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Signorelli C, Høeg BL, Asuzu C, Centeno I, Estapé T, Fisher P, Lam W, Levkovich I, Manne S, Miles A, Mullen L, Nekhlyudov L, Sade C, Shaw J, Singleton A, Travado L, Tsuchiya M, Lemmen J, Li J, Jefford M. International Survey of Psychosocial Care for Cancer Survivors in Low-/Middle- and High-Income Countries: Current Practices, Barriers, and Facilitators to Care. JCO Glob Oncol 2024; 10:e2300418. [PMID: 38781550 DOI: 10.1200/go.23.00418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/24/2024] [Accepted: 03/26/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE The number of cancer survivors living with and beyond cancer treatment is rising globally. It is fundamental to understand the extent and type of psychosocial care services offered worldwide. We evaluated models of cancer survivorship care, psychosocial care practices in the post-treatment survivorship phase, and barriers/facilitators to delivery of psychosocial care services, including in low- and middle-income countries (LMICs). METHODS The International Psycho-Oncology Society (IPOS) Survivorship Special Interest Group led a cross-sectional online survey between March and November 2022. Health care professionals and researchers in psycho-oncology were invited through the IPOS global membership, social media, and snowballing. The survey was administered to individuals but included questions related to practices in their country at a national level. RESULTS Two hundred eighty-three respondents from 37 countries participated (40% from LMICs), with a median of 12 years of experience (IQR, 6-20) in the psycho-oncology field. Participants reported that the most common elements of routine survivorship care were related to the prevention/management of recurrences/new cancers (74%), physical late effects (59%), and chronic medical conditions (53%), whereas surveillance/management of psychosocial late effects (27%) and psychosocial/supportive care (25%) were least common. Service availability was more commonly reported in high-income countries (HICs) than LMICs related to reproductive health (29% v 17%), genetic counseling/support (40% v 20%), and identifying/managing distress (39% v 26%) and pain (66% v 48%). Key barriers included providers focusing on treatment not survivorship (57%), medical not psychosocial care (60%), and a lack of allied health providers to deliver psychosocial care (59%). CONCLUSION The psychosocial needs of people living with cancer are not adequately available and/or provided in post-treatment survivorship even in HICs, because of barriers at patient, provider, and system levels.
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Affiliation(s)
- Christina Signorelli
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | | | - Chioma Asuzu
- Unit of Psycho-Oncology, Department of Radiation Oncology, College of Medicine, Ibadan, Nigeria
| | - Isabel Centeno
- Breast Cancer Center, Hospital Zambrano Hellion, Monterrey, Mexico
| | - Tania Estapé
- Psychosocial Oncology Department, FEFOC Foundation, Barcelona, Spain
| | - Peter Fisher
- University of Liverpool; Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Wendy Lam
- School of Public Health, LSK Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tiv'on, Israel
| | - Sharon Manne
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
| | - Anne Miles
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Louise Mullen
- National Cancer Control Programme, Health Services Executive, Kings Inns House, Dublin, Ireland
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Cristina Sade
- Psychosocial Oncology Department, Instituto Nacional del Cáncer, Santiago, Chile
| | - Joanne Shaw
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Anna Singleton
- Faculty of Medicine and Health, Engagement and Co-design Research Hub, University of Sydney, Sydney, Australia
| | - Luzia Travado
- Champalimaud Clinical and Research Center, Champalimaud Foundation, Lisbon, Portugal
| | - Miyako Tsuchiya
- Division of Healthcare Delivery, Survivorship and Policy Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
- Research Institute of Nursing, Musashino University, Tokyo, Japan
| | - Jesse Lemmen
- Pediatric Oncology, Emma's Children Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jie Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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Van Zyl A, Kruger M, Ndlovu S, Rogers PC. Health-Related Quality of Life of Adolescent and Young Adult-Aged Childhood Cancer Survivors in a South African Cohort: A Pilot Study Using the Minneapolis-Manchester Quality of Life Instrument. J Adolesc Young Adult Oncol 2024. [PMID: 38613471 DOI: 10.1089/jayao.2023.0123] [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: 04/15/2024] Open
Abstract
Purpose: We investigated the health-related quality of life (HRQoL) of an adolescent and young adult (AYA)-aged South African childhood cancer survivor (CCS) cohort. Methods: Participants completed the Minneapolis-Manchester Quality of Life adolescent and adult forms. The overall Cronbach's alpha coefficients were 0.81 (adolescent form) and 0.92 (adult form). The scale-level content validity indexes were acceptable (0.88 and 0.89 for the adolescent and adult forms, respectively). The total domain and overall HRQoL scores were calculated. Results: Sixty-two survivors completed the adolescent form and 30 completed the adult form. The median age was 17.5 years (range 13-34 years), and the median time from diagnosis was 12 years (male:female ratio 1:1.2). Risk factors for poor physical functioning included age at study visit (p = 0.015), solid tumor diagnosis (p = 0.012), radiotherapy (p = 0.021), and surgery (p = 0.006). Six or more late effects impacted most domains negatively; severe late effects (p = 0.020) decreased physical functioning. Lower socioeconomic status was associated with poorer physical (p = 0.006) and cognitive (p = 0.047) functioning. The adult form cohort had poorer psychological (p = 0.014) and social functioning (p = 0.005) and body image (p = 0.016) than the adolescent form cohort. Conclusion: Older age, radiotherapy, surgery, solid tumor diagnosis, and the number and severity of late effects negatively influenced HRQoL in AYA-aged CCSs. A long-term follow-up (LTFU) risk stratification system should include HRQoL status to assist with holistic LTFU care.
