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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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2
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Yao G, Lai JS, Garcia SF, Yount S, Cella D. Positive and negative psychosocial impacts on cancer survivors. Sci Rep 2023; 13:14749. [PMID: 37679401 PMCID: PMC10485019 DOI: 10.1038/s41598-023-41822-x] [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: 12/04/2022] [Accepted: 08/31/2023] [Indexed: 09/09/2023] Open
Abstract
The purpose of this study is to understand psychosocial impacts on cancer survivors using the patient-reported outcomes measurement information system (PROMIS) Psychosocial Illness Impact banks. Cancer survivors (n = 509; age: 59.5 ± 1.4; 51.5% men) completed the PROMIS positive and negative illness impact items consisting of four sub-domains: self-concept (SC), social impact (SI), stress response (SR), and spirituality (Sp). Illness impact was defined as changed scores from items measuring "current" experiences to recalled experiences prior to cancer diagnosis. Descriptive statistics, effect sizes (ES), and coefficient of variation (CV) were calculated at item and sub-domain levels. Analysis of variance was used to identify potentially influential factors on the impacts. Our study found survivors reported stronger positive than negative impacts (overall ES mean: 0.30 vs. 0.23) in general; and more moderate (ES ≧ 0.30) positive than negative impacts at the item level, 54.3% (25 of 46) and 40% (16 of 40) for positive and negative items, respectively. Participants reported more positive impacts on SI and Sp but more negative impacts on SR. The CV results showed more individual differences appeared on positive SC items. Younger survivors reported stronger positive and negative impacts. Women reported higher positive impacts. Survivors with higher education levels tended to have higher positive SI impacts, while those with a lower family income reported higher negative SI and negative SR impacts. We conclude positive and negative psychosocial impacts coexisted-the strength of impacts varied across sub-domains. Age, gender, education, and family income influenced the psychosocial impacts reported by survivors. These findings provide a foundation to develop interventions to strengthen positive and minimize negative impacts and improve cancer survivors' overall well-being.
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Affiliation(s)
- Grace Yao
- Department of Psychology, College of Science, National Taiwan University, Taipei, 106319, Taiwan (R.O.C.)
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Department of Pediatrics, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave, 21St Floor, Chicago, IL, 60611, USA.
| | - Sofia F Garcia
- Department of Medical Social Sciences, Department of Psychiatry and Behavioral Sciences, Center for Patient-Centered Outcomes, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Susan Yount
- Department of Medical Social Sciences, Department of Psychiatry and Behavioral Sciences, Center for Patient-Centered Outcomes, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - David Cella
- Department of Medical Social Sciences, Center for Patient-Centered Outcomes, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, 60611, USA
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3
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Maas A, Maurice-Stam H, van der Aa-van Delden AM, van Dalen EC, van Dulmen-den Broeder E, Tissing WJE, Loonen JJ, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Janssens GO, Ronckers C, Neggers S, Bresters D, Louwerens M, Versluys BAB, van der Heiden-van der Loo M, Kremer LCM, van Gorp M, Grootenhuis MA. Positive and negative survivor-specific psychosocial consequences of childhood cancer: the DCCSS-LATER 2 psycho-oncology study. J Cancer Surviv 2023:10.1007/s11764-023-01394-1. [PMID: 37170006 DOI: 10.1007/s11764-023-01394-1] [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: 03/23/2023] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Numerous studies investigated generic psychosocial outcomes in survivors of childhood cancer (CCS). The present study aimed to describe survivor-specific psychosocial consequences in CCS, and to identify socio-demographic and medical associated factors. METHODS CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963-2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed the Benefit & Burden Scale (BBSC) and the Impact of Cancer-Childhood Cancer (IOC-CS). Items were scored on a 5-point Likert scale (range 1-5). We examined outcomes with descriptive statistics, and socio-demographic and medical associated factors with regression analyses, corrected for multiple testing (p < 0.004). RESULTS CCS, N = 1713, age mean (M) 36 years, 49% female, ≥ 15 years since diagnosis, participated. On average, CCS reported 'somewhat' Benefit (M = 2.9), and 'not at all' to 'a little' Burden (M = 1.5) of childhood cancer. Average scores on IOC-CS' positive impact scales ranged from 2.5 (Personal Growth) to 4.1 (Socializing), and on the negative impact scales from 1.4 (Financial Problems) to 2.4 (Thinking/Memory). Apart from cognitive problems, CCS reported challenges as worries about relationship status, fertility, and how cancer had affected siblings. Female sex was associated with more Personal Growth, and more negative impact. CCS more highly educated, partnered, and employed had higher positive and lower negative impact. CCS older at diagnosis reported more positive impact. CNS tumor survivors and those who had head/cranium radiotherapy had higher negative impact. CNS tumor survivors reported less positive impact. CONCLUSION AND IMPLICATIONS The majority of CCS reported positive impact of cancer while most CCS reported little negative impact. While this may indicate resiliency in most CCS, health care providers should be aware that they can also experience survivor-specific challenges that warrant monitoring/screening, information provision and psychosocial support.
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Affiliation(s)
- Anne Maas
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | | | | | | | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Beatrix Children's Hospital, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | | | | | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Geert O Janssens
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cécile Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics Informatics and Epidemiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Neggers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Medicine, Section Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Birgitta A B Versluys
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Wilhelmina Children's Hospital/University Medical Center Utrecht, 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
| | - Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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4
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Tremolada M, Taverna L, Bonichini S, Pillon M, Biffi A. Psychological Well-Being, Cognitive Functioning, and Quality of Life in 205 Adolescent and Young Adult Childhood Cancer Survivors Compared to Healthy Peers. Front Psychol 2022; 13:860729. [PMID: 35651574 PMCID: PMC9149561 DOI: 10.3389/fpsyg.2022.860729] [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: 01/23/2022] [Accepted: 04/12/2022] [Indexed: 12/03/2022] Open
Abstract
The majority of the studies underlined how adolescent and young adult (AYA) Cancer Survivors had no significant differences in their well-being and quality of life compared with a control group of healthy counterparts, although French et al. (2013) found less years of education among cancer survivors. The present study aimed at comparing AYA cancer survivors and a control group of peers who had no history of serious illness, in terms of well-being, cognitive functioning, and perceptions of life. Participants in this study were 205 AYA cancer survivors, 126 males, off therapy from a mean of 10.87 years (SD = 4.91), with a mean age of 18.96 (SD = 3.08), recruited during follow-up visits and healthy counterparts (n = 205), matched for age and gender. They all completed self-report questionnaires: Ladder of Life, BSI-18 and Cognitive problems. Paired t test evidenced significant differences between survivors (Mean = 6.19; SD = 2.07) and controls (Mean = 6.88; SD = 2.02) in perceptions of quality of life regarding 5 years before the current time [t(204) = −3.39; p = 0.001], with a lower level for childhood cancer survivors. Specifically, Hierarchical regression (R2 = 0.05, p = 0.04) identified a shorter time since the completion of treatment (β = 0.18, p = 0.03) and a trend of stem cell transplantation experience (β = −0.11, p = 0.06) as factors associated with negative perception of precedent quality of life. The AYA cancer survivors reported lower cognitive difficulties (Mean = 1.46) than controls (Mean = 1.56) [t(204) = −3.41; p = 0.001]: in memory (Meanclinical = 1.32 vs Meancontrol = 1.50) [t(204) = −4.52; p = 0.001], in concentration (Meanclinical = 1.36 vs Meancontrol = 1.54) [t(204) = −4.66; p = 0.001] and in mental organization skills (Meanclinical = 1.47 vs Meancontrol = 1.56) [t(204) = −2.56; p = 0.01], even if they had a lower educational attainment [X(9)2 = 131.28; p = 0.001]. They showed similar satisfaction with their psychological well-being and their lives as healthy counterparts, except for past life perceptions associated with the cancer period. Important recommendations for future research and clinical suggestions could be given.
