.3; 95% CI: -0.4 to -0.1). However, in those cases where CYP had higher posttreatment quality of life scores (beta = 0.4; 95% CI = 0.1, 0.6) and posttreatment higher verbal intelligence scores (beta = 0.1; 95% CI = 0.01, 0.3), the mothers' QoL and family functioning scores were significantly greater. CONCLUSION We found a significant decrease in QoL of mothers who had a high financial burden and whose CYP had posttreatment seizures. However, those whose CYPs had higher posttreatment verbal intelligence scores and quality of life scores had significantly greater QoL scores. Identification of the factors that influence primary caregivers QoL has the potential to aid in the development of targeted strategies to alleviate stressors and improve the overall quality of life for primary caregivers and their children who are at high risk.
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Affiliation(s)
- Nida Zahid
- Department of Surgery, Aga Khan University, Karachi, Pakistan.
- Global Health and Migration Unit Department of Women's and Children's Health, Uppsala University, Box 256, Uppsala, 751 05, Sweden.
| | - Syed Ather Enam
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Thomas Mårtensson
- Global Health and Migration Unit Department of Women's and Children's Health, Uppsala University, Box 256, Uppsala, 751 05, Sweden
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Naureen Mushtaq
- Department of Pediatric Oncology, Aga Khan University, Karachi, Pakistan
| | - Mariya Moochhala
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | - Faiza Kausar
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Aneesa Hassan
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | | | - Farrukh Javed
- Department of Neurosurgery, Jinnah Post graduate Medical Centre, Karachi, Pakistan
| | - Lal Rehman
- Department of Neurosurgery, Jinnah Post graduate Medical Centre, Karachi, Pakistan
| | | | - Sadaf Altaf
- Department of Pediatric Oncology, Aga Khan University, Karachi, Pakistan
| | - Salman Kirmani
- Division of Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Nick Brown
- Global Health and Migration Unit Department of Women's and Children's Health, Uppsala University, Box 256, Uppsala, 751 05, Sweden.
- Department of Pediatrics, Aga Khan University, Karachi, Pakistan.
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Moscato EL, Albee MV, Anil A, Hocking MC. The interaction of family functioning and disease- and treatment-related factors on quality of life for children after cancer. J Psychosoc Oncol 2024:1-13. [PMID: 38831549 DOI: 10.1080/07347332.2024.2354298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
PURPOSE Children with cancer experience low quality of life (QOL), yet heterogeneity underscores a need to understand how risk and resilience factors interact. This study evaluated if family functioning relates to QOL differentially depending on diagnosis and treatment intensity. METHODS Participants included children (ages 8-14) who completed treatment within six months for either brain tumor (BT; n = 42) or non-central nervous system solid tumor (ST; n = 29). Caregivers and children rated QOL and family functioning. Treatment intensity was categorized as low, moderate, or high. Cross-informant moderation models tested hypothesized interactions. RESULTS Child-reported family functioning significantly interacted with diagnosis and treatment intensity in models of caregiver-reported QOL. More maladaptive family functioning was associated with reduced QOL for children with BT and moderately-intense treatments. CONCLUSIONS Children with BT and moderate treatment intensities are sensitive to family functioning, highlighting an at-risk group to target for family-level intervention. Future work should evaluate these associations longitudinally.
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Affiliation(s)
- Emily L Moscato
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - May V Albee
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ashley Anil
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Matthew C Hocking
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kasatkin VN, Romanova EN, Glebova EV, Deviaterikova AA, Tolchennikova VV, Sharapkova AA, Manukyan PA, Karpova NM, Sarkisyan RA, Karelin AF. Effects of cognitive-motor intervention for pediatric posterior fossa tumor survivors: results of a pilot study. J Neurooncol 2024; 168:57-67. [PMID: 38489149 DOI: 10.1007/s11060-024-04636-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/06/2024] [Indexed: 03/17/2024]
Abstract
The purpose of this prospective pilot study was to evaluate the feasibility and effects of cognitive-motor intervention on the cognitive and motor abilities of pediatric survivors of posterior fossa tumors. The study involved patients aged 7 to 18 years with cognitive deficits who had completed primary treatment for posterior fossa tumors. 25 participants (Mage=11.3 ± 2.93, 64% male; 17 medulloblastoma, 1 ependymoma, 1 desmoplastic medulloblastoma, 6 piloid astrocytoma; 22 in remission (Mmonths =45), 3 in stabilization (Mmonths=49)) were recruited from the Research Institute for Brain Development and Peak Performance. The intervention consisted of two phases with a 3-month break for home training, and a total duration of 6 months. Each phase lasted 7 weeks and included two assessment procedures (pre- and post-intervention) and 10 training sessions over a period of 5 weeks (two 3-hour sessions per week). At baseline and pre- and post-intervention, all participants underwent a battery of cognitive and motor tests. Each training session included gross motor training (GMT), graphomotor training (GT), and cognitive-motor training (CMT). Statistical analysis was performed using the Friedman test for repeated measures and post-hoc Durbin-Conover test. The results indicated significant improvements in visuospatial working memory, visual attention, eye-hand coordination, semantic verbal fluency, auditory-motor synchronization, reaction time, and a decrease in the rate of ataxia. These improvements remained stable even in the absence of direct intervention. The findings demonstrate positive effects and feasibility of the intervention and suggest the need for further research in this area including randomized controlled feasibility studies with a larger sample.
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Affiliation(s)
- Vladimir N Kasatkin
- Cognitive Development and Neurorehabilitation Foundation (Foundation CRANE), Moscow, Russia
| | - Elizaveta N Romanova
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia.
| | - Elena V Glebova
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia
| | - Alena A Deviaterikova
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia
| | - Vera V Tolchennikova
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia
| | - Anastasia A Sharapkova
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia
- Department of English Linguistics, Philological Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Piruza A Manukyan
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia
| | - Nadezhda M Karpova
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia
| | - Roza A Sarkisyan
- Research Institute for Brain Development and Peak Performance, RUDN University, Moscow, Russia
| | - Alexander F Karelin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
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Young K, Cashion C, Ekberg S, Hassall T, Bradford N. Quality of life and family functioning soon after paediatric brain tumour diagnosis: A cross-sectional observational study. Eur J Oncol Nurs 2023; 67:102463. [PMID: 37951071 DOI: 10.1016/j.ejon.2023.102463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/11/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE There is scant scholarly exploration of quality of life in families with a child who has a brain tumour early after diagnosis, despite this being a pivotal point in their illness trajectory. We aimed to describe quality of life in children and their parents, and family functioning, within six months of diagnosis; and to examine if this differed for various subpopulations. METHOD This is a cross-sectional analysis of baseline data of an ongoing longitudinal survey. Parents/carers of a child who had a diagnosis of a malignant or non-malignant brain tumour and were receiving care at the Queensland Children's Hospital were invited to complete an electronic survey. Univariate analyses were conducted with potential covariates and each dependent variable (child quality of life, caregiver quality of life, family functioning). Potential relationships between the outcome variables were explored through Pearson's correlation coefficient. RESULTS Seventy-nine diverse families completed the survey between August 2020 and September 2022. Caregiver quality of life did not differ by the child's tumour risk grade. It was lowest for those with a child who had undergone chemotherapy and/or radiation compared to surgery only, and for those with a child who had been diagnosed 6 months prior to survey completion compared to more recent diagnoses. A third of families reported problematic family functioning. Lower levels of problematic family functioning were associated with higher caregiver quality of life (r = -.49, p < .001). CONCLUSIONS Our findings suggest caregivers need greater psychosocial support early after diagnosis, and supports the need for family-centred care that fosters communication and cohesiveness.