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Affiliation(s)
- Anel Van Zyl
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
- School of Psychology, University of Kwa-Zulu Natal, Durban, South Africa
| | - Sandile Ndlovu
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Paul C Rogers
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Woodford J, Reuther C, Ljungberg JL, von Essen L. Involving parents of children treated for cancer in Sweden as public contributors to inform the design and conduct of an evaluation of internet-administered self-help for parents of children treated for cancer: a protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:2. [PMID: 38167254 PMCID: PMC10759441 DOI: 10.1186/s40900-023-00532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Public contribution in research can facilitate the design and conduct of meaningful research, resulting in feasible and sustainable solutions to healthcare challenges. However, the evidence concerning the acceptability, feasibility, and impact of public contribution in research is limited. We will embed a mixed-method examination of public contribution activities into the CHANGE trial. The overall aim of the CHANGE trial is to evaluate the efficacy and cost-effectiveness of an internet-administered, guided, low-intensity cognitive behavioral therapy-based self-help intervention (EJDeR) plus treatment as usual (TAU) versus TAU for symptoms of depression and/or Generalized Anxiety Disorder in a superiority randomized controlled trial with an internal pilot phase. In this protocol we describe how we aim to: (1) involve parents of children treated for cancer in the managing and undertaking, analysis and interpretation, and dissemination phases of the CHANGE trial; and (2) examine the acceptability, feasibility, and perceived impact of Parent Advisory Board contribution to the trial from the perspective of board members and public contribution coordinators. METHODS We will recruit around six parents of children treated for cancer to the Parent Advisory Board. Board members will contribute throughout the trial during online workshops and steering group meetings. An impact log will be used during workshops to record activities and examine the perceived impact of activities according to board members and public contribution coordinators, including anticipated and unanticipated changes to the research process and potential benefits and harms. Activities will be reported using the Guidance for Reporting Involvement of Patients and the Public checklist. We will conduct semi-structured interviews with board members and public contribution coordinators 6 months after the board is established and at the end of the trial to examine the acceptability, feasibility, and perceived impact of public contribution activities. We will also conduct interviews with board members and public contribution coordinators who withdraw participation. Findings will be reported in accordance with the Standards for Reporting Qualitative Research checklist. DISCUSSION We hope adding public contribution to the CHANGE trial will provide guidance on how to embed public contribution in research and add to the evidence base concerning the impact of public contribution.
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Affiliation(s)
- Joanne Woodford
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Johan Lars Ljungberg
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden.
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Reuther C, Lundgren J, Gottvall M, Ljungberg J, Woodford J, von Essen L. E-therapists' views on the acceptability and feasibility of an internet-administered, guided, low-intensity cognitive behavioural therapy intervention for parents of children treated for cancer: A qualitative study. Digit Health 2024; 10:20552076241260513. [PMID: 38846368 PMCID: PMC11155313 DOI: 10.1177/20552076241260513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
Background Childhood cancer treatment completion can be a period of vulnerability for parents and is associated with mental health difficulties such as depression and anxiety. We developed an internet-administered, guided, low-intensity cognitive behavioural therapy-based self-help intervention (EJDeR) for parents delivered on the U-CARE-portal (Portal). The acceptability and feasibility of EJDeR and study procedures were examined using a single-arm feasibility trial (ENGAGE). Results indicated that EJDeR and ENGAGE study procedures are acceptable and feasible, however, a need for clinical and technical modifications to EJDeR and refinements to ENGAGE study procedures was identified. Objectives This study aimed to explore the acceptability and feasibility of EJDeR and ENGAGE study procedures from the perspective of e-therapists to inform clinical and technical modifications to EJDeR and refinements to study procedures prior to progression to a superiority randomised controlled trial. Methods We conducted semi-structured interviews with 10 e-therapists. Data were analysed using manifest content analysis. Results We identified three categories relating to the acceptability and feasibility of EJDeR: (a) Support to e-therapists (subcategories: Clinical supervision and Technical difficulties); (b) Guidance to parents (subcategories: Support protocols and Synchronous communication); and (c) Content (subcategories: Relevancy of the intervention and Pacing of the intervention). We identified four categories relating to the acceptability and feasibility of study procedures: (a) Recruitment and training of e-therapists (subcategories: Definition of the role and Training program); (b) Retention of parents (subcategories: Parent suitability and screening and Frequency of weekly Portal assessments); (c) Retention of e-therapists (subcategories: Administrative requirements and Communication with the research team); and (d) The Portal. Conclusions EJDeR and study procedures were considered acceptable and feasible, however, clinical and technical modifications and refinements to study procedures were suggested to enhance acceptability and feasibility. Results may also inform implementation considerations for both EJDeR and other similar digital psychological interventions. Trial registration number ISRCTN 57233429.