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Affiliation(s)
- Marta Tremolada
- Department of Development and Social Psychology, University of Padua, Padua, Italy.,Department of Woman's and Child's Health, Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
| | - Livia Taverna
- Department of Development and Social Psychology, University of Padua, Padua, Italy.,Faculty of Education, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Sabrina Bonichini
- Department of Development and Social Psychology, University of Padua, Padua, Italy
| | - Marta Pillon
- Department of Woman's and Child's Health, Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
| | - Alessandra Biffi
- Department of Woman's and Child's Health, Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
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5
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Carlos RC, Obeng-Gyasi S, Cole SW, Zebrack BJ, Pisano ED, Troester MA, Timsina L, Wagner LI, Steingrimsson JA, Gareen I, Lee CI, Adams AS, Wilkins CH. Linking Structural Racism and Discrimination and Breast Cancer Outcomes: A Social Genomics Approach. J Clin Oncol 2022; 40:1407-1413. [PMID: 35108027 PMCID: PMC9851699 DOI: 10.1200/jco.21.02004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/03/2021] [Accepted: 01/10/2022] [Indexed: 01/23/2023] Open
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6
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Hendriks MJ, Hartmann N, Harju E, Roser K, Michel G. "I don't take for granted that I am doing well today": a mixed methods study on well-being, impact of cancer, and supportive needs in long-term childhood cancer survivors. Qual Life Res 2022; 31:1483-1497. [PMID: 34820777 PMCID: PMC9023419 DOI: 10.1007/s11136-021-03042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE With increasing numbers of childhood cancer survivors (CCS), it is important to identify the impact of cancer and CCS' needs for support services that can mitigate the long-term impact on psychosocial wellbeing, including health-related quality of life (HRQOL). We aimed (1) to describe survivors' wellbeing, impact of cancer, and supportive care needs and (2) to determine how socio-demographic or clinical characteristics and impact of cancer relate to survivors' unmet needs. METHOD In this mixed methods study, a quantitative survey was used to assess HRQOL, psychological distress, impact of cancer, and supportive care needs. Qualitative interviews were conducted to explore the meaning of wellbeing, health, and impact of cancer. RESULTS Overall, 69 CCS participated in the survey of which 28 participated in qualitative interviews (aged ≥ 18 years, diagnosed with cancer ≤ 18 years). Few CCS (13%) reported poor physical HRQOL, but almost half reported poor mental HRQOL (49%) and psychological distress (42%). Health was considered to encompass both: physical and emotional aspects of wellbeing. Cancer positively impacted CCS' ability to care and attitude towards life, whereas relationships and insurance were negatively impacted. Risks for unmet needs increased in CCS with self-reported low health status, late effects, psychological distress, with older age at study or longer time since end of treatment. CONCLUSION In our study, many CCS experienced various psychosocial, psychological and informational unmet needs, indicating that survivors' needs are currently not duly addressed. Current efforts to provide supportive psychosocial care in Switzerland should be further operationalized to provide adequate support.
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Affiliation(s)
- Manya Jerina Hendriks
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
- Department of Neonatology, Clinical Ethics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nathalie Hartmann
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Erika Harju
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Katharina Roser
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland.
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7
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Sociodemographic and Medical Determinants of Quality of Life in Long-Term Childhood Acute Lymphoblastic Leukemia Survivors Enrolled in EORTC CLG Studies. Cancers (Basel) 2021; 14:cancers14010152. [PMID: 35008314 PMCID: PMC8750449 DOI: 10.3390/cancers14010152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/18/2022] Open
Abstract
Simple Summary Long-term quality of life and its potential risk factors in childhood acute lymphoblastic leukemia (ALL) patients remain uncertain. In this cross-sectional study, we investigated daily life quality and life challenges in adult survivors of ALL using multiple self-report questionnaires. Furthermore, risk factors, including gender, age at diagnosis, relapse/second neoplasm, risk group, and cranial radiotherapy, were explored in detail. Younger, female, and relapsed patients appeared to encounter more life challenges, while physical challenges occurred more often in relapsed and high-risk patients. More positive effects on socializing were found in the older patients compared to younger patients. This study provides important information for individual and specialized support. Abstract Background: due to increasing survival rates in childhood acute lymphoblastic leukemia (ALL), the number of survivors has been expanding. A significant proportion of these survivors can experience long-term emotional and psychosocial problems. However, the exact risk factors remain inconclusive. We investigated potential risk factors for decreased daily life quality and life challenges in long-term childhood ALL survivors enrolled between 1971 and 1998 in EORTC studies. Methods: self-report questionnaires were collected from 186 survivors (109 females; mean age at diagnosis 5.62 years, range 0.2–14.7; median time since diagnosis of 20.5 years (12.9–41.6)), including the Short-Form Health Survey (SF-12) and Impact of Cancer-Childhood Survivors (IOC-CS). Multivariable linear regression models were used to assess the impact of gender, age at diagnosis, relapse/second neoplasm, National Cancer Institute (NCI) risk group and cranial radiotherapy on 2 subscales of the SF-12 (physical and mental health) and five subscales of the IOC-CS (life challenges, body and health, personal growth, thinking and memory problems and socializing). Results: mental component scores of SF-12 were not significantly associated with any risk factor. Physical component scores were lower in relapsed, irradiated and NCI high-risk patients. Regarding IOC-CS negative impact subscales, life challenges was more negatively impacted by cancer in female, younger (i.e., <6 years) and relapsed patients. Regarding the positive impact scales, personal growth was more positively impacted in relapsed patients, whereas body and health, and socializing, were less positively impacted in these patients, compared to non-relapsed patients. Socializing was more positively impacted in older patients (>6 years). Conclusions: this study demonstrates that long-term outcomes can be both adverse and positive, depending on the patient’s demographic and clinical characteristics. Younger, female, and relapsed patients might encounter more life challenges years after their disease, while physical challenges could occur more often in relapsed and high-risk patients. Finally, the positive effect on socializing in the older patients sheds new light on the importance of peer interactions for this subgroup. Specific individual challenges thus need specialized support for specific subgroups.