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Affiliation(s)
- Kate Young
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Queensland University of Technology, 515 Ring Rd, Kelvin Grove, QLD, 4059, Australia; Children's Brain Cancer Centre at the Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland Government, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Christine Cashion
- Children's Brain Cancer Centre at the Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland Government, 62 Graham St, South Brisbane, QLD, 4101, Australia; Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Queensland Government, 501 Stanley St, South Brisbane, QLD, 4101, Australia
| | - Stuart Ekberg
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Queensland University of Technology, 515 Ring Rd, Kelvin Grove, QLD, 4059, Australia; Children's Brain Cancer Centre at the Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland Government, 62 Graham St, South Brisbane, QLD, 4101, Australia; School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, O Block, Ring Road, Kelvin Grove, QLD, 4059, Australia
| | - Timothy Hassall
- Children's Brain Cancer Centre at the Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland Government, 62 Graham St, South Brisbane, QLD, 4101, Australia; Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Queensland Government, 501 Stanley St, South Brisbane, QLD, 4101, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Queensland University of Technology, 515 Ring Rd, Kelvin Grove, QLD, 4059, Australia; Children's Brain Cancer Centre at the Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland Government, 62 Graham St, South Brisbane, QLD, 4101, Australia
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Wang J, Li J, Jiang X, Sun P, Li X, Wang G. Validation of the Chinese version of PedsQL™ brain tumor module. Front Pediatr 2023; 11:1277223. [PMID: 37964811 PMCID: PMC10642520 DOI: 10.3389/fped.2023.1277223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/13/2023] [Indexed: 11/16/2023] Open
Abstract
Background The study introduced the Pediatric Quality of Life Inventory™ (PedsQL™) brain tumor module for the first time in China. Further, the Chinese version of the PedsQL™ brain tumor module was developed and its feasibility, reliability, and validity were investigated. Methods A total 129 cases completed the assessment. Feasibility was evaluated according to the percentage of missing items and the time required to complete the questionnaire. Internal consistency, retest reliability, and split-half reliability were tested to confirm reliability. We evaluated validity by testing content validity, construct validity, and criterion-related validity. The consistency between the child-self and parent-proxy reports was analyzed by calculating the correlation coefficient (r value) between them. Results The Cronbach's alpha values for all subscales were above 0.7 and many subscales scored more than 0.9. The intra-class correlation coefficients of retest reliability were higher than 0.9. The split-half reliability scores for all subscales were higher than 0.6. The factor-item correlations ranged between 0.575-0.922 in the child report and 0.492-0.949 in the parent report. Exploratory factor analyses produced five factors corresponding to each subscale in the child report and six factors in the parent report. Conclusion The feasibility, reliability, and validity of the Chinese PedsQL™ brain tumor module were ascertained through this study. This module can be used to effectively monitor children with brain tumors and conduct descriptive or exploratory studies to determine the risk factors affecting their quality of life. This would help develop a new basis for formulating measures to improve patient prognosis and quality of life.
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Affiliation(s)
- Juan Wang
- Department of Neurosurgery, Xijing Hospital, Airforce Military Medical University (Fourth Military Medical University), Xi’an, China
| | - Jin Li
- Nursing Department of Zhengzhou People's Hospital, Zhengzhou, China
| | - Xiaofan Jiang
- Department of Neurosurgery, Xijing Hospital, Airforce Military Medical University (Fourth Military Medical University), Xi’an, China
| | - Pei Sun
- Department of Neurosurgery, Xi’an Children’s Hospital, Xi’an, China
| | - Xia Li
- Department of Neurosurgery, Xijing Hospital, Airforce Military Medical University (Fourth Military Medical University), Xi’an, China
| | - Guanyi Wang
- Department of Neurosurgery, Xijing Hospital, Airforce Military Medical University (Fourth Military Medical University), Xi’an, China
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Rüther M, Hagan AJ, Verity SJ. The role of CNS tumor location in health-related quality of life outcomes: A systematic review of supratentorial vs infratentorial tumors in childhood survivorship. APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-20. [PMID: 37851360 DOI: 10.1080/21622965.2023.2268776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Continued advancements in the treatment of pediatric brain tumors have resulted in a growing proportion of children surviving previously incurable diagnoses. However, survivors of pediatric brain tumors show reduced Health-Related Quality of Life (HRQoL) compared to healthy populations and non-CNS childhood cancer survivors. This review systematically evaluates the existing literature on the influence of supratentorial and infratentorial brain tumor locations on Health-Related Quality of Life outcomes in survivors of pediatric brain tumors. Five electronic databases were searched for relevant articles published between their inception and January 2022. A purpose-developed evaluative tool was constructed to assess the quality of eligible studies. 16 of the 5270 identified articles were included in this review (n = 1391). This review found little evidence relating to the impact of brain tumor location on HRQoL, with only one study finding a significant difference between supratentorial and infratentorial tumor survivors. Key limitations of the current evidence include poor statistical reporting, ambiguous construct definitions, and insufficient adjustment for confounds. Findings from this review show that recovery from a pediatric brain tumor extends beyond recovery post-treatment and that further study into the factors influencing survivor HRQoL, including the influence of tumor location, is necessary.
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Affiliation(s)
- Marike Rüther
- Department of Paediatric Health Psychology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Alexander James Hagan
- Department of Paediatric Health Psychology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Sarah J Verity
- Department of Paediatric Health Psychology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
- Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
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Moscato EL, Fisher AP, Pillay-Smiley N, Salloum R, Wade SL. Caregivers matter: Neurological vulnerability for pediatric brain tumor survivors. Neurooncol Pract 2023; 10:418-428. [PMID: 37720398 PMCID: PMC10502790 DOI: 10.1093/nop/npad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background Pediatric brain tumor survivors (PBTS) are at risk of worse quality of life (QOL) due to the impact of neurotoxic treatments on the developing nervous system. Parenting factors such as protectiveness have been linked to worse QOL in childhood cancer survivors generally, but have yet to be explored for PBTS. We examined whether parenting behaviors moderated the association between neurotoxic treatment and QOL for PBTS. Methods PBTS (n = 40; ages 10-25) and their caregivers (n = 47) completed measures of parenting behaviors including warmth (support/connectedness) and psychological control (protectiveness) and QOL. We divided the sample into moderate/high and low neurotoxicity groups based on chart review using the Pediatric Neuro-Oncology Rating of Treatment Intensity and examined moderator effects. Results Survivor-reported primary caregiver warmth moderated the relationship between neurotoxicity and caregiver-reported QOL. Moderate/high neurotoxicity was associated with lower caregiver-reported QOL only when survivor-reported primary caregiver warmth was low, P = .02. Similar results were found for survivor-reported QOL. Caregiver-reported psychological control moderated the association between neurotoxicity and caregiver-reported QOL such that neurotoxicity only affected QOL at high levels of psychological control, P = .01. Conclusions Heightened associations between parenting and QOL in the context of neurotoxic treatments underscore the need to better support PBTS. Findings are consistent with research suggesting that family factors may be particularly important for children with other neurological insults. Limitations include cross-sectional design and a small/heterogeneous clinical sample with low ethnic/racial diversity. Prospective studies are needed to refine evidence-based screening and develop psychosocial intervention strategies to optimize QOL for PBTS and their families.
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Affiliation(s)
- Emily L Moscato
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center; Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Allison P Fisher
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center; Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Natasha Pillay-Smiley
- Cancer and Blood Diseases Institute, The Cure Starts Now Foundation Brain Tumor Center; Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ralph Salloum
- Division of Hematology and Oncology, Nationwide Children’s Hospital; Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Shari L Wade
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center; Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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Zupanec S, Herriage T, Landier W. Children's Oncology Group 2023 blueprint: Nursing discipline. Pediatr Blood Cancer 2023; 70 Suppl 6:e30575. [PMID: 37470719 PMCID: PMC10655901 DOI: 10.1002/pbc.30575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
In contrast to other Children's Oncology Group (COG) committees, the COG nursing discipline is unique in that it provides the infrastructure necessary for nurses to support COG clinical trials and implements a research agenda aimed at scientific discovery. This hybrid focus of the discipline reflects the varied roles and expertise within pediatric oncology clinical trials nursing that encompass clinical care, leadership, and research. Nurses are broadly represented across COG disease, domain, and administrative committees, and are assigned to all clinically focused protocols. Equally important is the provision of clinical trials-specific education and training for nurses caring for patients on COG trials. Nurses involved in the discipline's evidence-based practice initiative have published a wide array of systematic reviews on topics of clinical importance to the discipline. Nurses also develop and lead research studies within COG, including stand-alone studies and aims embedded in disease/ treatment trials. Additionally, the nursing discipline is charged with responsibility for developing patient/family educational resources within COG. Looking to the future, the nursing discipline will continue to support COG clinical trials through a multifaceted approach, with a particular focus on patient-reported outcomes and health equity/disparities, and development of interventions to better understand and address illness-related distress in children with cancer.
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Affiliation(s)
- Sue Zupanec
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Wendy Landier
- University of Alabama at Birmingham, Birmingham, Alabama
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Hoornaert M, Laurent C, Lelong C, Deltenre P, Devroede B. A Rare Case of Unilateral Auditory Neuropathy Induced by Proton Therapy. Cureus 2023; 15:e45085. [PMID: 37842417 PMCID: PMC10568656 DOI: 10.7759/cureus.45085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Hearing loss (HL) is one of the most common complications of the treatment in head and neck oncology. Most cases of HL are due to the ototoxicity of platinum-based chemotherapy (PBC) - resulting usually in a symmetric bilateral sensorineural hearing loss (SNHL) - or radiotherapy. Radiation-induced SNHL is progressive, permanent, and dose-dependent. Total dose and follow-up time are important factors affecting incidence rates. However, the hearing consequences of proton radiation therapy (PRT), a radiation-type therapy especially used in pediatric malignancies of the central nervous system (CNS), remains unclear and poorly documented. We report here a case of a four-year-old patient with unilateral auditory neuropathy spectrum disorder (ANSD) related to PRT. This case highlights the need for appropriate auditory monitoring in patients undergoing PRT for CNS or head and neck malignancies.