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Affiliation(s)
- Christina Reuther
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Johan Lundgren
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Maria Gottvall
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden
| | - Johan Ljungberg
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Winzig J, Inhestern L, Paul V, Nasse ML, Krauth KA, Kandels D, Rutkowski S, Escherich G, Bergelt C. Parent-reported health-related quality of life in pediatric childhood cancer survivors and factors associated with poor health-related quality of life in aftercare. Qual Life Res 2023; 32:2965-2974. [PMID: 37204653 PMCID: PMC10474174 DOI: 10.1007/s11136-023-03436-8] [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] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Despite advances in cancer treatment, there is a prevalence of pediatric childhood cancer survivors still at risk of developing adverse disease and treatment outcomes, even after the end of treatment. The present study aimed to (1) explore how mothers and fathers assess the health-related quality of life (HRQoL) of their surviving child and (2) evaluate risk factors for poor parent-reported HRQoL in childhood cancer survivors about 2.5 years after diagnosis. METHODS We assessed parent-reported HRQoL of 305 child and adolescent survivors < 18 years diagnosed with leukemia or tumors of central nervous system (CNS) with the KINDL-R questionnaire in a prospective observational study with a longitudinal mixed-methods design. RESULTS In agreement with our hypotheses, our results show that fathers rate their children's HRQoL total score as well as the condition-specific domains family (p = .013, d = 0.3), friends (p = .027, d = 0.27), and disease (p = .035, d = 0.26) higher than mothers about 2.5 years after diagnosis. Taking variance of inter-individual differences due to family affiliation into account, the mixed model regression revealed significant associations between the diagnosis of CNS tumors (p = .018, 95% CI [- 7.78, - 0.75]), an older age at diagnosis, (p = .011, 95% CI [- 0.96, - 0.12]), and non-participation in rehabilitation (p = .013, 95% CI [- 10.85, - 1.28]) with poor HRQoL in children more than 2 years after being diagnosed with cancer. CONCLUSION Based on the results, it is necessary for health care professionals to consider the differences in parental perceptions regarding children's aftercare after surviving childhood cancer. High risk patients for poor HRQoL should be detected early, and families should be offered support post-cancer diagnosis to protect survivors' HRQoL during aftercare. Further research should focus on characteristics of pediatric childhood cancer survivors and families with low participation in rehabilitation programs.
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Affiliation(s)
- Jana Winzig
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Verena Paul
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Mona L Nasse
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany
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McLoone JK, Sansom-Daly UM, Paglia A, Chia J, Larsen HB, Fern LA, Cohn RJ, Signorelli C. A Scoping Review Exploring Access to Survivorship Care for Childhood, Adolescent, and Young Adult Cancer Survivors: How Can We Optimize Care Pathways? Adolesc Health Med Ther 2023; 14:153-174. [PMID: 37753163 PMCID: PMC10519427 DOI: 10.2147/ahmt.s428215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
Childhood, adolescent, and young adult (CAYA) cancer survivors are at risk of developing late effects associated with their cancer and its treatment. Survivors' engagement with recommended follow-up care to minimize these risks is suboptimal, with many barriers commonly reported. This scoping review aims to summarize the barriers to accessing follow-up care, using the dimensions of Levesque's framework for accessing healthcare. We retrieved quantitative studies addressing barriers and facilitators to accessing survivorship care in CAYA survivors from PubMed, EMBASE and CINAHL. Data was categorized into the five healthcare access dimensions outlined in Levesque's framework: i) approachability, ii) acceptability, iii) availability and accommodation, iv) affordability, and v) appropriateness. We identified 27 quantitative studies in our review. Commonly reported barriers to accessing care included a lack of survivor and provider knowledge of cancer survivorship, poor health beliefs, low personal salience to engage in follow-up care, high out-of-pocket costs and survivors living long distances from clinical services. Many studies reported increased barriers to care during the transition from paediatric to adult-oriented healthcare services, including a lack of developmentally appropriate services, lack of appointment reminders, and a poorly defined transition process. Healthcare-related self-efficacy was identified as an important facilitator to accessing follow-up care. The transition from pediatric to adult-oriented healthcare services is a challenging time for childhood, adolescent, and young adult cancer survivors. Optimizing CAYAs' ability to access high-quality survivorship care thus requires careful consideration of the quality and acceptability of services, alongside financial and physical/practical barriers (eg distance from available services, appointment-booking mechanisms). Levesque's model highlighted several areas where evidence is well established (eg financial barriers) or lacking (eg factors associated with engagement in follow-up care) which are useful to understand barriers and facilitators that impact access to survivorship for CAYA cancer survivors, as well as guiding areas for further evaluation.
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Affiliation(s)
- Jordana K McLoone
- Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, UNSW Sydney, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Ursula M Sansom-Daly
- Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, UNSW Sydney, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Alexia Paglia
- Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, UNSW Sydney, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Jessica Chia
- Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, UNSW Sydney, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Hanne Bækgaard Larsen
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark & Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lorna A Fern
- Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Richard J Cohn
- Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, UNSW Sydney, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Christina Signorelli
- Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, UNSW Sydney, Sydney, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
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Cowfer BA, Dietrich MS, Akard TF, Gilmer MJ. Relationships Between Parental Anxiety and Child Quality of Life in Advanced Childhood Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:209-216. [PMID: 37032466 DOI: 10.1177/27527530221147876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Background: Family factors, such as household income and parental psychosocial distress, have been associated with quality of life in children with cancer. However, relationships between parent anxiety and child health-related quality of life (HRQoL) have not been evaluated in children with advanced cancer. Objective: To examine relationships between parent anxiety and both parent-reported and child self-reported HRQoL for children with advanced cancer. Method: Children (aged 5-17 years) with relapsed or refractory cancer and their parents participated in this single-institution cross-sectional study. Parents completed measures of their own baseline anxiety (State-Trait Anxiety Inventory-Trait [STAI-T] form) and their ill child's HRQoL (PedsQL Generic and PedsQL Cancer, parent report). Children completed age-specific PedsQL Generic and PedsQL Cancer, child report. Spearman's rho coefficients assessed correlations between total parent STAI-T score and both parent-reported and child-reported HRQoL scales. Results: Twenty children (Mage = 9.5 years, 50% female) and their 20 parents (90% mothers) participated. The strongest and statistically significant (p < .05) correlations were inverse associations between parental trait anxiety and parent-reported child psychosocial HRQoL (rs = -.54), emotional functioning (rs = -.49), school functioning (rs = -.45), and child pain and hurt (rs = -.45). Correlations of parental anxiety with all dimensions of child-reported HRQoL were generally smaller (rs < .40), positive, and not statistically significant (p > .05). Discussion: Given the inverse correlations between parental anxiety and child psychosocial HRQoL, assessment of parent mental health needs and access to interventions should be provided routinely for parents of children with advanced cancer.