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8
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Petersen NN, Hansson H, Lie HC, Brinkkjaer M, Graungaard B, Hamilton Larsen M, Hamilton Larsen E, Schmiegelow K, Fridh MK, Baekgaard Larsen H. A qualitative study of young childhood cancer survivors and their parents' experiences with treatment-related late effects in everyday life post-treatment. J Adv Nurs 2021; 78:858-868. [PMID: 34636441 DOI: 10.1111/jan.15073] [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: 07/03/2021] [Revised: 09/17/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
AIMS The purpose of this secondary analysis was to explore how young cancer survivors and their parents experience and manage treatment-related late effects in daily life post-treatment. DESIGN A phenomenological-hermeneutic explorative study. METHODS Using purposive sampling, we included 15 childhood cancer survivors (aged 11-18 years) and their parents who participated in semi-structured interviews from September 2019 through May 2020. We analysed the interviews paired using a thematic approach focused on meaning. RESULTS The central theme, 'Negotiation daily life', emerged as well as three interrelated sub-themes, that is 'A changed everyday life', 'Physical activity as a tool' and 'Friends as a tool'. The childhood cancer survivors and their parents experienced, understood and interpreted the late effects differently. The difference between the survivors' perceptions and those of their parents in managing treatment-related late effects in everyday life resulted in a continuous negotiation process between the parties. Parents highlighted the negative impact of late effects on their child's daily life in relation to physical activity, school and socialization while the survivors wished to leave the cancer experience behind and 'move on' with their friends. As a result, most of the survivors developed strategies to manage their social activities while their parents felt that the survivors neglected the late effects. CONCLUSION The ongoing negotiation process between the childhood cancer survivors and their parents show the complexity of the new family dynamics on returning to everyday life post-treatment. For clinical nurses, that means that there should be focus on family dynamics and how the childhood cancer survivors and parents, respectively, manage the childhood cancer survivors' late effects. IMPACT Healthcare providers should distinguish between the needs of the survivors and those of their parents as they transition from treatment to everyday life, and especially in the management of late effects caused by the treatment.
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Affiliation(s)
- Natasha Nybro Petersen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Helena Hansson
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Hanne C Lie
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maria Brinkkjaer
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Benjamin Graungaard
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Marie Hamilton Larsen
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elna Hamilton Larsen
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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9
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van Erp LME, Maurice-Stam H, Kremer LCM, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Versluys BAB, Loonen JJ, Bresters D, Louwerens M, van der Heiden-van der Loo M, van den Berg MH, Ronckers CM, van der Kooi ALLF, van Gorp M, van Dulmen-den Broeder E, Grootenhuis MA. Health-related quality of life in Dutch adult survivors of childhood cancer: A nation-wide cohort study. Eur J Cancer 2021; 152:204-214. [PMID: 34119924 DOI: 10.1016/j.ejca.2021.04.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/20/2021] [Accepted: 04/30/2021] [Indexed: 01/16/2023]
Abstract
AIM To investigate the health-related quality of life (HRQOL) of Dutch adult childhood cancer survivors (CCS) and to identify risk factors of impaired HRQOL. METHODS Adult CCS (age >18, diagnosed <18, ≥5 years since diagnosis) from the Dutch LATER registry completed the Medical Outcome Study Short Form 36 (SF-36) to measure HRQOL and provided sociodemographic characteristics. Age-adjusted mean SF-36 scale scores of CCS were compared to the Dutch general population for men and women separately using t-tests, with effect size d. Multivariate logistic regression models were built to identify sociodemographic and cancer-related risk factors for impaired physical and mental HRQOL. RESULTS Both male and female CCS (N = 2301, mean age = 35.4 years, 49.6% female) reported significantly (p ≤ .005) worse HRQOL than the general population on almost all scales of the SF-36 (-.11 ≤ d ≤ -.56). Largest differences were found on vitality and general health perceptions. Significant risk factors (p ≤ .05) for impaired physical HRQOL were female sex, older age at diagnosis, not having a partner, low educational attainment, disease recurrence and exposure to radiotherapy, specifically to lower extremity radiation. Odds ratios (ORs) ranged from 1.6 to 3.7. Significant risk factors for impaired mental HRQOL were age 26-35 years, male sex, not having a partner and low educational attainment. ORs ranged from 1.3 to 2.0. CONCLUSION Adult CCS had worse HRQOL than the general population. CCS most at risk were those with low educational attainment and without a partner. Adult CCS could benefit from routine surveillance of their HRQOL. Special attention for CCS' vitality and health perceptions and beliefs is warranted.
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Affiliation(s)
- L M E van Erp
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - L C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - W J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
| | - H J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - A C H de Vries
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, the Netherlands
| | - M M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, the Netherlands
| | - B A B Versluys
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - J J Loonen
- Radboud University Medical Center, Nijmegen, the Netherlands
| | - D Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands
| | - M Louwerens
- Leiden University Medical Center, Leiden, the Netherlands
| | | | - M H van den Berg
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Paediatrics, Amsterdam, the Netherlands
| | - C M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Brandenburg Medical School, Institute of Biostatistics and Registry Research, Neuruppin, Germany
| | - A L L F van der Kooi
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Erasmus MC, University Medical Centre, Rotterdam, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology
| | - M van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - E van Dulmen-den Broeder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Amsterdam UMC/location VUmc, Amsterdam, the Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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10
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Sansom-Daly UM, Wakefield CE, Ellis SJ, McGill BC, Donoghoe MW, Butow P, Bryant RA, Sawyer SM, Patterson P, Anazodo A, Plaster M, Thompson K, Holland L, Osborn M, Maguire F, O’Dwyer C, De Abreu Lourenco R, Cohn RJ. Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial. Cancers (Basel) 2021; 13:2460. [PMID: 34070134 PMCID: PMC8158368 DOI: 10.3390/cancers13102460] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/20/2022] Open
Abstract
Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors' mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention ('Recapture Life') in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (Mage = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00-15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times.
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Affiliation(s)
- Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2033, Australia
| | - Phyllis Butow
- Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW 2050, Australia;
| | | | - Susan M. Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia;
- Royal Children’s Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Pandora Patterson
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia;
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Antoinette Anazodo
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Megan Plaster
- Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, WA 6009, Australia;
| | - Kate Thompson
- Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
- Department of Social Work, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Lucy Holland
- Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Herston, QLD 4006, Australia;
- School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Michael Osborn
- Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia;
| | - Fiona Maguire
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Catherine O’Dwyer
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW 2000, Australia;
| | - Richard J. Cohn
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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11
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Steineck A, Barton KS, Bradford MC, Yi-Frazier JP, Rosenberg AR. Tincture of Time: The Evolution of Goals in Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2021; 10:703-710. [PMID: 33960833 DOI: 10.1089/jayao.2020.0223] [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: 11/12/2022] Open
Abstract
Purpose: A diagnosis of cancer often derails an individual's goals. The purpose of this mixed-methods analysis was to describe the evolution of adolescent and young adult (AYA)-reported goals in the year after a diagnosis of new or advanced cancer. Methods: As part of the Promoting Resilience in Stress Management (PRISM) phase 2 randomized controlled trial, AYAs with cancer (ages 12-25 years) were asked at baseline, 6 months, and 12 months: "Please give an example of a goal you hope to accomplish over the next month/year." We used content analysis to categorize goals as follows: life milestones, physical health, mental/emotional health, cancer specific, and hobbies/interests. We summarized goal categories at each time point: for the entire cohort, by baseline diagnosis status (new vs. advanced cancer), treatment status (on-therapy vs. off-therapy), and baseline health-related quality of life (high vs. low). Results: Eighty-six participants completed the study and were included in the analysis (control: n = 41, PRISM: n = 45); 69 reported their goals at 6 months, and 54 at 12 months. Participants submitted a total of 169 goals at baseline, 148 at 6 months, and 126 at 12 months. At baseline, cancer-specific goals were most common for the short-term (35%), whereas milestone goals were most common for the long-term (46%). At 6 months, milestone goals were most common in both short- (38%) and long-term (51%) categories. A similar pattern was seen at 12 months. Conclusion: AYAs' goals change over the first year of their cancer experience, with a shift in short-term goals from cancer-specific goals at baseline to milestone goals at later time points. ClinicalTrials.gov (NCT02340884).