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Affiliation(s)
- Mathilde Hoornaert
- Otolaryngology-Head and Neck Surgery, Erasme Hospital, Brussels University Hospital (HUB), Brussels, BEL
| | - Celine Laurent
- Otolaryngology-Head and Neck Surgery, Erasme Hospital, Brussels University Hospital (HUB), Brussels, BEL
| | - Clement Lelong
- Otolaryngology-Head and Neck Surgery, Erasme Hospital, Brussels University Hospital (HUB), Brussels, BEL
| | - Paul Deltenre
- Auditory Neurophysiology Laboratory, Brugmann Hospital, Brussels, BEL
| | - Benoit Devroede
- Otolaryngology-Head and Neck Surgery, Queen Fabiola Children's University Hospital, Brussels University Hospital (HUB), Brussels, BEL
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11
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Priboi C, van Gorp M, Maurice-Stam H, Michel G, Kremer LCM, Tissing WJE, Loonen JJ, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Ronckers CM, Bresters D, Louwerens M, Neggers SJCCM, van der Heiden-van der Loo M, van Dulmen-den Broeder E, Grootenhuis M. Psychosexual development, sexual functioning and sexual satisfaction in long-term childhood cancer survivors: DCCSS-LATER 2 sexuality substudy. Psychooncology 2023; 32:1279-1288. [PMID: 37365748 DOI: 10.1002/pon.6181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Childhood cancer may negatively impact childhood cancer survivors' (CCS) sexuality. However, this is an understudied research area. We aimed to describe the psychosexual development, sexual functioning and sexual satisfaction of CCS, and identify determinants for these outcomes. Secondarily, we compared the outcomes of a subsample of emerging adult CCS to the Dutch general population. METHODS From the Dutch Childhood Cancer Survivor Study LATER cohort (diagnosed 1963-2001), 1912 CCS (18-71 years, 50.8% male) completed questions on sexuality, psychosocial development, body perception, mental and physical health. Multivariable linear regressions were used to identify determinants. Sexuality of CCS age 18-24 (N = 243) was compared to same-aged references using binomial tests and t-tests. RESULTS One third of all CCS reported hindered sexuality due to childhood cancer, with insecure body the most often reported reason (44.8%). Older age at study, lower education, surviving central nervous system cancer, poorer mental health and negative body perception were identified as determinants for later sexual debut, worse sexual functioning and/or sexual satisfaction. CCS age 18-24 showed significantly less experience with kissing (p = 0.014), petting under clothes (p = 0.002), oral (p = 0.016) and anal sex (p = 0.032) when compared to references. No significant differences with references were found for sexual functioning and sexual satisfaction, neither among female CCS nor male CCS age 18-24. CONCLUSIONS Emerging adult CCS reported less experience with psychosexual development, but similar sexual functioning and sexual satisfaction compared to references. We identified determinants for sexuality, which could be integrated in clinical interventions for CCS at risk for reduced sexuality.
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Affiliation(s)
- Cristina Priboi
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cécile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
- Willem Alexander Children's Hospital, Leiden, The Netherlands
| | | | | | | | - Eline van Dulmen-den Broeder
- Department of Obstetrics and Gynecology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
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12
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Keating R, Curry S, Hussey J. Cardiorespiratory fitness and health-related quality of life in survivors of childhood central nervous system tumours. Support Care Cancer 2023; 31:395. [PMID: 37318588 DOI: 10.1007/s00520-023-07854-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE We assessed cardiorespiratory fitness and health-related quality of life (HRQoL) in survivors of childhood central nervous system (CNS) tumours. METHODS Participants were recruited from the National Children's Cancer Service in Children's Health Ireland at Crumlin. Inclusion criteria included diagnosis of a primary CNS tumour, aged between 6 and 17 years, between 3 months and 5 years post completion of oncology treatment, independently mobile, and deemed clinically appropriate to participate by treating oncologist. Cardiorespiratory fitness was assessed using the six-minute walk test. HRQoL was assessed with the PedsQL Generic Core Scales, Version 4.0. RESULTS Thirty-four participants (n = 16 male) were recruited, with a mean age of 12.21 ± 3.31 years and a mean time since completion of oncology treatment of 2.19 ± 1.29 years. Mean six-minute walk distance (6MWD) achieved was 489.56 ± 61.48 m, equating to the 8th percentile overall. 6MWD was significantly reduced when compared to predicted population norms (p < 0.001). PedsQL parent proxy-report and child-report scores were significantly lower when compared to healthy paediatric norms (p < 0.001 - p = 0.011). A significant positive correlation was found between 6MWD and both parent proxy-report (r = 0.55, p < 0.001) and child-report (r = 0.48, p = 0.005) PedsQL total scores. CONCLUSION Survivors of childhood CNS tumours present with impaired cardiorespiratory fitness and HRQoL. Higher levels of cardiorespiratory fitness are associated with higher levels of HRQoL. IMPLICATIONS FOR CANCER SURVIVORS Routine screening of cardiorespiratory fitness and HRQoL in survivors of childhood CNS tumours may be beneficial. Healthcare providers should encourage and provide education on the potential benefits of physical activity to improve overall quality of life.
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Affiliation(s)
- Rachael Keating
- School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland.
- Physiotherapy Department, Children's Health Ireland at Crumlin, Dublin, Ireland.
| | - Sarah Curry
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Juliette Hussey
- School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
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13
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Roydhouse J, Reeve BB. Incorporating Information From Proxies for Patient-Centered Outcomes in Adult and Pediatric Oncology Settings. J Clin Oncol 2023; 41:1518-1522. [PMID: 36269934 DOI: 10.1200/jco.22.01049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jessica Roydhouse
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI
| | - Bryce B Reeve
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
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14
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Ten Considerations for Integrating Patient-Reported Outcomes into Clinical Care for Childhood Cancer Survivors. Cancers (Basel) 2023; 15:cancers15041024. [PMID: 36831370 PMCID: PMC9954048 DOI: 10.3390/cancers15041024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Patient-reported outcome measures (PROMs) are subjective assessments of health status or health-related quality of life. In childhood cancer survivors, PROMs can be used to evaluate the adverse effects of cancer treatment and guide cancer survivorship care. However, there are barriers to integrating PROMs into clinical practice, such as constraints in clinical validity, meaningful interpretation, and technology-enabled administration of the measures. This article discusses these barriers and proposes 10 important considerations for appropriate PROM integration into clinical care for choosing the right measure (considering the purpose of using a PROM, health profile vs. health preference approaches, measurement properties), ensuring survivors complete the PROMs (data collection method, data collection frequency, survivor capacity, self- vs. proxy reports), interpreting the results (scoring methods, clinical meaning and interpretability), and selecting a strategy for clinical response (integration into the clinical workflow). An example framework for integrating novel patient-reported outcome (PRO) data collection into the clinical workflow for childhood cancer survivorship care is also discussed. As we continuously improve the clinical validity of PROMs and address implementation barriers, routine PRO assessment and monitoring in pediatric cancer survivorship offer opportunities to facilitate clinical decision making and improve the quality of survivorship care.
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15
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Rajagopal R, Raman N, Ong LC, Foo JC, Fong CY. Health-related quality of life among Malaysian pediatric survivors of central nervous system tumor. Pediatr Hematol Oncol 2023; 40:26-39. [PMID: 35608384 DOI: 10.1080/08880018.2022.2069895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Pediatric central nervous system tumor survivors (CNSTS) experience late effects that may affect their health-related quality of life (HRQOL). The study aims: i) compare HRQOL among Malaysian CNSTS with acute lymphoblastic leukemia survivors (ALLS) and healthy children, and ii) explore factors associated with low HRQOL. We performed a comparative cross-sectional HRQOL study of 46 CNSTS aged 5-18 years and 90 ALLS (age and gender-matched) who completed treatment for >1 year, and a published cohort of healthy children. Pediatric Quality of Life Inventory (PedsQL) was used for all groups and PedsQL Cancer Module for CNSTS and ALLS. Multiple regression analysis was used to determine factors associated with low HRQOL. Mean PedsQL total scale score, physical health score and psychosocial health score of CNSTS were 69.0 (SD 20.3), 68.7 (SD 27.9) and 69.2 (SD 19.2) respectively. These scores were significantly lower in all domains particularly in teenagers compared with healthy children and ALLS. The median PedsQL Cancer Module score of CNSTS was significantly lower than ALLS in total scale, cognitive problems and communication. Physical impairment was associated with lower PedsQL scores in all 3 domains; special education placement was associated with lower PedsQL total scale and physical health scores and clinically significant internalizing behavioral difficulties score was associated with lower PedsQL psychosocial health scores. CNSTS reported lower PedsQL scores in all domains than ALLS and healthy children. Clinicians need to be vigilant of HRQOL needs among CNSTS, especially those with risk factors of special education needs, physical impairment, and internalizing behavioral difficulties.