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Affiliation(s)
- Brittany A Cowfer
- Vanderbilt University Medical Center and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Mary S Dietrich
- Vanderbilt University School of Nursing and Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Terrah Foster Akard
- Vanderbilt University School of Nursing and Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Mary Jo Gilmer
- Vanderbilt University School of Nursing and Vanderbilt University School of Medicine, Nashville, TN, USA
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Fukushima H, Suzuki R, Yamaki Y, Hosaka S, Inaba M, Masumoto K, Muroi A, Tsurubuchi T, Okubo R, Hidaka K, Mizumoto M, Sakurai H, Takada H. Longitudinal health-related quality of life analysis in childhood cancer survivors after proton beam therapy. Int J Clin Oncol 2023:10.1007/s10147-023-02353-7. [PMID: 37209157 DOI: 10.1007/s10147-023-02353-7] [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] [Received: 03/05/2023] [Accepted: 04/30/2023] [Indexed: 05/22/2023]
Abstract
PURPOSE Whilst proton beam therapy (PBT) for children with cancer is expected to reduce their comorbidities, to date only a limited number of studies have been published. To analyze the long-term comorbidity and health-related quality of life (HRQoL) of childhood cancer survivors (CCSs) after PBT, we conducted a questionnaire-based study. METHODS Questionnaires were sent to CCSs who underwent PBT at the University of Tsukuba Hospital during the period from 1984 to 2020. Scores from 41 CCSs who did not undergo PBT (noPBT-CCSs) and from the general population were used for comparison. RESULTS In total, 110 individuals who underwent PBT participated in the study. Among them, 40 individuals were longitudinally analyzed. The range of change in the scores was significantly greater in the CCSs whose initial scores were low. Although the comorbidity levels were more severe, HRQoL tended to be better in the PBT-CCSs than in the noPBT-CCSs with central nervous system (CNS) or solid tumors, respectively. When compared with the general population, the psychosocial health summary scores and its components were not different in the noPBT-CNS-CCSs. On the other hand, the psychosocial health summary scores and/or at least one of the scores of emotional, social, and school functioning were significantly higher in the other CCSs groups. CONCLUSIONS The HRQoL scores of CCSs with low initial scores can be greatly changed over time. Appropriate psychosocial support for this population is warranted. PBT may avoid reduction in HRQoL in terms of the psychosocial functioning of CCSs with CNS tumors.
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Affiliation(s)
- Hiroko Fukushima
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
- Department of Child Health, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Ryoko Suzuki
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
- Department of Child Health, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yuni Yamaki
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Sho Hosaka
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Masako Inaba
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Kouji Masumoto
- Department of Pediatric Surgery, University of Tsukuba Hospital, Tsukuba, Japan
| | - Ai Muroi
- Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takao Tsurubuchi
- Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Reiko Okubo
- Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kyoko Hidaka
- Department of Clinical Psychology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Masashi Mizumoto
- Department of Radiation Oncology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Hideyuki Sakurai
- Department of Radiation Oncology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Hidetoshi Takada
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
- Department of Child Health, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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9
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Farooqui Z, Johnston M, Schepers E, Brewer N, Hartman S, Jenkins T, Bondoc A, Pai A, Geller J, Tiao GM. Quality of Life Outcomes for Patients Who Underwent Conventional Resection and Liver Transplantation for Locally Advanced Hepatoblastoma. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050890. [PMID: 37238438 DOI: 10.3390/children10050890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Hepatoblastoma is the most common malignant liver tumor of childhood, with liver transplant and extended resection used as surgical treatments for locally advanced tumors. Although each approach has well-described post-operative complications, quality-of-life outcomes have not been described following the two interventions. Long-term pediatric survivors of hepatoblastoma who underwent conventional liver resection or liver transplantation at a single institution from January 2000-December 2013 were recruited to complete quality-of-life surveys. Survey responses for the Pediatric Quality of Life Generic Core 4.0 (PedsQL, n = 30 patient and n = 31 parent surveys) and Pediatric Quality of Life Cancer Module 3.0 (PedsQL-Cancer, n = 29 patient and n = 31 parent surveys) were collected from patients and parents. The mean total patient-reported PedsQL score was 73.7, and the parent-reported score was 73.9. There were no significant differences in scores on the PedsQL between patients who underwent resection compared to those who underwent transplantation (p > 0.05 for all comparisons). On the PedsQL-Cancer module, procedural anxiety scores were significantly lower for patients who underwent resection as compared to transplant (M = 33.47 points less, CI [-60.41, -6.53], p-value 0.017). This cross-sectional study demonstrates that quality of life outcomes are overall similar among patients receiving transplants and resections. Patients who received a resection reported worse procedural anxiety.