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Affiliation(s)
- Angela Steineck
- Center for Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Palliative Care and Resilience Research Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA
| | - Krysta S Barton
- Palliative Care and Resilience Research Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Biostatistics Epidemiology and Analytics for Research (BEAR) Core, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Miranda C Bradford
- Palliative Care and Resilience Research Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Biostatistics Epidemiology and Analytics for Research (BEAR) Core, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Joyce P Yi-Frazier
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Palliative Care and Resilience Research Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA
| | - Abby R Rosenberg
- Center for Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Palliative Care and Resilience Research Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA
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12
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van Erp LME, Maurice-Stam H, Kremer LCM, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Versluys BAB, van der Heiden-van der Loo M, Huizinga GA, Grootenhuis MA. A vulnerable age group: the impact of cancer on the psychosocial well-being of young adult childhood cancer survivors. Support Care Cancer 2021; 29:4751-4761. [PMID: 33527229 PMCID: PMC8236461 DOI: 10.1007/s00520-021-06009-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/19/2021] [Indexed: 02/04/2023]
Abstract
Purpose This study aimed to increase our understanding of the psychosocial well-being of young adult childhood cancer survivors (YACCS) as well as the positive and negative impacts of cancer. Methods YACCS (aged 18–30, diagnosed ≤ 18, time since diagnosis ≥ 5 years) cross-sectionally filled out the “Pediatric Quality of Life Inventory Young Adults” (PedsQL-YA), “Hospital Anxiety and Depression Scale” (HADS), and “Checklist Individual Strengths” (CIS-20R) to measure fatigue and survivor-specific “Impact of Cancer - Childhood Survivors” (IOC-CS), which measures the long-term impact of childhood cancer in several domains. Descriptive statistics (IOC-CS), logistic regression (HADS, CIS-20R), and ANOVA (PedsQL-YA, HADS, CIS-20R) were performed. Associations between positive and negative impacts of childhood cancer and psychosocial outcomes were examined with linear regression analyses. Results YACCS (N = 151, 61.6% female, mean age 24.1 ± 3.6, mean time since diagnosis 13.6 ± 3.8) reported lower HRQOL (− .4 ≤ d ≤ − .5, p ≤ .001) and more anxiety (d = .4, p ≤ .001), depression (d = .4, p ≤ .01), and fatigue (.3 ≤ d ≤ .5, p ≤ .001) than young adults from the general Dutch population. They were at an increased risk of experiencing (sub)clinical anxiety (OR = 1.8, p = .017). YACCS reported more impact on scales representing a positive rather than negative impact of CC. Various domains of impact of childhood cancer were related to psychosocial outcomes, especially “Life Challenges” (HRQOL β = − .18, anxiety β = .36, depression β = .29) and “Body & Health” (HRQOL β = .27, anxiety β = − .25, depression β = − .26, fatigue β = − .47). Conclusion YACCS are vulnerable to psychosocial difficulties, but they also experience positive long-term impacts of childhood cancer. Positive and negative impacts of childhood cancer were associated with psychosocial outcomes in YACCS. Screening of psychosocial outcomes and offering targeted interventions are necessary to optimize psychosocial long-term follow-up care for YACCS.
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Affiliation(s)
- L M E van Erp
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands
| | - H Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.
| | - L C M Kremer
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - W J E Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | - H J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands
| | - A C H de Vries
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - M M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - B A B Versluys
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - G A Huizinga
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.,Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands
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13
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Yu Q, Zhong X, Chen B, Feng Y, Ma M, Diamond CA, Voeller JS, Kim M, DeSantes KB, Capitini CM, Patel NJ, Hoover-Regan ML, Burke MJ, Janko K, Puccetti DM, Ikonomidou C, Li L. Isobaric Labeling Strategy Utilizing 4-Plex N, N-Dimethyl Leucine (DiLeu) Tags Reveals Proteomic Changes Induced by Chemotherapy in Cerebrospinal Fluid of Children with B-Cell Acute Lymphoblastic Leukemia. J Proteome Res 2020; 19:2606-2616. [PMID: 32396724 PMCID: PMC7334086 DOI: 10.1021/acs.jproteome.0c00291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The use of mass spectrometry for protein identification and quantification in cerebrospinal fluid (CSF) is at the forefront of research efforts to identify and explore biomarkers for the early diagnosis and prognosis of neurologic disorders. Here we implemented a 4-plex N,N-dimethyl leucine (DiLeu) isobaric labeling strategy in a longitudinal study aiming to investigate protein dynamics in children with B-cell acute lymphoblastic leukemia (B-cell ALL) undergoing chemotherapy. The temporal profile of CSF proteome during chemotherapy treatment at weeks 5, 10-14, and 24-28 highlighted many differentially expressed proteins, such as neural cell adhesion molecule, neuronal growth regulator 1, and secretogranin-3, all of which play important roles in neurodegenerative diseases. A total of 63 proteins were significantly altered across all of the time points investigated. The most over-represented biological processes from gene ontology analysis included platelet degranulation, complement activation, cell adhesion, fibrinolysis, neuron projection, regeneration, and regulation of neuron death. We expect that results from this and future studies will provide a means to monitor neurotoxicity and develop strategies to prevent central nervous system injury in response to chemotherapy in children.
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Affiliation(s)
- Qinying Yu
- School of Pharmacy, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Xiaofang Zhong
- School of Pharmacy, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Bingming Chen
- School of Pharmacy, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Yu Feng
- School of Pharmacy, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Min Ma
- School of Pharmacy, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Carol A. Diamond
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Julie S. Voeller
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Miriam Kim
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Kenneth B. DeSantes
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Christian M. Capitini
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Neha J. Patel
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Margo L. Hoover-Regan
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Michael J. Burke
- Children’s Hospital of Wisconsin, Pediatric Leukemia & Lymphoma Program, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Kimberly Janko
- Department of Neurology, Division of Child Neurology, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Diane M. Puccetti
- Department of Pediatrics, Division of Hematology, Oncology and Bone Marrow Transplant, Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Chrysanthy Ikonomidou
- Department of Neurology, Division of Child Neurology, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Lingjun Li
- School of Pharmacy, University of Wisconsin–Madison, Madison, Wisconsin, United States
- Department of Chemistry, University of Wisconsin–Madison, Madison, Wisconsin, United States
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14
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Steineck A, Bradford MC, Lau N, Scott S, Yi-Frazier JP, Rosenberg AR. A Psychosocial Intervention's Impact on Quality of Life in AYAs with Cancer: A Post Hoc Analysis from the Promoting Resilience in Stress Management (PRISM) Randomized Controlled Trial. CHILDREN-BASEL 2019; 6:children6110124. [PMID: 31684055 PMCID: PMC6915541 DOI: 10.3390/children6110124] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/11/2019] [Accepted: 10/23/2019] [Indexed: 01/15/2023]
Abstract
Promoting Resilience in Stress Management (PRISM), a psychosocial intervention for adolescents and young adults (AYAs) with serious illness, enhances resilience resources via four skills-based training sessions. A recent randomized controlled trial showed PRISM improved health-related quality of life (HRQOL) compared to usual care (UC). This post hoc exploratory analysis aimed to better understand the effect of PRISM on HRQOL by describing changes in HRQOL subdomain scores. English-speaking AYAs (12–25 years) with cancer were randomized to PRISM or UC. At enrollment and six months later, HRQOL was assessed using the Pediatric Quality of Life Inventory (PedsQL) Generic Short Form (SF-15) and Cancer Module. Scores at each time point were summarized descriptively and individual HRQOL trajectories were categorized (<70 vs. ≥70). “Positive” trajectories indicate participants maintained scores ≥70 or improved from <70 to ≥70 during the study period. Baseline assessments were completed by 92 participants (48 PRISM, 44 UC); six-month assessments were completed by 74 participants (36 PRISM, 38 UC). For the SF-15, positive trajectories in psychosocial domains were more common with PRISM; trajectories in the physical subdomain were similar across groups. For the Cancer Module, positive trajectories were more common with PRISM in the following subdomains: nausea, treatment anxiety, worry, cognitive, physical appearance, and communication. From this, we conclude PRISM may improve HRQOL, especially in psychosocial domains of wellbeing.