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Affiliation(s)
- Revathi Rajagopal
- Division of Hematology-Oncology, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Nur'Aini Raman
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Lai Choo Ong
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Jen Chun Foo
- Division of Hematology-Oncology, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Choong Yi Fong
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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16
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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] [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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17
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Horan MR, Sim JA, Krull KR, Baker JN, Huang IC. A Review of Patient-Reported Outcome Measures in Childhood Cancer. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101497. [PMID: 36291433 PMCID: PMC9601091 DOI: 10.3390/children9101497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/07/2022] [Accepted: 09/23/2022] [Indexed: 11/20/2022]
Abstract
Patient-reported outcomes (PROs) are used in clinical work and research to capture the subjective experiences of childhood cancer patients and survivors. PROs encompass content domains relevant and important to this population, including health-related quality-of-life (HRQOL), symptoms, and functional status. To inform future efforts in the application of PRO measures, this review describes the existing generic and cancer-specific PRO measures for pediatric cancer populations and summarizes their characteristics, available language translations, content coverage, and measurement properties into tables for clinicians and researchers to reference before choosing a PRO measure that suits their purpose. We have identified often unreported measurement properties that could provide evidence about the clinical utility of the PRO measures. Routine PRO assessment in pediatric cancer care offers opportunities to facilitate clinical decision-making and improve quality of care for these patients. However, we suggest that before implementing PRO measures into research or clinical care, the psychometric properties and content coverage of the PRO measures must be considered to ensure that PRO measures are appropriately assessing the intended construct in childhood cancer patients.
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Affiliation(s)
- Madeline R. Horan
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Jin-ah Sim
- School of AI Convergence, Hallym University, Chuncheon 200160, Korea
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Justin N. Baker
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
- Correspondence: ; Tel.: +1-(901)-595-8369
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18
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The Influence of Socioeconomic Status (SES) and Processing Speed on the Psychological Adjustment and Wellbeing of Pediatric Brain Tumor Survivors. Cancers (Basel) 2022; 14:cancers14133075. [PMID: 35804846 PMCID: PMC9264789 DOI: 10.3390/cancers14133075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Processing speed (PS) is one of the most impaired functions in pediatric brain tumor survivors (PBTSs) and it has been linked to difficulties in their psychological functioning, together with other non-insult-related risk factors, such as socio-economic status (SES). Given the psychological adjustment difficulties observed in PBTS, the aim of the current study was to explore the relationship between SES and psychological functioning, measured with the Child Behavioral Checklist (CBCL) and the Strengths and Difficulties Questionnaire, and considering the contribution of PS as a mediator. The results demonstrated that the influence of SES on the CBCL total index was mediated by PS. Furthermore, PS was found to have a mediating effect on the SES–internalizing problems relationship but not on the SES–externalizing problems relationship. These findings suggest that PS may be a rehabilitation target to prevent psychological distress and should be addressed, especially for PBTSs who live in a disadvantaged situation. Abstract (1) Background: The relationship between processing speed (PS) and psychological adjustment in the healthy population is well established, as is that between low socio-economic status (SES) and psychological distress. While PS is one of the most impaired functions in pediatric brain tumor survivors (PBTSs), previous research has demonstrated that low SES may be a predictor of increased psychosocial risk in PBTSs. Given the psychological adjustment difficulties observed in PBTS, in the current study we aimed to explore the relationship between SES and psychological functioning, considering the contribution of PS as a mediator. (2) Methods: demographic and clinical data of 80 children (age range: 4–17 y.o.) were retrospectively collected. Psychological measures were the parent-compiled versions of the Child Behavioral Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). Mediation analysis models were performed on psychological measures with and without the inclusion of covariates. (3) Results: The influence of SES on the CBCL total index was mediated by PS. Furthermore, PS was found to have a mediating effect on the relationship between SES and internalizing problems but not on the relationship between SES and externalizing problems. (4) Conclusions: The results suggest that PS may be a rehabilitation target for the prevention of psychological distress and should be addressed especially for PBTSs who live in a disadvantaged situation.
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19
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Khaleqi-Sohi M, Sadria G, Ghalibafian M, Khademi-Kalantari K, Irannejad S. The Effects of Physical Activity and Exercise Therapy on Pediatric Brain Tumor Survivors: A systematic review. J Bodyw Mov Ther 2022; 30:1-9. [DOI: 10.1016/j.jbmt.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/24/2021] [Accepted: 11/05/2021] [Indexed: 02/03/2023]
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20
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Pellegrini C, Caraceni AT, Massimino M, De Vivo A, Blandini MG, Simoncini B, Chisari M, Bedodi LIE, Sensi R, Brunelli C. Development and field testing of a neuro psychomotor multidimensional grid for the assessment of children with cns tumor. Pediatr Hematol Oncol 2022; 39:108-120. [PMID: 34289789 DOI: 10.1080/08880018.2021.1948648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Central Nervous System (CNS) tumors are the most common pediatric solid tumor and development neuro psychomotor (DNPM) therapy can contribute to the rehabilitation of these children. This paper describes the development of a DNPM multidimensional assessment grid for children with CNS tumor (DNPM-CNS grid).The development process included 4 phases: (P1) literature review and grid development (Version 1.0), (P2) two rounds consultations with experts (Version 1.1 and 2.0), (P3) field testing, (P4) final revision (Version 3.0).(P1) The DNPM-CNS grid was developed based on previous tools and manuals and on clinical experience with this patient population. (P2) A total of 52 questionnaires were filled in by experts about relevance of assessment areas, pertinence, comprehensibility and feasibility of the grid. Average scores ranged from 7.6 to 10. (P3) At case level, good inter-rater agreement scores (78%) and limited non-evaluability rates (18%) emerged. At item level, 27% of items reached high disagreement and 26% high not-evaluability rates. The qualitative assessment was judged clinically useful for planning the neuro-oncology rehabilitation treatment and a good feasibility of the DNPM-CNS grid emerged both for preschool and school-age children. (P4) The final version of the grid consists of 8 assessment areas with 133 items.The DNPM-CNS grid is a comprehensive tool that can guide the overall DNPM assessment in a limited amount of time. It can be used as a screening tool to customize more specific assessments. Further research is needed to better characterize grid psychometric properties.Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2021.1948648 .
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Affiliation(s)
- Chiara Pellegrini
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.,Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Augusto T Caraceni
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Annarita De Vivo
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Maria Grazia Blandini
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Beatrice Simoncini
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Chisari
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Livia I E Bedodi
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Raffaella Sensi
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Cinzia Brunelli
- Palliative care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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21
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Cantisano N, Menei P, Roualdes V, Seizeur R, Allain P, Le Gall D, Roy A, Dinomais M, Laurent A, Besnard J. Relationships between executive functioning and health-related quality of life in adult survivors of brain tumor and matched healthy controls. J Clin Exp Neuropsychol 2022; 43:980-990. [PMID: 35230209 DOI: 10.1080/13803395.2022.2040432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Few studies have considered health-related quality of life (HRQOL) as a primary outcome measure in adult survivors of primary brain tumor (PBT), and fewer still have studied the cognitive factors that may influence it. Research suggests that executive functions (EFs) are associated with HRQOL, but there is scant evidence to support this. The present study was conducted to (1) extend prior findings about HRQOL limitations in a sample of stable, long-term adult survivors of PBT, (2) investigate the associations between objective/reported EFs and HRQOL, and (3) identify the EFs that contribute most to HRQOL. METHOD We recruited 40 survivors of PBT (> 2 years post-treatment) and 40 matched healthy controls. Participants completed an objective EF assessment (inhibition, working memory, shifting, and rule detection) and two self-report questionnaires probing EFs (Behavior Rating Inventory of Executive Function-Adult) and HRQOL (Medical Outcomes Study Short-Form 36). Participants' relatives completed observer-rated versions of these questionnaires. RESULTS Patients' objective EF performances were relatively intact. However, patients and caregivers reported significantly more problems than healthy controls and their relatives, for both EFs and HRQOL. There were only negligible links between objective EFs and HRQOL, whereas numerous associations were found between reported EFs and HRQOL components. ANCOVA models revealed that specific reported EF processes contributed to both the physical and mental components of HRQOL, regardless of group. CONCLUSIONS From a clinical point of view, this study demonstrates that even several years after end of treatment, adult PBT survivors experience substantial problems across different HRQOL domains. HRQOL assessment should therefore be part of the long-term follow-up of PBT survivors, and clinicians should consider EF limitations when designing appropriate survivorship care plans. These findings indicate that cognitive interventions targeting EFs could improve HRQOL.