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Affiliation(s)
- Zishaan Farooqui
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Michael Johnston
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Emily Schepers
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Nathalie Brewer
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Stephen Hartman
- Department of Surgery, University of Cincinnati College of Medicine, CARE/Crawley Building, Suite E-870 Eden Avenue, Cincinnati, OH 45267, USA
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Todd Jenkins
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Alexander Bondoc
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Ahna Pai
- Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - James Geller
- Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Gregory M Tiao
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
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10
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Christen S, Roser K, Harju E, Gumy-Pause F, Mader L, Vetsch J, von Bueren AO, Michel G. Worries and anxiety in parents of adult survivors of childhood cancer: A report from the Swiss Childhood Cancer Survivor Study-Parents. Pediatr Blood Cancer 2023; 70:e30246. [PMID: 36772880 DOI: 10.1002/pbc.30246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Having a child diagnosed with cancer is distressing for parents. We aimed to compare worries and anxiety in parents of adult childhood cancer survivors with parents of the Swiss general population (GP-parents), and to evaluate characteristics associated with worry in parents of survivors. METHODS We conducted a nationwide, population-based study in parents of survivors (survivors aged ≥20 years at study, ≤16 years at diagnosis, >5 years post diagnosis) and GP-parents (≥1 child aged ≥20 years at study). We used the Worry and Anxiety Questionnaire (WAQ), and computed the WAQ total score (worries; possible range 0-80) and caseness for generalized anxiety disorder (anxiety), cognitive, somatic, and any criteria. We used multilevel, multivariable linear regression to identify characteristics associated with worries in parents of survivors. RESULTS We included 787 parents of 513 survivors (41.0% fathers) and 478 GP-parents (42.3% fathers). Parents of survivors and GP-parents did not differ regarding worries (16.6 vs. 17.1, p = .977), anxiety (2.7% vs. 3.6%, p = .536), cognitive (p = .440), and somatic criteria (p = .067). Less parents of survivors met any criteria (17.7% vs. 24.0%, p = .039). Half of parents reported current cancer-related worries. Higher cancer-related worries were reported by mothers (β = 4.1; 95% CI: 2.0-6.2), parents with one child (β = 5.9; 95% CI: 2.0-9.7), currently experiencing disadvantages because of their child's former disease (β = 7.3; 95% CI: 4.0-10.6), or with support needs (β = 9.0; 95% CI: 3.9-14.2; p = .001). CONCLUSIONS It is encouraging that most parents of adult survivors report similar worries and anxiety as GP-parents, but cancer-related worries are still prevalent. Efforts should be made to empower parents to seek psycho-social support if required.
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Affiliation(s)
- Salome Christen
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
| | - Erika Harju
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
| | - Fabienne Gumy-Pause
- Pediatric Oncology and Hematology Unit, Department of Women, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
- CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Luzius Mader
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Janine Vetsch
- Department of Health Sciences, Institute of Applied, Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Andre O von Bueren
- Pediatric Oncology and Hematology Unit, Department of Women, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
- CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
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11
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Thiblin E, Woodford J, Reuther C, Lundgren J, Lutvica N, von Essen L. Internet-administered, low-intensity cognitive behavioral therapy for parents of children treated for cancer: A feasibility trial (ENGAGE). Cancer Med 2023; 12:6225-6243. [PMID: 36404407 PMCID: PMC10028033 DOI: 10.1002/cam4.5377] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/05/2022] [Accepted: 10/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Parents of children treated for cancer may experience mental health difficulties, such as depression and anxiety. There is a lack of evidence-based psychological interventions for parents, with psychological support needs unmet. An internet-administered, guided, low-intensity cognitive behavioral therapy-based (LICBT) self-help intervention may provide a solution. METHODS The feasibility and acceptability of such an intervention was examined using a single-arm feasibility trial (ENGAGE). Primary objectives examined: (1) estimates of recruitment and retention rates; (2) feasibility and acceptability of data collection instruments and procedures; and (3) intervention feasibility and acceptability. Clinical outcomes were collected at baseline, post-treatment (12 weeks), and follow-up (6 months). RESULTS The following progression criteria were met: sample size was exceeded within 5 months, with 11.0% enrolled of total population invited, study dropout rate was 24.0%, intervention dropout was 23.6%, missing data remained at ≤10% per measure, and no substantial negative consequences related to participation were reported. Intervention adherence was slightly lower than progression criteria (47.9%). CONCLUSION Findings suggest an internet-administered, guided, LICBT self-help intervention may represent a feasible and acceptable solution for parents of children treated for cancer. With minor study protocol and intervention modifications, progression to a pilot randomized controlled trial (RCT) and subsequent superiority RCT is warranted.
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Affiliation(s)
- Ella Thiblin
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Johan Lundgren
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Nina Lutvica
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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12
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Youlden DR, Baade PD, Aitken JF. Long-term childhood cancer survival in Australia using period estimation. Pediatr Blood Cancer 2023; 70:e30136. [PMID: 36495243 DOI: 10.1002/pbc.30136] [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] [Received: 09/19/2022] [Revised: 10/25/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
Estimates of childhood cancer survival are usually reported at 5 years after diagnosis only. Using cases prevalent between 2014 and 2018 from the population-based Australian Childhood Cancer Registry, we used the period method to calculate relative survival up to 20 years post diagnosis by cancer type. Twenty-year relative survival for all childhood cancers combined (n = 14,353) was 83.8% (95% confidence interval [CI] = 82.6%-85.0%). Survival decreased only slightly after 10 years for most childhood cancers, except for some types of brain and liver tumours. These contemporary estimates of long-term survival provide valuable information to assist childhood cancer patients and their families in planning for the future.