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Affiliation(s)
- Angela Steineck
- Center for Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA 98105, USA.
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA.
| | - Miranda C Bradford
- Children's Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA 98105, USA.
| | - Nancy Lau
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA.
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA 98105, USA.
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA 98105, USA.
| | - Samantha Scott
- Center for Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA 98105, USA.
| | - Joyce P Yi-Frazier
- Center for Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA 98105, USA.
| | - Abby R Rosenberg
- Center for Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA 98105, USA.
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA 98105, USA.
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA 98105, USA.
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15
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Belpame N, Kars MC, Deslypere E, Rober P, Van Hecke A, Verhaeghe S. Living as a Cancer Survivor: A Qualitative Study on the Experiences of Belgian Adolescents and Young Adults (AYAs) after Childhood Cancer. J Pediatr Nurs 2019; 49:e29-e35. [PMID: 31401013 DOI: 10.1016/j.pedn.2019.07.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Insight was sought in how a childhood cancer experience plays a role in daily life of adolescents and young adults (AYA) survivors. DESIGN AND METHODS A qualitative research in which semi-structured interviews were held with 21 AYA survivors of childhood cancer between the ages of 14 and 25. The AYA survivors were recruited from two pediatric oncology departments of two university hospitals in Belgium. RESULTS The current situation and behavior of AYA-survivors who have been treated for childhood cancer are covered in 5 categories: The Feeling of Being Different while Aiming for Normalcy in Relationships, Living with Existential Uncertainty, The Conscious Protection of Health, The Attachment to the Parent(s) with Whom the Cancer Experience was Shared, and The Desire to Be Meaningful to Others. CONCLUSIONS The AYA survivors did not feel that their cancer experience dominated their current daily life, yet, the cancer experience had an important impact on their functioning. PRACTICE IMPLICATIONS The findings of the study can be used to optimize holistic psychosocial care of AYA survivors. By starting from the key elements in their current functioning, health care professionals can tailor their support to the way in which AYA survivors have integrated their cancer experience into their everyday lives.
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Affiliation(s)
- Nathalie Belpame
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Ghent University Hospital, Belgium.
| | | | - Eva Deslypere
- Institute for Family and Sexuality Studies, University of Leuven, Belgium.
| | - Peter Rober
- Institute for Family and Sexuality Studies, University of Leuven, Belgium.
| | - Ann Van Hecke
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
| | - Sofie Verhaeghe
- University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
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16
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Anthony SJ, Robertson T, Selkirk E, Dix D, Klaassen RJ, Sung L, Klassen AF. The social impact of early psychological maturity in adolescents with cancer. Psychooncology 2019; 28:586-592. [PMID: 30646430 DOI: 10.1002/pon.4982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/12/2018] [Accepted: 01/01/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE There is a growing need to assess the long-term quality of life (QOL) of pediatric oncology patients since many children now survive their disease. This paper highlights the subjective perspectives of pediatric cancer patients and specifically explores how experiencing cancer at a young age impacts adolescents in the areas of social functioning, peer relationships, and QOL. The findings emerged from a qualitative research study that explored how pediatric oncology patients ascribe meaning to their illness. METHODS Study participants were recruited from four Canadian academic pediatric hospitals. In this study, we used an interpretative description approach. Semistructured interviews were completed, transcribed verbatim, and coded through the method of constant comparison. RESULTS A total of 37 children and adolescents (n = 19 female; 51%) participated. The majority of participants were diagnosed with leukemia (n = 16; 43%) or lymphoma (n = 9; 24%). Sixty-two percent of participants were adolescents between the ages of 13 and 18 years (n = 23). Data illustrated a unique adolescent experience, which has been reported as a subset of the original population. Adolescent participants noted an accelerated experience of maturation, which invited reflections of gratitude as well as feelings of isolation and disconnect from peers. Participants were saddened to have "missed out" on normative parts of childhood. CONCLUSION Findings highlighted experiences of accelerated maturity that prompted adverse social outcomes for adolescent participants, which impacted their QOL. Future research is needed to explore the intersection of accelerated maturity attributed to illness, social functioning, and QOL. Peer support through technology engagement is suggested for this population.
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Affiliation(s)
- Samantha J Anthony
- Child Health Evaluative Sciences, The Hospital for Sick Children/Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Taylor Robertson
- Child Health Evaluative Sciences, The Hospital for Sick Children/Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada
| | - Enid Selkirk
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - David Dix
- Department of Pediatrics Hem/Onc/BMT, BC Children's Hospital, Vancouver, BC, Canada
| | - Robert J Klaassen
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Lillian Sung
- Division of Haematology-Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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17
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Pérez-Campdepadrós M, Castellano-Tejedor C, Blasco T. Aspectos psicosociales de la calidad de vida en supervivientes pediátricos de tumores en el sistema nervioso central. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: Los supervivientes de tumores del sistema nervioso central (TSNC) presentan peor calidad de vida en relación a la salud (CVRS) que los supervivientes de otras neoplasias y la población normativa. El tipo y gravedad de las secuelas no parecen tener un impacto claro en la CVRS, pero la afectación del cociente intelectual (CI) sí podría modular la CVRS. Además, las estrategias de afrontamiento del paciente y de los progenitores y el malestar emocional parental podrían también actuar sobre la CVRS. Objetivo: Determinar si las estrategias de afrontamiento del adolescente y su CI, y las estrategias de afrontamiento, el estrés general y el malestar emocional parental, modulan las dimensiones psicosociales de la CVRS del superviviente. Método: Estudio transversal descriptivo-correlacional. Se reclutaron 37 adolescentes (12-19 años) que llevaban ≥1 año fuera de tratamiento oncológico y 44 progenitores. Resultados: En la CVRS valorada por los adolescentes, las dimensiones Relación con los Padres y Vida Familiar, Amigos y Apoyo Social, y Entorno Escolar dependen de la estrategia de afrontamiento de resolución del problema usada por el adolescente. La dimensión Aceptación Social depende del estilo de afrontamiento improductivo del adolescente y del estilo de búsqueda de ayuda social de los padres. La CVRS valorada por los padres depende de las secuelas, el CI del adolescente y, el tipo de tratamiento oncológico recibido. Discusión y conclusiones: Las estrategias de afrontamiento centradas en la resolución del problema, deben ser consideradas para valorar e intervenir en la mejora de la CVRS de los supervivientes TSNC.