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Affiliation(s)
- Nicole Cantisano
- Centre d'Etudes En Psychopathologie Et Psychologie de la Santé (Ea 7411), University of Toulouse Jean Jaurès, Toulouse, France
| | - Philippe Menei
- Department of Neurosurgery, Angers University Hospital, Angers, France
| | - Vincent Roualdes
- Department of Neurosurgery, Nantes University Hospital, Nantes, France
| | - Romuald Seizeur
- Department of Neurosurgery, Brest Regional University Hospital, Brest, France
| | - Philippe Allain
- Department of Neurology, Angers University Hospital, Angers, France.,Univ Angers, Department of Psychology, Nantes Université, Laboratoire de psychologie des Pays de la Loire (LPPL, UR 4638), SFR CONFLUENCES, F-49000, Angers, France
| | - Didier Le Gall
- Department of Neurology, Angers University Hospital, Angers, France.,Univ Angers, Department of Psychology, Nantes Université, Laboratoire de psychologie des Pays de la Loire (LPPL, UR 4638), SFR CONFLUENCES, F-49000, Angers, France
| | - Arnaud Roy
- Univ Angers, Department of Psychology, Nantes Université, Laboratoire de psychologie des Pays de la Loire (LPPL, UR 4638), SFR CONFLUENCES, F-49000, Angers, France.,Centre Référent Des Troubles d'Apprentissage Et Centre de Compétence Nantais de Neurofibromatose, Nantes University Hospital, Nantes, France
| | - Mickaël Dinomais
- Department of Paediatric Physical Medicine and Rehabilitation, Angers University Hospital, Angers, France
| | | | - Jérémy Besnard
- Univ Angers, Department of Psychology, Nantes Université, Laboratoire de psychologie des Pays de la Loire (LPPL, UR 4638), SFR CONFLUENCES, F-49000, Angers, France
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22
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The impact of CNS-directed treatment on quality of life in childhood cancer survivors. Qual Life Res 2022; 31:817-829. [PMID: 34455525 PMCID: PMC8882709 DOI: 10.1007/s11136-021-02984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Pediatric cancer survivors may have lower quality of life (QoL), but most research has assessed outcomes either in treatment or long-term survivorship. We focused on early survivorship (i.e., 3 and 5 years post-diagnosis), examining the impact of CNS-directed treatment on child QoL, as well as sex and age at diagnosis as potential moderators. METHODS Families of children with cancer (ages 5-17) were recruited at diagnosis or relapse (N = 336). Survivors completed the PedsQL at 3 (n = 96) and 5 years (n = 108), along with mothers (101 and 105, respectively) and fathers (45 and 53, respectively). The impact of CNS treatment, sex, and age at diagnosis on child QoL was examined over both time since diagnosis and time since last treatment using mixed model analyses. RESULTS Parent-report of the child's total QoL was in the normative range and stable between 3 and 5 years when examining time since diagnosis, while child reported QoL improved over time (p = 0.04). In terms of time since last treatment, mother and child both reported the child's QoL improved over time (p = 0.0002 and p = 0.0006, respectively). Based on parent-report, males with CNS-directed treatment had lower total QoL than females and males who did not receive CNS-directed treatment. Age at diagnosis did not moderate the impact of treatment type on total QoL. CONCLUSIONS Quality of life (QoL) in early survivorship may be low among males who received CNS-directed treatment. However, this was only evident on parent-report. Interventions to improve child QoL should focus on male survivors who received CNS-directed treatment, as well as females regardless of treatment type.
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Kim HY, Kang KA, Han SJ, Chun J. Web-Based Research Trends on Child and Adolescent Cancer Survivors Over the Last 5 Years: Text Network Analysis and Topic Modeling Study. J Med Internet Res 2022; 24:e32309. [PMID: 35103615 PMCID: PMC8848247 DOI: 10.2196/32309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/06/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Being diagnosed with cancer during childhood or adolescence can disrupt important periods in an individual’s physical, psychosocial, and spiritual development and potentially reduce the quality of life (QOL) after treatment. Research is urgently required to improve the QOL for child and adolescent cancer survivors, and it is necessary to analyze the trends in prior research reported in international academic journals to identify knowledge structures. Objective This study aims to identify the main keywords based on network centrality, subgroups (clusters) of keyword networks by using a cohesion analysis method, and the main theme of child and adolescent cancer survivor–related research abstracts through topic modeling. This study also aims to label the subgroups by comparing the results of the cohesion and topic modeling. Methods A text network analysis method and topic modeling were used to explore the main trends in child and adolescent cancer survivor research by structuring a network of keyword (semantic morphemes) co-occurrence in the abstracts of articles published in 5 major web-based databases from 2016 to 2020. A total of 1677 child and adolescent cancer survivor–related studies were used for data analyses. Data selection, processing, and analyses were also conducted. Results The top 5 keywords in terms of degree and eigenvector centrality were risk, control interval, radiation, childhood cancer treatment, and diagnosis. Of the 1677 studies used for data analyses, cluster 1 included 780 (46.51%) documents under risk management, cluster 2 contained 557 (33.21%) articles under health-related QOL and supportive care, and cluster 3 consisted of 340 (20.27%) studies under cancer treatment and complications. Conclusions This study is significant in that it confirms the knowledge structure based on the main keywords and cross-disciplinary trends in child and adolescent cancer survivor research published in the last 5 years worldwide. The primary goal of child and adolescent cancer survivor research is to prevent and manage the various aspects of the problems encountered during the transition to a normal life and to improve the overall QOL. To this end, it is necessary to further revitalize the study of the multidisciplinary team approach for the promotion of age-specific health behaviors and the development of intervention strategies with increased feasibility for child and adolescent cancer survivors.
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Affiliation(s)
- Hyun-Yong Kim
- Logos Health Design Institute, Sahmyook University, Seoul, Republic of Korea
| | - Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Suk-Jung Han
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Jiyoung Chun
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
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Chen P, Hudson MM, Li M, Huang IC. Health utilities in pediatric cancer patients and survivors: a systematic review and meta-analysis for clinical implementation. Qual Life Res 2022; 31:343-374. [PMID: 34224073 DOI: 10.1007/s11136-021-02931-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Health utility (HU) is a useful metric for evaluating cost and utility of cancer therapies or prioritizing healthcare resources. We conducted a meta-analysis to compare HUs in association with clinical parameters and identify missing cancer-related themes from the extant HU measures for pediatric cancer patients and survivors. METHODS Studies published in the PubMed, Embase, Web of Science, and Cochrane Library were identified. Meta-analyses were performed to estimate weighted means of HUs assessed by self- and proxy-responses. Mixed-effects meta-regressions were applied to compare HUs between cancer patients/survivors and general populations. Missing themes in the extant measures were identified based on established patient-reported outcomes frameworks. RESULTS Of 123 selected studies included pediatric cancer populations, 44% used the Health Utilities Index version 2 (HUI2), and 48% used version 3 (HUI3). Compared to general populations, cancer patients undergoing therapies for acute lymphoblastic leukemia (ALL) had 0.129 (95% CI - 0.183 to - 0.075) and brain tumor had 0.257 (95% CI - 0.354 to - 0.160) lower HUs per proxy-reported HUI3, whereas survivors of ALL had 0.028 (95% CI - 0.062 to 0.007) and brain tumor had 0.188 (95% CI - 0.237 to - 0.140) lower HUs per proxy-reported HUI3. Compared to general populations, cancer patients treated with multimodality therapy and survivors off therapy 2-5 years had significantly poorer HUs (p's < 0.05). Missing cancer-specific contents from the HU measures were identified. CONCLUSION Pediatric cancer patients and survivors had poorer HUs than general populations. It is important to select appropriate HUs for economic evaluations, and offer interventions to minimize HU deficits for particular cancer populations.
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Affiliation(s)
- Pingyu Chen
- Department of Health Economics, China Pharmaceutical University, Nanjing, China
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, 881 Madison Avenue, Room 219, Memphis, TN, 38103, USA
| | - Melissa M Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Minghui Li
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, 881 Madison Avenue, Room 219, Memphis, TN, 38103, USA.
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Room S6027, Memphis, TN, 38105, USA.
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Akdeniz Kudubes A, Semerci R, Bektas M, Akgün Kostak M. The effects of administered interventions on quality of life of children with cancer in Turkey: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2022; 31:e13544. [PMID: 35088493 DOI: 10.1111/ecc.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/23/2021] [Accepted: 12/02/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The present systematic review and meta-analysis aimed to analyse the effects of administered interventions on the quality of life of children with cancer in Turkey. METHODS The quantitative studies conducted with paediatric oncology patients, analysing the quality of life of Turkish children, and published papers from 2009 to 2019 were searched. Joanna Briggs Institution MAStARI Experimental and Quasi-Experimental Research Control List and Quality Index were used for methodological assessment. Five studies comprising a total of 264 samples were included. Four studies were nonrandomised controlled trials, and one was a quasi-experimental study. RESULTS Tests for heterogeneity showed that the studies, which included interventions increasing the quality of life of children with cancer, were heterogeneous. The common effect size of all studies on quality of life was determined as having a strong positive effect. CONCLUSIONS This meta-analysis and systematic review contribute to the knowledge of Turkish health care professionals regarding these interventions by producing results with high levels of evidence on the improvement of the quality of life among children with cancer. The present study also significantly raises awareness and encourages health care professionals to implement interventions for the improvement of quality of life among children with cancer.