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Affiliation(s)
- Danny R Youlden
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Peter D Baade
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Queensland, Australia.,School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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13
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van Gorp M, Joosten MMH, Maas A, Drenth BL, van der Aa-van Delden A, Kremer LCM, van Dulmen-den Broeder E, Tissing WJE, Loonen JJ, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Ronckers C, Bresters D, Louwerens M, Neggers SJCCM, van der Heiden-van der Loo M, Maurice-Stam H, Grootenhuis MA. Psychosocial functioning of parents of Dutch long-term survivors of childhood cancer. Psychooncology 2023; 32:283-294. [PMID: 36426662 PMCID: PMC10107521 DOI: 10.1002/pon.6069] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe health-related quality of life (HRQoL), post-traumatic stress and post-traumatic growth of parents of long-term survivors of childhood cancer (CCS) and study associated factors. METHODS Parents of survivors of the Dutch Childhood Cancer Survivor Study LATER cohort below 30 years and diagnosed 1986-2001 were invited to complete the TNO-AZL Questionnaire for Adult's HRQoL (e.g., sleep and aggressive emotions), Self-Rating Scale for Post-traumatic Stress Disorder, Post-traumatic Growth Inventory, and Illness Cognition Questionnaire. HRQoL domain scores were compared to references using Mann-Whitney U tests. Correlations between post-traumatic stress, growth and HRQoL were evaluated. Medical characteristics of their child and illness cognitions were studied as associated factors of HRQOL, post-traumatic stress and growth. p < 0.05 was considered statistically significant. RESULTS Parents (n = 661 of n = 448 survivors, 56% female, mean time since child's diagnosis: 21.3 [SD: 3.3] years) reported better HRQoL in social functioning and aggressive emotions than references (r = .08-0.17). Mothers additionally reported better HRQoL in pain, daily activities, sexuality, vitality, positive and depressive emotions (r = .07-0.14). Post-traumatic stress was symptomatic in 3%, and associated with worse HRQoL (r = -0.27-0.48). Post-traumatic growth was positively associated to post-traumatic stress and better HRQoL (r = 0.09-0.12). Cancer recurrence was associated to better HRQoL (β = 0.37-0.46). Acceptance illness cognitions were associated to better (β = 0.12-0.25), and helplessness to worse outcomes (β = 0.14-0.38). CONCLUSIONS HRQoL of parents of young adult survivors of CCS is comparable to references or slightly better. Only a small proportion reports symptomatic post-traumatic stress. Improving acceptance and reducing feelings of helplessness may provide treatment targets for parents with psychosocial problems.
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Affiliation(s)
- Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Mala M H Joosten
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Anne Maas
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Babet L Drenth
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, 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
| | - 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 Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Health Services Research, Carl v 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
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14
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Huang HM, Yeh TC, Lee TY. Comparison of psychosocial adaptations among childhood cancer survivors, their siblings and peers in Taiwan. J Pediatr Nurs 2022; 67:e1-e8. [PMID: 36336534 DOI: 10.1016/j.pedn.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to understand the difference in psychosocial adaptation among childhood cancer survivors, their healthy siblings and peers, and the factors affecting the psychosocial adaptation of these cancer survivors. DESIGN AND METHODS A total of 222 children (ages 8-17) including childhood cancer survivors, their siblings, and healthy peers participated in this cross-sectional study. All the children completed the anxiety and quality of life scales for their age groups. RESULTS Anxiety levels and quality of life were similar among the childhood cancer survivors, their siblings, and their peers. The anxiety of elementary school-age survivors of acute leukemia was higher than that of those with solid tumors. Elementary school-age survivors who completed three or more years of treatment had lower anxiety than those who completed treatment within the three years. For adolescent survivors, the higher their body mass index, the higher their anxiety, which was associated with low quality of life. Those diagnosed with anxiety and at an older age had lower quality of life. CONCLUSIONS Although there were no differences in survivors' psychosocial adaptation compared to their siblings and healthy peers, more than half of these adolescents had moderate to severe anxiety. Future study may need to explore the causes of their anxiety. PRACTICE IMPLICATIONS During the follow-ups of the childhood cancer survivors, age-specific adaptive strategies can be discussed to reduce their anxiety and improve their quality of life.
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Affiliation(s)
- Hsiu-Mei Huang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ting-Chi Yeh
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Mackay Children's Hospital and Mackay Medical College, Taipei, Taiwan
| | - Tzu-Ying Lee
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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15
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Meng J, Wu J, Zhang X, Guo L, Li H. A longitudinal evaluation on 3-year change of anxiety and depression, and their risk factors among parents of childhood and adolescence patients with resectable osteosarcoma: A cohort study. Medicine (Baltimore) 2022; 101:e30981. [PMID: 36281181 PMCID: PMC9592357 DOI: 10.1097/md.0000000000030981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Psychological disorders often occur among parents of children with cancer. The current study aimed to explore the longitudinal change of anxiety and depression and their related factors among parents of childhood and adolescence patients with osteosarcoma. A total of 56 childhood and adolescence patients with osteosarcoma who underwent tumor resection and corresponding 104 parents were enrolled. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and HADS-Depression (HADS-D) of parents were evaluated at baseline (the day of patients' hospital discharge), 0.5 year, 1 year, 2 years, and 3 years. From baseline to the 3rd year, HADS-A (from 8.3 ± 3.1 to 9.4 ± 3.1. P < .001), HADS-D score (from 7.7 ± 3.2 to 8.8 ± 2.9, P = .001), anxiety rate (from 45.2% to 60.6%, P = .038), depression rate (from 38.5% to 57.7%, P = .002) were elevated; meanwhile, anxiety severity (P = .001) and depression severity (P = .001) were also increased. Furthermore, multivariate logistic regression analysis presented that the role of mother, divorced/widowed marital status, declined family annual income, elevated Enneking stage, and amputation were independently correlated with elevated risk of parents' baseline anxiety or depression (all P < .05). Additionally, declined family annual income, elevated Enneking stage, and amputation were independently correlated with increased risk of parents' 3-year anxiety or depression (all P < .05). Anxiety and depression deteriorate with time in parents of childhood and adolescence patients with osteosarcoma, which are affected by parental role, marital status, family annual income, surgery type, and Enneking stage.