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Corella Aznar EG, Ayerza Casas A, Carboné Bañeres A, Calvo Escribano MÁC, Labarta Aizpún JI, Samper Villagrasa P. Quality of life and chronic health conditions in childhood acute leukaemia survivors. Med Clin (Barc) 2018; 152:167-173. [PMID: 30017209 DOI: 10.1016/j.medcli.2018.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Survival of childhood acute lymphoblastic leukaemia involves an increasing risk of long-term morbidities. Due to the impact of cancer treatment and comorbidities, AL survivors may experience a decrease in their health-related quality of life. OBJECTIVE We aimed to describe the long-term comorbidities, related quality of life and their development predictors in these survivors. METHODS cross-sectional study of 54 survivors aged ≥18 and who have a survival rate of more than 10 years. Quality of life was assessed by personal interview using SF-36 questionnaire. RESULTS 53.7% of AL survivors developed more than one comorbidity (24.7% hypothyroidism; 20.3% obesity; 14.8% metabolic syndrome; 18.5% subclinical cardiac dysfunction); 20.3% of them were severe. 73.3% of high-risk leukaemias and 66.6% of patients treated with radiotherapy or stem cells transplantation reported long-term comorbidity, P<.05. Global quality of live score was: 86.3 (14) (classified as very good). Patients with high-risk acute leukaemia (83.2 vs. 89.5), severe long-term comorbidities (80.4 vs. 89.7) and females (81.8 vs. 89.9), reported worse quality of life, P<.05. Physical summary score was worse in: obese (80 vs. 92) and hypothyroid (84.9 vs. 92.4) and radiotherapy-treated survivors (82.3 vs. 87.5); mental summary was worse in survivors with hypogonadism (68.2 vs. 86.3) and trasplanted patients (77.2 vs. 83.1), P<.05. CONCLUSIONS Acute leukaemia survivors reported an increase prevalence of chronic comorbidities, related to cancer-treatment. Despite a decrease in scores for certain physical or mental items, global quality of life was very good in all acute leukaemia survivors, even better than compared with the general population.
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Affiliation(s)
| | | | - Ana Carboné Bañeres
- Oncohematología Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, España
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Piette C, de Rojas T, Suciu S, Kicinski M, Bertrand Y, de Schaetzen G, Gilotay C, Meulemans B, Rossi S, Röhrlich P, Benoit Y. Lessons learnt from the medical and psychosocial evaluation of childhood acute lymphoblastic leukemia (ALL) survivors enrolled in EORTC Children Leukemia Group Trials between 1971 and 1998 and future perspectives for long-term outcome research. J Cancer Policy 2018. [DOI: 10.1016/j.jcpo.2018.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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Fisher PL, McNicol K, Cherry MG, Young B, Smith E, Abbey G, Salmon P. The association of metacognitive beliefs with emotional distress and trauma symptoms in adolescent and young adult survivors of cancer. J Psychosoc Oncol 2018; 36:545-556. [PMID: 29611779 DOI: 10.1080/07347332.2018.1440276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE/OBJECTIVES Adolescent and young adults who have survived cancer are at an increased risk of psychological distress. This study investigated whether metacognitive beliefs are associated with emotional distress and trauma symptoms in adolescent and young adult (AYA) survivors of cancer independent of known covariates, including current physical health difficulties. DESIGN Cross-sectional survey using multiple self-report measures. SAMPLE AND METHODS Eighty-seven AYA survivors of cancer were recruited from follow-up appointments at an oncology unit and completed self-report questionnaires measuring emotional distress, posttraumatic stress symptoms, metacognitive beliefs, demographic information, and current physical health difficulties. Data were analysed using correlational and hierarchical multiple regression analyses. FINDINGS Metacognitive beliefs explained an additional 50% and 41% of the variance in emotional distress and posttraumatic stress symptoms, respectively, after controlling for known covariate effects, including current physical health difficulties. Conclusions/Implications for Psychosocial Providers or Policy: The metacognitive model of psychopathology is potentially applicable to AYA survivors of cancer who present with elevated general distress and/or posttraumatic stress symptoms. Prospective studies are required to determine whether metacognitive beliefs and processes have a causal role in distress in AYA survivors of cancer.
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Affiliation(s)
- Peter L Fisher
- a Department of Psychological Sciences , University of Liverpool , Liverpool , UK.,b Liverpool Cancer Psychology Service, Linda McCartney Centre, Royal Liverpool University Hospital , Liverpool , UK.,c Nidaros DPS, Division of Psychiatry, Ostmarka University Hospital , Trondheim , Norway
| | - Kirsten McNicol
- d Division of Clinical Psychology, University of Liverpool , Liverpool , UK
| | - Mary Gemma Cherry
- a Department of Psychological Sciences , University of Liverpool , Liverpool , UK.,b Liverpool Cancer Psychology Service, Linda McCartney Centre, Royal Liverpool University Hospital , Liverpool , UK
| | - Bridget Young
- a Department of Psychological Sciences , University of Liverpool , Liverpool , UK
| | - Ed Smith
- e The Christie Hospital , Manchester , UK
| | - Gareth Abbey
- a Department of Psychological Sciences , University of Liverpool , Liverpool , UK
| | - Peter Salmon
- a Department of Psychological Sciences , University of Liverpool , Liverpool , UK.,b Liverpool Cancer Psychology Service, Linda McCartney Centre, Royal Liverpool University Hospital , Liverpool , UK
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Mader L, Michel G, Roser K. Unemployment Following Childhood Cancer. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:805-812. [PMID: 29229046 PMCID: PMC5736865 DOI: 10.3238/arztebl.2017.0805] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 03/24/2017] [Accepted: 08/08/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Childhood cancer survivors are at risk of physical and mental long-term sequelae that may interfere with their employment situation in adulthood. We updated a systematic review from 2006 and assessed unemployment in adult childhood cancer survivors compared to the general population, and its predictors. METHODS Systematic literature searches for articles published between February 2006 and August 2016 were performed in CINAHL, EMBASE, PubMed, PsycINFO, and SocINDEX. We extracted unemployment rates in studies with and without population controls (controlled /uncontrolled studies). Unemployment in controlled studies was evaluated using a meta-analytic approach. RESULTS We included 56 studies, of which 27 were controlled studies. Approximately one in six survivors was unemployed. The overall meta-analysis of controlled studies showed that survivors were more likely to be unemployed than controls (Odds Ratio [OR] = 1.48, 95% confidence interval [CI]: [1.14; 1.93]). Elevated odds were found in survivors in the US and Canada (OR = 1.86, 95% CI: [1.26; 2.75]), as well as in Europe (OR = 1.39, 95% CI: [0.97; 1.97]). Survivors of brain tumors in particular were more likely to be unemployed (OR = 4.62, 95% CI: [2.56; 8.31]). Narrative synthesis across all included studies revealed younger age at study and diagnosis, female sex, radiotherapy, and physical late effects as further predictors of unemployment. CONCLUSION Childhood cancer survivors are at considerable risk of unemployment in adulthood. They may benefit from psycho-social care services along the cancer trajectory to support labor market integration.