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Affiliation(s)
- Aslı Akdeniz Kudubes
- Department of Pediatric Nursing, Faculty of Health Sciences, Bilecik Şeyh Edebali University, Bilecik, Turkey
| | - Remziye Semerci
- Department of Pediatric Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Murat Bektas
- Department of Pediatric Nursing, Faculty of Health Sciences, Bilecik Şeyh Edebali University, Bilecik, Turkey
| | - Melahat Akgün Kostak
- Department of Pediatric Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey
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26
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Desjardins L, Solomon A, Shama W, Mills D, Chung J, Hancock K, Barrera M. The impact of caregiver anxiety/depression symptoms and family functioning on child quality of life during pediatric cancer treatment: From diagnosis to 6 months. J Psychosoc Oncol 2022; 40:790-807. [PMID: 35016592 DOI: 10.1080/07347332.2021.2015646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A pediatric cancer diagnosis can have a significant impact on the quality of life (QOL) of the child. Diagnosis and treatment impact caregiver anxiety/depression symptoms and family functioning, and these in turn may influence child QOL. However, there has been limited longitudinal examination of the impact of both caregiver anxiety/depression symptoms and family functioning on youth QOL at specific points during the early diagnosis and treatment period. Ninety-six caregivers of youth (diagnosed with leukemia/lymphoma or a solid tumor) reported on their own anxiety/depression symptoms, family functioning, demographic and medical factors, and on their child's generic and cancer-specific QOL shortly after diagnosis (T1) and 6 months later (T2). Caregiver anxiety/depression symptoms were associated with poorer cancer-specific and generic child QOL within and across time points. Family conflict was associated with youth cancer-related QOL at T1. Attendance to caregiver anxiety/depression symptoms and family functioning, beginning early in the cancer trajectory, is an important aspect of family-centered care. Routine psychosocial screening and triage may help identify and intervene to support both caregiver and child psychosocial well-being.
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Affiliation(s)
- Leandra Desjardins
- Charles-Bruneau Cancer Care Centre, Sainte-Justine University Health Centre, Montreal, Canada.,Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Aden Solomon
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Wendy Shama
- Department of Social Work, Division of Hematology/Oncology, BC Children's Hospital, Vancouver, Canada
| | - Denise Mills
- Department of Nursing, Division of Hematology/Oncology, BC Children's Hospital, Vancouver, Canada
| | - Joanna Chung
- Department of Psychology, Division of Hematology/Oncology, BC Children's Hospital, Vancouver, Canada
| | - Kelly Hancock
- 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
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27
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Stavinoha PL, Trinh-Wong T, Rodriguez LN, Stewart CM, Frost K. Educational Pain Points for Pediatric Brain Tumor Survivors: Review of Risks and Remedies. CHILDREN 2021; 8:children8121125. [PMID: 34943320 PMCID: PMC8700207 DOI: 10.3390/children8121125] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 01/29/2023]
Abstract
Evolving treatment paradigms have led to increased survival rates for children diagnosed with a brain tumor, and this has increasingly shifted clinical and research focus to morbidity and quality of life among survivors. Among unfavorable outcomes, survivors of pediatric brain tumors are at risk for academic failure and low educational attainment, which may then contribute to lower health related quality of life, lower income and vocational status, and a greater likelihood of dependence on others in adulthood. Several specific risk factors for lower educational performance and attainment have been investigated. These are typically examined in isolation from one another which clouds understanding of the full range and potential interplay of contributors to educational difficulties. This review integrates and summarizes what is known about the direct and indirect barriers to educational success and performance (i.e., educational pain points) to enhance clinician knowledge of factors to consider when working with pediatric brain tumor survivors. Specific barriers to educational success include neurocognitive difficulties, school absences, psychosocial challenges, challenges to knowledge and communication, and physical and sensory difficulties. Finally, we discuss the current state of educational interventions and supports and offer recommendations for future research to improve educational outcomes for pediatric brain tumor survivors.
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Sharkey CM, Mullins LL, Clawson AH, Gioia A, Hawkins MAW, Chaney JM, Walsh KS, Hardy KK. Assessing neuropsychological phenotypes of pediatric brain tumor survivors. Psychooncology 2021; 30:1366-1374. [PMID: 33823083 DOI: 10.1002/pon.5692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Pediatric brain tumor survivors (PBTS) are at risk for both neurocognitive impairments and psychological difficulties, yet these two domains have historically been discretely examined, with assessment of psychosocial outcomes rarely included in studies of cognitive outcomes. Taking a person-centered approach, the current study aimed to more comprehensively evaluate PBTS late effect profiles, including both neurocognitive and psychological sequelae, and predictors of these profiles. METHOD PBTS (N = 89) were assessed in a pediatric neuropsychological clinic between May 2009 and May 2018, diagnosed at least 1 year prior, and off-treatment for at least 3 months (Mage = 6.57 years, SD = 4.53; 46.1% female). Parent- and teacher-report of psychological symptoms, and performance-based measures of neurocognitive functioning were examined using latent profile analysis. The R3STEP procedure identified predictors of class membership. RESULTS The optimal model identified four classes characterized by: (1) average functioning across all measures ("Average," n = 47), (2) average psychosocial functioning and impaired neurocognitive functioning ("Cognitive Deficit," n = 25), (3) elevated social problems and significant neurocognitive impairments ("Social/Cognitive Deficit," n = 9), and (4) impaired visual planning and problem-solving and elevated parent-reported psychosocial problems, but average processing speed, working memory, and teacher-reported psychosocial outcomes ("Discrepant," n = 8). Ethnicity, race, radiation treatment, and diagnoses of neurofibromatosis 1, hydrocephalus, and cerebellar mutism syndrome were significant predictors of class membership (ps < 0.05). CONCLUSION The present study identified distinct phenotypes with unique patterns of relations among neurocognitive and psychological domains. These findings are a vital first step toward identifying those at highest risk for poor outcomes and informing interventions that effectively address interrelated treatment targets for specific groups.
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Affiliation(s)
- Christina M Sharkey
- Children's National Hospital, Division of Pediatric Neuropsychology, Washington DC, USA
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Ashley H Clawson
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Anthony Gioia
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - John M Chaney
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Karin S Walsh
- Children's National Hospital, Division of Pediatric Neuropsychology, Washington DC, USA
| | - Kristina K Hardy
- Children's National Hospital, Division of Pediatric Neuropsychology, Washington DC, USA
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Caru M, Perreault S, Levesque A, Sultan S, Desjardins L, Rondeau É, Romo L, Curnier D, Kern L. Validity and reliability of the French version of the Pediatric Quality of Life Inventory™ brain tumor module. Qual Life Res 2021; 30:2387-2404. [PMID: 33723696 DOI: 10.1007/s11136-021-02815-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Assessing health-related quality of life (HRQoL) is an increasingly important aspect of standard care in pediatric oncology. Currently, there is a gap in the availability of French questionnaires to assess the quality of life of French-speaking pediatric brain tumor (PBT) patients, which has important implications in the care of this population. The first aim of this study was to translate the original English Pediatric Quality of Life Inventory™ (PedsQL) brain tumor module version into French. The second aim was to describe the stability, repeatability and convergent validity of the French PedsQL brain tumor module. METHODS A total of 61 PBT patients were included in this study. Among them, 15 children and 20 parents participated in the translation process. As part of the validation study, 48 children and 48 parents answered the PedsQL brain tumor module twice, and the PedsQL generic core scales and the patient-reported outcomes measurement information system (PROMIS-37 pediatric profile v2.0) questionnaire were administered once to the participants. The mean age of the 25 boys and 23 girls was 8.3 ± 4.8 years. For temporal stability, we used intraclass correlation coefficients (ICCs), for repeatability, we used the Bland and Altman method to assess the accuracy at a 1-week interval, and we used Pearson's correlation coefficients for convergent validity between the PedsQL brain tumor module, PedsQL general module and the PROMIS. RESULTS Temporal stability for the parent proxy-reports (average ICC = 0.98) and the child self-reports (average ICC = 0.98) were excellent. There was a high absolute stability over a 1-week interval for the parent proxy-reports (ICC > 0.96) and child self-reports (ICC > 0.96). Convergent validity between parent proxy-reports and child self-reports was supported by positive correlations for five subscales. Children reported higher scores in cognitive problems and the movement and balance parameters than their parents and reported lower scores on the worry parameter than their parents. CONCLUSION The strong psychometric properties of the French version of the PedsQL brain tumor module indicate that it is a validate and reliable questionnaire to measure HRQoL in PBT patients. The availability of a French version of the PedsQL brain tumor module supports the wider dissemination of the assessment of HRQOL in PBT patients.