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Affiliation(s)
- Jie Meng
- Department of Orthopedic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jing Wu
- Department of Orthopedic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xinying Zhang
- Department of Orthopedic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Libo Guo
- Department of Orthopedic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Honghe Li
- Department of Orthopedic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
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16
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O'Brien K, Scaife J, Iantorno S, Bucher B. Caregiver health-related quality of life 1 year following pediatric gastrostomy tube placement. Surg Open Sci 2022; 10:111-115. [PMID: 36118361 PMCID: PMC9474284 DOI: 10.1016/j.sopen.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/15/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Karlie O'Brien
- University of Utah School of Medicine, Salt Lake City, UT, USA
- Corresponding author at: University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132. Tel.: + 1 (801)-879-7901.
| | - Jack Scaife
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Stephanie Iantorno
- Division of Pediatric Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Brian Bucher
- Division of Pediatric Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA
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17
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Kang Z, Yang J. Construction and validation of an autophagy-related long non-coding RNA signature to predict the prognosis of kidney renal papillary cell carcinoma. J Investig Med 2022; 70:1536-1544. [PMID: 35725019 DOI: 10.1136/jim-2022-002379] [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] [Accepted: 05/26/2022] [Indexed: 12/18/2022]
Abstract
To identify the autophagy-related long non-coding RNAs (ARlncRNAs) associated with the prognosis of kidney renal papillary cell carcinoma (KIRP), thereby establishing a clinical prognostic model. The gene expression matrix and clinical survival information of patients with KIRP were downloaded from The Cancer Genome Atlas database, and were divided into the training and testing groups. ARlncRNAs associated with the KIRP prognosis were analyzed by univariate, Least Absolute Shrinkage and Selection Operator (LASSO(, and multivariate Cox regression to construct a signature. We combined clinical factors associated with the prognosis with ARlncRNAs to establish a prognostic model of patients with KIRP. A nomogram was established to predict 1-year, 3-year, and 5-year survival of patients with KIRP. Besides, we built the lncRNA-messenger RNA co-expression network and used Kyoto Encyclopedia of Genes and Genomes and Gene Set Enrichment Analysis to detect the biological functions of ARlncRNAs. LEF1-AS1, CU634019.6, C2orf48, AC027228.2, and AC107464.3 were identified. A prognosis-related ARlncRNAs signature was constructed in the training group and validated in the testing group. Patients with KIRP with a low risk score had significantly longer survival time than those with a high risk score. The risk score significantly affected the prognosis of patients, thereby being used for modeling. The area under the receiver operating characteristic curve values of 1-year, 3-year, and 5-year overall survival were 0.80, 0.78, and 0.84 in the training group, respectively. The signature had high concordance index and good accuracy in predicting the prognosis, which were confirmed by the nomogram. The prognosis-related ARlncRNAs signature we identified had a more accurate prediction for the prognosis of patients with KIRP.
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Affiliation(s)
- Zhen Kang
- Department of Urology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China.,College of Medicine, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Junfeng Yang
- Department of Urology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China .,College of Medicine, Kunming University of Science and Technology, Kunming, Yunnan, China
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18
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Pastor R, Bouzas C, Albertos I, García C, García Á, Prieto T, Velázquez J, Sánchez-Jiménez E, Rodríguez R, Martín FJ, Campón AM, Tur JA. Health-Related Quality of Life in Spanish Schoolchildren and Its Association with the Fitness Status and Adherence to the Mediterranean Diet. Nutrients 2022; 14:2322. [PMID: 35684122 PMCID: PMC9182729 DOI: 10.3390/nu14112322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distress and well-being, as well as perception of current and future health. Objective: To assess associations between health-related quality of life, fitness status, and adherence to the Mediterranean diet in Spanish children and adolescents. Methods: A cross-sectional study was carried out in a sample of 305 (47.2% women) children and adolescents aged between 8 and 16 years, in the primary and secondary schools of the province of Ávila (central Spain) (NCT05380674). Subjects were classified according to their quality of life: group 1 (highest quality of life) > group 2 (medium quality of life) > group 3 (lowest quality of life). Results: More participants in group 1 showed higher adherence to Mediterranean diet (70.8%) than other groups (group 2: 55.0%; group 3: 43.4%). It was less likely to find optimal levels of muscle strength as quality of life decreased (OR; 95% CI: group 2: 0.535; 0.303−0.955; and group 3: 0.424; 0.234−0.768). Similar trends were found for speed and agility, but only group 3 showed significant results (OR; 95% CI: group 3: 0.297; 0.162−0.545). Flexibility was also the worst in groups 2 and 3 (OR; 95% CI: G2: 0.403; 0.213−0.762; and group 3: 0.520; 0.282−0.958). Conclusion: High fitness status and adherence to the Mediterranean diet were associated with improved health-related quality of life in schoolchildren of central Spain.
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Affiliation(s)
- Rosario Pastor
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (R.P.); (C.B.)
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (R.P.); (C.B.)
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Foundation Health Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
| | - Irene Albertos
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Carolina García
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Ángela García
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Teresa Prieto
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Jorge Velázquez
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Elena Sánchez-Jiménez
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Rocío Rodríguez
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Francisco Javier Martín
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Angélica María Campón
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (I.A.); (C.G.); (Á.G.); (T.P.); (J.V.); (E.S.-J.); (R.R.); (F.J.M.); (A.M.C.)