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Affiliation(s)
- Luzius Mader
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
| | - Gisela Michel
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
| | - Katharina Roser
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
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Health-related quality of life and psychological distress in young adult survivors of childhood cancer and their association with treatment, education, and demographic factors. Qual Life Res 2017; 27:529-537. [PMID: 29090422 PMCID: PMC5846974 DOI: 10.1007/s11136-017-1716-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 11/30/2022]
Abstract
Purpose This study investigated health-related quality of life (HRQOL) and psychological distress among young adult (YA) survivors of childhood cancer and the association of these measures with treatment, education, and demographic factors ≥ 5 years post diagnosis. Methods Participants included cancer survivors (n = 91) recruited through the Cancer Registry of Norway (CRN) and healthy controls (n = 223) recruited from a student population. All participants completed self-report questionnaires, and the Pediatric Quality of Life Inventory (PedsQL™) 4.0 and the Hopkins Symptom Checklist-10 (HSCL-10) as a measure of HRQOL and distress, respectively. Results Survivors reported HRQOL at the same level as controls, except for poorer physical functioning. Survivors in general, and female survivors specifically, had higher odds than controls of reporting symptoms of distress above cut-off, but survivors did not have higher mean levels of distress compared to controls. Survivors reporting distress levels above the cut-off had significantly poorer HRQOL regarding physical functioning and lower total PedsQL scores than controls scoring above the cut-off. Age (for HRQOL only), female gender, low educational level, and perceived low economic status significantly predicted HRQOL and distress. Education interacted with the effect of cranial radiation in predicting HRQOL. Conclusions Survivors reported similar mean levels of HRQOL and distress as controls, except for physical functioning. For cancer survivors, demographic variables predicted HRQOL and distress. Some groups of survivors require closer follow-up, and more attention should be paid to factors associated with poor HRQOL and psychological distress in survivors, including female gender, lower education level, and lower income. Survivors treated with cranial radiation may be particular vulnerable in combination with low education regarding HRQOL.
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Husson O, Zebrack B, Block R, Embry L, Aguilar C, Hayes-Lattin B, Cole S. Personality Traits and Health-Related Quality of Life Among Adolescent and Young Adult Cancer Patients: The Role of Psychological Distress. J Adolesc Young Adult Oncol 2017; 6:358-362. [DOI: 10.1089/jayao.2016.0083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bradley Zebrack
- University of Michigan School of Social Work, Ann Arbor, Michigan
| | | | - Leanne Embry
- Department of Pediatric Hematology/Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Christine Aguilar
- Department of Pediatric Hematology/Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | | | - Steve Cole
- HopeLab Foundation, Redwood City, California
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Husson O, Zebrack BJ, Aguilar C, Hayes-Lattin B, Cole S. Cancer in adolescents and young adults: Who remains at risk of poor social functioning over time? Cancer 2017; 123:2743-2751. [DOI: 10.1002/cncr.30656] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/18/2017] [Accepted: 02/07/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Olga Husson
- Department of Medical Psychology; Radboud University Medical Center; Nijmegen the Netherlands
| | | | - Christine Aguilar
- Division of Pediatric Hematology/Oncology; University of Texas Health Science Center at San Antonio; San Antonio Texas
| | | | - Steve Cole
- HopeLab Foundation; Redwood City California
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Husson O, Zebrack BJ. Psychometric Evaluation of an Adolescent and Young Adult Module of the Impact of Cancer Instrument. J Adolesc Young Adult Oncol 2017; 6:159-170. [DOI: 10.1089/jayao.2016.0038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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Husson O, Zebrack B. Perceived impact of cancer among adolescents and young adults: Relationship with health-related quality of life and distress. Psychooncology 2016; 26:1307-1315. [DOI: 10.1002/pon.4300] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/10/2016] [Accepted: 10/30/2016] [Indexed: 11/09/2022]
Affiliation(s)
- O. Husson
- Department of Medical Psychology; Radboud University Medical Centre; Nijmegen The Netherlands
| | - B.J. Zebrack
- University of Michigan School of Social Work; Ann Arbor MI USA
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Fisher PL, McNicol K, Young B, Smith E, Salmon P. Alleviating Emotional Distress in Adolescent and Young Adult Cancer Survivors: An Open Trial of Metacognitive Therapy. J Adolesc Young Adult Oncol 2016; 4:64-9. [PMID: 26812553 DOI: 10.1089/jayao.2014.0046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Metacognitive therapy (MCT) is an effective psychological treatment for a range of emotional disorders. However, the applicability of MCT to treating emotional distress in physical health populations has yet to be tested. The present study examined the potential of MCT for alleviating emotional distress in adolescent and young adult cancer (AYAC) survivors. METHODS Twelve AYAC survivors, aged 18-23, who had completed acute medical treatment participated in this pilot open trial with 6 months follow-up. Each participant completed a baseline period followed by 8-14 sessions of MCT that targeted perseverative thinking (worry and rumination), attentional control, and metacognitive beliefs. The primary outcome variable was severity of depression and anxiety symptoms as measured by the Hospital Anxiety and Depression Scale (HADS). RESULTS MCT was associated with large and statistically significant reductions in anxiety, depression, trauma symptoms, and metacognitive beliefs and processes. In the intention-to-treat sample, 50% of participants met standardized criteria for recovery on the HADS at posttreatment and these gains were maintained through to 6-month follow-up. CONCLUSION MCT is a promising transdiagnostic approach to treating different forms of emotional distress in AYAC survivors. Further investigation in controlled trials is now warranted.
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Affiliation(s)
- Peter L Fisher
- 1 Psychological Sciences, University of Liverpool , Liverpool, United Kingdom
| | - Kirsten McNicol
- 1 Psychological Sciences, University of Liverpool , Liverpool, United Kingdom
| | - Bridget Young
- 1 Psychological Sciences, University of Liverpool , Liverpool, United Kingdom
| | - Ed Smith
- 2 The Christie Hospital , Manchester, United Kingdom
| | - Peter Salmon
- 1 Psychological Sciences, University of Liverpool , Liverpool, United Kingdom
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Berg CJ, Stratton E, Esiashvili N, Mertens A. Young Adult Cancer Survivors' Experience with Cancer Treatment and Follow-Up Care and Perceptions of Barriers to Engaging in Recommended Care. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:430-42. [PMID: 25948413 PMCID: PMC4712118 DOI: 10.1007/s13187-015-0853-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18-34 recruited from a university-affiliated children's hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14 (SD = 3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p = 0.003), being male (p < 0.001), lack of insurance (p = 0.002), and having had chemotherapy (p = 0.05). Participants reported varied experiences in terms of how health and treatment information was presented, from none or too little to overwhelming or anxiety-provoking amounts. Barriers to engaging in survivorship care included no/limited insurance, time, or transportation; major life changes; anxiety; and difficulty transitioning from pediatrics to adult care. Participants highlighted the need for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivorship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Room 524, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Erin Stratton
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Room 524, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Natia Esiashvili
- Department of Radiology, School of Medicine, Woodruff Health Sciences Center, Emory University, 1440 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Ann Mertens
- Aflac Cancer Center/Department of Pediatrics, Department of Oncology, School of Medicine, Woodruff Health Sciences Center, Emory University, 1440 Clifton Road NE, Atlanta, GA, 30322, USA
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Pailler ME, Johnson TM, Kuszczak S, Attwood KM, Zevon MA, Griffiths E, Thompson J, Wang ES, Wetzler M. Adjustment to Acute Leukemia: The Impact of Social Support and Marital Satisfaction on Distress and Quality of Life Among Newly Diagnosed Patients and Their Caregivers. J Clin Psychol Med Settings 2016; 23:298-309. [DOI: 10.1007/s10880-016-9459-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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30
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Yi J, Kim MA, An S. The Experiences of Korean Young Adult Survivors of Childhood Cancer: A Photovoice Study. QUALITATIVE HEALTH RESEARCH 2016; 26:1044-1054. [PMID: 26265716 DOI: 10.1177/1049732315599374] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Photovoice was used to understand the impact of childhood cancer on Korean young adult survivors. Seven survivors of childhood cancer (currently aged 20-27 years), diagnosed before the age of 19 and with cancer treatment completed, participated in five sessions. The participants took photographs that captured their group's weekly topics and participated in discussions about their feelings and experiences. Fifty-six photo images with narratives on the survivors' experiences were produced on these four participant-selected themes: Relationships With Others, Stigma, Overcoming Difficulties, and The Future This study on Korean childhood cancer survivors sheds light on their perspectives about the impact of cancer. Using an innovative methodology that takes the participants' point of view, this study contributes to the literature on young adult cancer survivors' quality of life and their psychosocial adjustment. The results can inform educational programs and increase public awareness by providing survivors' schoolteachers and peers with knowledge about childhood cancer.