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Affiliation(s)
- Maxime Caru
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada. .,Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), Department of Psychology, University of Paris Nanterre, Nanterre, France. .,Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.
| | - Sébastien Perreault
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Ariane Levesque
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Serge Sultan
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Leandra Desjardins
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Émélie Rondeau
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Lucia Romo
- Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), Department of Psychology, University of Paris Nanterre, Nanterre, France.,Mental and Brain Diseases Clinic (CMME), INSERM U 1266, University Hospital Group Paris Psychiatry & Neuroscience, Paris, France
| | - Daniel Curnier
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Laurence Kern
- Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), Department of Psychology, University of Paris Nanterre, Nanterre, France.,Laboratoire EA 29 31, Laboratoire Interdisciplinaire en Neurosciences, Physiologie et Psychologie: Apprentissages, Activité Physique et Santé (LINP2‑2APS), University of Paris Nanterre, Nanterre, Ile‑de‑France, France
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Kohler BE, Baque E, Sandler CX, Brookes DSK, Terranova CO, Rixon M, Hassall T, Trost SG. Physical ACTivity in Survivorship (PACTS): study protocol for a randomized controlled trial evaluating a goal-directed therapeutic exercise program in pediatric posterior fossa brain tumor survivors. BMC Pediatr 2021; 21:105. [PMID: 33648474 PMCID: PMC7919081 DOI: 10.1186/s12887-021-02566-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Posterior fossa brain tumors (PFBT) are the most common solid tumor in children. Recent increases in survival rates are encouraging; however, survivors may experience a plethora of disease- and treatment-related complications that can persist into adulthood. Therapeutic exercise interventions have been shown to improve quality of survivorship in other pediatric cancer diagnoses. There is also evidence that goal-directed interventions are effective at improving motor activities, function, and self-care in children with complex health conditions. Yet, there is currently no evidence on the efficacy of goal-directed therapeutic exercise in pediatric PFBT survivors. The Physical ACTivity in Survivorship (PACTS) study aims to investigate the effects of a novel goal-directed therapeutic exercise program on cardiorespiratory fitness and physical activity-related goal attainment in pediatric survivors of PFBT. METHOD PFBT survivors, aged five to 17 years, who underwent surgery at least 12 months earlier and completed radiation therapy and/or chemotherapy at least 6 months prior will be recruited from the Queensland Children's Hospital (Brisbane, Australia) (target n = 48). Following baseline assessment, participants are randomized into either the intervention or usual care group. The intervention group will receive weekly individualized, goal-directed exercise therapy delivered face-to-face for 12 weeks, along with an accompanying home-based program (three sessions per week). Outcomes will be assessed at baseline, immediately post-intervention, and at 6- and 12-months post-intervention. The primary outcomes are cardiorespiratory fitness (Peak VO2) and physical activity-related goal attainment. Secondary outcomes are cardiorespiratory endurance, high-level mobility skills, functional muscle strength, habitual physical activity, gait, balance, quality of life, fatigue, participation, perceived movement skill competence and parameters of body composition. DISCUSSION PACTS is the first study to investigate the efficacy of goal-directed therapeutic exercise in children with PFBT and provide evidence needed to inform clinical practice recommendations for managing quality of survivorship in PFBT survivors. TRIAL REGISTRATION ACTRN12619000841178 .
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Affiliation(s)
- Brooke E Kohler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Emmah Baque
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Carolina X Sandler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Denise S K Brookes
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Caroline O Terranova
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Matthew Rixon
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Tim Hassall
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
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31
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Benzing V, Siegwart V, Spitzhüttl J, Schmid J, Grotzer M, Roebers CM, Steinlin M, Leibundgut K, Everts R, Schmidt M. Motor ability, physical self-concept and health-related quality of life in pediatric cancer survivors. Cancer Med 2021; 10:1860-1871. [PMID: 33527768 PMCID: PMC7940246 DOI: 10.1002/cam4.3750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/05/2020] [Accepted: 12/15/2020] [Indexed: 12/31/2022] Open
Abstract
Background Cancer survivorship is frequently associated with severe late effects. However, research into pediatric cancer survivors on late effects in motor ability, physical self‐concept and their relationship to quality of life is limited. Methods Using multiple regression analyses, 78 pediatric cancer survivors and 56 typically developing children were compared in motor ability, physical self‐concept and health‐related quality of life. In addition, mediational multi‐group analyses between motor ability (independent variable), physical self‐concept (mediator) and quality of life (dependent variable) were calculated. Results Pediatric cancer survivors had a lower motor ability (gHedges = 0.863), a lower physical self‐concept with regard to several scales of the PSDQ‐S (gHedges = 0.318–0.764) and a higher relative risk for a below average quality of life than controls (RR = 1.44). Children with a history of cancer involving the central nervous system showed poorer motor ability compared to those without central nervous system involvement (gHedges = 0.591). Furthermore, the physical self‐concept significantly mediated the relationship between motor ability and quality of life in pediatric cancer survivors but not in typically developing children. Conclusions Results show the importance of monitoring and supporting the development of motor ability in the aftercare of pediatric cancer survivors. Physical activity interventions may be advisable to prevent physical activity‐related late effects and potentially improve related psychosocial variables such as quality of life.
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Affiliation(s)
- Valentin Benzing
- Institute of Sport Science, University of Bern, Bern, Switzerland.,Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Valerie Siegwart
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Janine Spitzhüttl
- Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jürg Schmid
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Michael Grotzer
- Division of Pediatric Oncology, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - Maja Steinlin
- Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kurt Leibundgut
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Regula Everts
- Division of Pediatric Hematology and Oncology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, Bern, Switzerland
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Psychological Outcomes, Health-Related Quality of Life, and Neurocognitive Functioning in Survivors of Childhood Cancer and Their Parents. Pediatr Clin North Am 2020; 67:1103-1134. [PMID: 33131537 DOI: 10.1016/j.pcl.2020.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood cancer disrupts the lives of patients and their families and affects acute and long-term psychological health. This article summarizes (1) psychological challenges, including depression, anxiety, worries, and posttraumatic stress, as well as positive outcomes such as benefit finding and posttraumatic growth in young survivors and parents; (2) health-related quality of life; (3) interventions to support survivors and parents with psychological difficulties; and (4) neurocognitive problems and interventions to help alleviate them. Although many survivors and parents fare well in the long term, many survivors may benefit from interventions. Interventions should be further evaluated and integrated into routine clinical care.
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Sharkey CM, Espeleta HC, Traino KA, Roberts CM, Perez MN, Bakula DM, Chaney JM, Alderson RM, Mullins LL. Psychological adjustment outcomes among pediatric brain tumor survivors: A meta-analysis. Pediatr Blood Cancer 2020; 67:e28644. [PMID: 32761992 DOI: 10.1002/pbc.28644] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pediatric brain tumor survivors (PBTS) are at significant risk for psychological adjustment difficulties, including greater depressive and anxious symptomology. Systematic reviews have identified this heightened risk among youth with medical conditions, but these reviews have not been specific to PBTS. Therefore, the current study aimed to directly examine the psychological adjustment of PBTS as compared to healthy peers. PROCEDURE A systematic review and meta-analysis was conducted using PubMed, PsychInfo, and Academic Search Premier databases. The search yielded 2833 articles, with 22 articles meeting inclusion criteria. RESULTS A statistically significant overall medium effect size (Hedge's g = 0.32) indicated that PBTS exhibited poorer overall psychological adjustment relative to healthy comparison groups. Studies that included younger children were associated with larger between-group differences. When evaluating specific outcomes, PBTS had relatively higher levels of depressive symptoms (Hedge's g = 0.36), anxious symptoms (Hedge's g = 0.11), and general distress (Hedge's g = 0.22), but not more externalizing problems. CONCLUSIONS The present study confirmed that PBTS are indeed at greater risk for psychological adjustment difficulties relative to healthy comparison groups. These findings highlight the importance of psychosocial screening among this population. Given that depressive symptoms were the most elevated relative to healthy peers, investigation of such symptomatology among PBTS is particularly important.
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Affiliation(s)
| | - Hannah C Espeleta
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Katherine A Traino
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Caroline M Roberts
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Megan N Perez
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Dana M Bakula
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - John M Chaney
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - R Matt Alderson
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
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Erker C, Tamrazi B, Poussaint TY, Mueller S, Mata-Mbemba D, Franceschi E, Brandes AA, Rao A, Haworth KB, Wen PY, Goldman S, Vezina G, MacDonald TJ, Dunkel IJ, Morgan PS, Jaspan T, Prados MD, Warren KE. Response assessment in paediatric high-grade glioma: recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group. Lancet Oncol 2020; 21:e317-e329. [PMID: 32502458 DOI: 10.1016/s1470-2045(20)30173-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 12/27/2022]
Abstract
Response criteria for paediatric high-grade glioma vary historically and across different cooperative groups. The Response Assessment in Neuro-Oncology working group developed response criteria for adult high-grade glioma, but these were not created to meet the unique challenges in children with the disease. The Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group, consisting of an international panel of paediatric and adult neuro-oncologists, clinicians, radiologists, radiation oncologists, and neurosurgeons, was established to address issues and unique challenges in assessing response in children with CNS tumours. We established a subcommittee to develop response assessment criteria for paediatric high-grade glioma. Current practice and literature were reviewed to identify major challenges in assessing the response of paediatric high-grade gliomas to various treatments. For areas in which scientific investigation was scarce, consensus was reached through an iterative process. RAPNO response assessment recommendations include the use of MRI of the brain and the spine, assessment of clinical status, and the use of corticosteroids or antiangiogenics. Imaging standards for brain and spine are defined. Compared with the recommendations for the management of adult high-grade glioma, for paediatrics there is inclusion of diffusion-weighted imaging and a higher reliance on T2-weighted fluid-attenuated inversion recovery. Consensus recommendations and response definitions have been established and, similar to other RAPNO recommendations, prospective validation in clinical trials is warranted.