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (R.P.); (C.B.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Foundation Health Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
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Cheung AT, Li WHC, Ho LLK, Xia W, Luo Y, Chan GCF, Chung JOK. Associations of Physical Activity and Handgrip Strength with Different Domains of Quality of Life in Pediatric Cancer Survivors. Cancers (Basel) 2022; 14:cancers14102554. [PMID: 35626159 PMCID: PMC9139327 DOI: 10.3390/cancers14102554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA level and HGS are associated with higher scores in different QoL domains (i.e., physical, emotional, social, and school functioning) in pediatric cancer survivors. PA was assessed with a validated self-reported PA rating scale. In total, 191 Chinese pediatric cancer survivors aged 9 to 16 years were included in the analysis. Results showed that engaging in a higher level of PA was significantly associated with improved QoL in different domains, including physical (β = 0.543, p < 0.001), emotional (β = 0.449, p < 0.001), social (β = 0.434, p < 0.001), and school functioning (β = 0.407, p < 0.001). Greater HGS was also associated with better physical (β = 0.230, p ≤ 0.001) and emotional (β = 0.261, p ≤ 0.001) functioning. Findings from this study provide evidence of the significant beneficial impact of regular PA on pediatric cancer survivors’ QoL along their survivorship trajectory.
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Affiliation(s)
- Ankie Tan Cheung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (A.T.C.); (L.L.K.H.)
| | - William Ho Cheung Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (A.T.C.); (L.L.K.H.)
- Correspondence: ; Tel.: +852-3943-0889
| | - Laurie Long Kwan Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (A.T.C.); (L.L.K.H.)
| | - Wei Xia
- School of Nursing, Sun-Yat-sen University, Guangzhou 510080, China;
| | - Yuanhui Luo
- Xiangya School of Nursing, Central South University, Changsha 410013, China;
| | - Godfrey Chi Fung Chan
- Department of Pediatric Oncology, Hong Kong Children’s Hospital, Kowloon, Hong Kong, China;
| | - Joyce Oi Kwan Chung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China;
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20
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Wakefield CE, Sansom-Daly UM, McGill BC, Hetherington K, Ellis SJ, Robertson EG, Donoghoe MW, McCarthy M, Kelada L, Girgis A, King M, Grootenhuis M, Anazodo A, Patterson P, Lowe C, Dalla-Pozza L, Miles G, Cohn RJ. Providing Psychological Support to Parents of Childhood Cancer Survivors: ' Cascade' Intervention Trial Results and Lessons for the Future. Cancers (Basel) 2021; 13:cancers13225597. [PMID: 34830752 PMCID: PMC8615912 DOI: 10.3390/cancers13225597] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary We assessed a new group-based cognitive behavior therapy videoconferencing program to support parents of childhood cancer survivors. The trial allocated parents to three groups: Cascade, peer-support, waitlist. Cascade achieved good parent engagement. We successfully delivered Cascade to participants who lived >3200 km apart. Any technical difficulties caused only minor disruptions. Most Cascade parents were satisfied and reported experiencing benefits from the program. However, Cascade did not improve our main outcomes, including parents’ quality of life, depression and anxiety. Cascade parents reported a short-term improvement in their confidence to use the skills they learnt, but this did not translate into actual use. After six months, Cascade parents felt their child survivor had lower psychological health than waitlisted parents. Our findings show that while some parents find Cascade helpful, it may not suit everyone. We used these findings to further improve Cascade and will trial the new version in future. Abstract We conducted a three-armed trial to assess Cascade, a four-module group videoconferencing cognitive behavior therapy (CBT) intervention for parents of childhood cancer survivors currently aged <18 years. We allocated parents to Cascade, an attention control (peer-support group), or a waitlist. The primary outcome was parents’ health-related quality of life (PedsQL-Family Impact/EQ-5D-5L) six months post-intervention. Parents also reported their anxiety/depression, parenting self-agency, fear of recurrence, health service and psychotropic medication use, engagement in productive activities, confidence to use, and actual use of, CBT skills, and their child’s quality of life. Seventy-six parents opted in; 56 commenced the trial. Cascade achieved good parent engagement and most Cascade parents were satisfied and reported benefits. Some parents expressed concerns about the time burden and the group format. Most outcomes did not differ across trial arms. Cascade parents felt more confident to use more CBT skills than peer-support and waitlisted parents, but this did not lead to more use of CBT. Cascade parents reported lower psychosocial health scores for their child than waitlisted parents. Cascade parents’ health service use, psychotropic medication use, and days engaged in productive activities did not improve, despite some improvements in waitlisted parents. Our trial was difficult to implement, but participants were largely satisfied. Cascade did not improve most outcomes, possibly because many parents were functioning well pre-enrolment. We used these findings to improve Cascade and will trial the new version in future.
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Affiliation(s)
- Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Correspondence: ; Tel.: +61-(2)-9382-3113; Fax: +61-(2)-9382-1789
| | - Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Kate Hetherington
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia;
| | - Eden G. Robertson
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Maria McCarthy
- Clinical Sciences, Brain and Mind, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia;
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 2052, Australia
| | - Lauren Kelada
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Afaf Girgis
- South West Sydney Clinical Campuses, UNSW Medicine and Health, Sydney, NSW 2052, Australia;
| | - Madeleine King
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia;
| | - Martha Grootenhuis
- Princess Máxima Center for Pediatric Oncology, 3584 CT Utrecht, The Netherlands;
| | - Antoinette Anazodo
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Pandora Patterson
- Research, Evaluation and Social Policy Unit, Canteen, Newtown, NSW 2042, Australia;
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Cherie Lowe
- Queensland Children’s Cancer Centre, Queensland Children’s Hospital, South Brisbane, QLD 4101, Australia;
| | - Luciano Dalla-Pozza
- Cancer Centre for Children, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia;
| | - Gordon Miles
- Child and Adolescent Mental Health Service, Perth Children’s Hospital, Perth, WA 6009, Australia;
| | - Richard J. Cohn
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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