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Affiliation(s)
- Craig Erker
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Dalhousie University and IWK Health Centre, Halifax, NS, Canada.
| | - Benita Tamrazi
- Department of Radiology, Keck School of Medicine, University of Southern California and Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Tina Y Poussaint
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
| | - Sabine Mueller
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA; Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Daddy Mata-Mbemba
- Department of Diagnostic Imaging, Dalhousie University and IWK Health Centre, Halifax, NS, Canada
| | - Enrico Franceschi
- Department of Medical Oncology, Azienda USL, Bologna, Italy; IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Alba A Brandes
- Department of Medical Oncology, Azienda USL, Bologna, Italy; IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Arvind Rao
- Departments of Computational Medicine and Bioinformatics and Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Kellie B Haworth
- Division of Neuro-Oncology, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Patrick Y Wen
- Center For Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Stewart Goldman
- Department of Haematology, Oncology, Neuro-Oncology, and Stem Cell Transplantation, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Gilbert Vezina
- Department of Radiology, Children's National Medical Center, Washington, DC, USA
| | - Tobey J MacDonald
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Ira J Dunkel
- Department of Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul S Morgan
- Department of Medical Physics and Clinical Engineering, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
| | - Tim Jaspan
- Department of Radiology, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
| | - Michael D Prados
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Katherine E Warren
- Department of Pediatric Oncology, Dana- Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute, Boston, MA, USA
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Rensen N, Steur LMH, Schepers SA, Merks JHM, Moll AC, Kaspers GJL, Van Litsenburg RRL, Grootenhuis MA. Determinants of health-related quality of life proxy rating disagreement between caregivers of children with cancer. Qual Life Res 2020; 29:901-912. [PMID: 31820207 PMCID: PMC7142061 DOI: 10.1007/s11136-019-02365-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Proxy reports of health-related quality of life (HRQoL) are commonly used in pediatric oncology. However, it is not known if caregivers' reports differ. This study therefore aims to compare paternal and maternal proxy reports, and explore determinants of couple disagreement (sociodemographic and medical characteristics, and parental QoL and distress). METHODS Both parents completed the PedsQL generic (child's HRQoL), Short Form-12 (own QoL) and Distress Thermometer for Parents. To assess agreement in child HRQoL, intra-class correlation coefficients (ICCs) were calculated. Differences between fathers/mothers were assessed with paired t tests. Systematic disagreement patterns were visualized with Bland-Altman plots. Characteristics of parental couples with a mean proxy difference in the highest quartile (highest proxy score minus lowest proxy score) were explored with multiple logistic regression analysis. RESULTS Parents of 120 children with cancer (87% post-treatment, mean age 11.0 ± 5.7 years) participated. No significant differences were found between paternal and maternal proxy scores, and agreement was good on all scales (ICCs 0.65-0.83). Bland-Altman plots revealed no systematic disagreement patterns, but there was a wide range in magnitude of the differences, and differences went in both directions. Couples with a mean proxy difference (irrespective of which direction) in the highest quartile (± 20 points) were more likely to have a child in active treatment, with retinoblastoma or relapsed disease, and to diverge in their own QoL. CONCLUSIONS If proxy reports of only one parent are available, clinicians may reasonably assume that paternal and maternal reports are interchangeable. However, if in doubt, respondent's sex is not of major importance, but clinicians should be aware of patient's and family's characteristics.
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Affiliation(s)
- Niki Rensen
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lindsay M H Steur
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
| | - Gertjan J L Kaspers
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Raphaële R L Van Litsenburg
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Recklitis CJ, Liptak C, Footer D, Fine E, Chordas C, Manley P. Prevalence and Correlates of Pain in Adolescent and Young Adult Survivors of Pediatric Brain Tumors. J Adolesc Young Adult Oncol 2019; 8:641-648. [DOI: 10.1089/jayao.2019.0029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Christopher J. Recklitis
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Cori Liptak
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Dana Footer
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Elizabeth Fine
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Christine Chordas
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Peter Manley
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Silva N, Pereira M, Otto C, Ravens-Sieberer U, Canavarro MC, Bullinger M. Do 8- to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires. Qual Life Res 2019; 28:1725-1750. [PMID: 31055778 DOI: 10.1007/s11136-019-02189-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE This meta-analytic review aimed to estimate the magnitude of health-related quality of life (HrQoL) impairments, as assessed by the KIDSCREEN questionnaires, both self- and parent-reported, in 8- to 18-years-old children/adolescents with chronic health conditions. METHODS To identify studies using the KIDSCREEN questionnaires, three electronic databases (PubMed, PsycINFO, EBSCOhost Psychology & Behavioral Sciences) were searched. The final search (February 14-15, 2018) revealed 528 non-duplicated articles, of which 23 papers (21 studies) directly compared the HrQoL of pediatric patients to community/healthy controls and were included in the meta-analysis. Pooled mean differences (MD) with 95% CIs were estimated using the inverse-variance random-effects method. RESULTS Of the 21 studies, 16 used self-reports, one used parent-reports and four adopted a multi-informant approach. Self-reported data were retrieved from 20 studies (4852 cases/28,578 controls), and parent-reported data were retrieved from four studies (511 cases/433 controls). Pediatric patients presented significant HrQoL impairments in the domains of physical well-being (MD = - 4.84, 95% CI - 6.44/- 3.24 for self-reports; MD = - 6.86, 95% CI - 10.42/- 3.29 for parent-reports) and peers and social support (MD = - 1.29, 95% CI - 2.25/- 0.34 for self-reports; MD = - 3.90, 95% CI - 5.28/- 2.52 for parent-reports), compared to community/healthy peers. Between-studies heterogeneity was explained by diagnostic categories, instrument version and informants. CONCLUSIONS The identification of significant HrQoL impairments among pediatric patients, specifically in the physical and social domains, highlights the importance of routine psychosocial assessment and intervention in primary pediatric healthcare services. Specific recommendations include the use of profile measures, both self- and parent-reports, and the prioritization of oncology, endocrinology and neurology services.
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Affiliation(s)
- Neuza Silva
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal. .,Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W26, 20246, Hamburg, Germany.
| | - Marco Pereira
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Christiane Otto
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W29, 20246, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W29, 20246, Hamburg, Germany
| | - Maria Cristina Canavarro
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W26, 20246, Hamburg, Germany
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38
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Are we friends? Best friend nominations in pediatric brain tumor survivors and associated factors. Support Care Cancer 2019; 27:4237-4244. [PMID: 30847703 DOI: 10.1007/s00520-019-04706-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [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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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] [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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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] [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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Holland AA, Colaluca B, Bailey L, Stavinoha PL. Impact of attention on social functioning in pediatric medulloblastoma survivors. Pediatr Hematol Oncol 2018; 35:76-89. [PMID: 29652554 DOI: 10.1080/08880018.2018.1440333] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Parent-reported attention problems have been associated with social functioning in a broad sample of pediatric cancer survivors. OBJECTIVE The present study focused on a more homogeneous sample (pediatric medulloblastoma survivors), with the novel inclusion of self-reported attention ratings. PARTICIPANTS/METHODS Thirty-three pediatric medulloblastoma survivors, ages 7-18 years, completed a brief IQ measure and self-report of attentional and social functioning. Parents rated patients' attentional and social functioning. RESULTS Mean attention ratings were average based on both parent- and self-report, though parent ratings were significantly discrepant from normative means. No significant demographic or treatment-related predictors of self-reported attention problems were identified, whereas female gender was associated with greater parent-reported attention problems. Canonical correlation analysis revealed a significant association between parent-reported attention difficulties and social functioning in pediatric medulloblastoma survivors, but there was no association between self-reported attention problems and measures of social functioning. CONCLUSIONS Consistent with existing literature in broader samples of pediatric cancer survivors, the present study further affirms attention deficits as an underlying contributor to social deficits in pediatric medulloblastoma survivors while also finding little relationship between self-reports of attention and social performance. Notably, present findings provide additional support suggesting that attention functioning is a more significant contributor to social outcomes for pediatric medulloblastoma survivors than the level of cognitive ability.
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Affiliation(s)
- Alice Ann Holland
- a University of Texas Southwestern Medical Center , Dallas , Texas , USA.,b Children's Medical Center , Dallas , Texas , USA
| | - Beth Colaluca
- c Cook Children's Health Care System , Fort Worth , Texas , USA
| | - Laurie Bailey
- c Cook Children's Health Care System , Fort Worth , Texas , USA
| | - Peter L Stavinoha
- a University of Texas Southwestern Medical Center , Dallas , Texas , USA.,b Children's Medical Center , Dallas , Texas , USA
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