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Affiliation(s)
- Jaehee Yi
- University of Utah, Salt Lake City, Utah, USA
| | - Min Ah Kim
- Myongji University, Seoul, Republic of Korea
| | - Sangmin An
- Yonsei University, Seoul, Republic of Korea
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Sleurs C, Lemiere J, Vercruysse T, Nolf N, Van Calster B, Deprez S, Renard M, Vandecruys E, Benoit Y, Uyttebroeck A. Intellectual development of childhood ALL patients: a multicenter longitudinal study. Psychooncology 2016; 26:508-514. [PMID: 27246629 DOI: 10.1002/pon.4186] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND In childhood acute lymphoblastic leukemia (ALL), radiotherapy for CNS prophylaxis is not used in frontline therapy anymore. Standard treatment for ALL nowadays consists of polychemotherapy. Therefore, assessment of potential chemotherapy-induced cognitive side effects becomes important. Although neurotoxicity was demonstrated in cross-sectional studies, longitudinal studies remain scarce. PROCEDURE We evaluated intellectual development of 94 pediatric ALL patients between 1990 and 1997, diagnosed before the age of 12 years, treated according to the European Organisation for Research and Treatment of Cancer Children's Leukemia Group 58881 protocol. Three assessments of the Wechsler Intelligence Scale for Children Revised were performed since diagnosis, according to age. Using repeated measures regression analysis, we investigated the effect of gender (low versus increased) risk group, parents' education, age at diagnosis, intelligence quotient (IQ) subscale (verbal (VIQ) versus performance (PIQ) intelligence), and test session. RESULTS PIQ scores were lower than VIQ at baseline (-5.3 points on average, p = 0.0032), yet PIQ increased more strongly (PIQ: +3.9 points per test session; VIQ: +0.8, p = 0.0079), so this baseline difference disappeared (p = 0.0079). There were no clear effects of gender (girls: +0.6 points; p = 0.78) or risk group (low risk: +1.5 points; p = 0.49), but IQ scores were higher when one parent had followed higher education (+9.5 points, p < 0.0001). Finally, diagnosis at younger age predicted lower IQ scores (-1.3 points per year, p = 0.0009). CONCLUSION Given that IQ scores did not decline, our findings demonstrate a stable pattern. However, the lower PIQ scores at baseline may indicate that performance functioning is vulnerable to acute neurotoxicity. Also, lower scores for younger patients highlight the stronger impact of the disease and/or treatment at younger age.Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Charlotte Sleurs
- University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium.,KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Jurgen Lemiere
- University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium
| | - Trui Vercruysse
- University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium
| | - Nathalie Nolf
- Ghent University Hospital, Department of Pediatric Hematology and Oncology, Ghent, Belgium
| | - Ben Van Calster
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Sabine Deprez
- University Hospitals Leuven, Department of Radiology, Leuven, Belgium.,KU Leuven, Department of Imaging and Pathology, Leuven, Belgium
| | - Marleen Renard
- University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium
| | - Els Vandecruys
- Ghent University Hospital, Department of Pediatric Hematology and Oncology, Ghent, Belgium
| | - Yves Benoit
- Ghent University Hospital, Department of Pediatric Hematology and Oncology, Ghent, Belgium
| | - Anne Uyttebroeck
- University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium.,KU Leuven, Department of Development and Regeneration, Leuven, Belgium
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Sleurs C, Deprez S, Emsell L, Lemiere J, Uyttebroeck A. Chemotherapy-induced neurotoxicity in pediatric solid non-CNS tumor patients: An update on current state of research and recommended future directions. Crit Rev Oncol Hematol 2016; 103:37-48. [PMID: 27233118 DOI: 10.1016/j.critrevonc.2016.05.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 03/21/2016] [Accepted: 05/10/2016] [Indexed: 11/26/2022] Open
Abstract
Neurocognitive sequelae are known to be induced by cranial radiotherapy and central-nervous-system-directed chemotherapy in childhood Acute Lymphoblastic Leukemia (ALL) and brain tumor patients. However, less evidence exists for solid non-CNS-tumor patients. To get a better understanding of the potential neurotoxic mechanisms of non-CNS-directed chemotherapy during childhood, we performed a comprehensive literature review of this topic. Here, we provide an overview of preclinical and clinical studies investigating neurotoxicity associated with chemotherapy in the treatment of pediatric solid non-CNS tumors. Research to date suggests that chemotherapy has deleterious biological and psychological effects, with animal studies demonstrating histological evidence for neurotoxic effects of specific agents and human studies demonstrating acute neurotoxicity. Although the existing literature suggests potential neurotoxicity throughout neurodevelopment, research into the long-term neurocognitive sequelae in survivors of non-CNS cancers remains limited. Therefore, we stress the critical need for neurodevelopmental focused research in children who are treated for solid non-CNS tumors, since they are at risk for potential neurocognitive impairment.
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Affiliation(s)
- Charlotte Sleurs
- Department of Pediatric Hematology and Oncology, University Hospital Leuven, Leuven, Belgium; Department of Radiology, University Hospital Leuven, Leuven, Belgium.
| | - Sabine Deprez
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Louise Emsell
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hematology and Oncology, University Hospital Leuven, Leuven, Belgium; Department of Child & Adolescent Psychiatry, University Hospital Leuven, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospital Leuven, Leuven, Belgium
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Tremolada M, Bonichini S, Basso G, Pillon M. Perceived social support and health-related quality of life in AYA cancer survivors and controls. Psychooncology 2016; 25:1408-1417. [DOI: 10.1002/pon.4072] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 10/25/2015] [Accepted: 12/10/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Marta Tremolada
- Department of Developmental and Social Psychology; University of Padua; Padua Italy
| | - Sabrina Bonichini
- Department of Developmental and Social Psychology; University of Padua; Padua Italy
| | - Giuseppe Basso
- Department of Child and Woman Health, Oncology Hematology Division; University-Hospital of Padua; Padua Italy
| | - Marta Pillon
- Department of Child and Woman Health, Oncology Hematology Division; University-Hospital of Padua; Padua Italy
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Souza CMCD, Cristofani LM, Cornacchioni ALB, Odone Filho V, Kuczynski E. Comparative study of quality of life of adult survivors of childhood acute lymphocytic leukemia and Wilms' tumor. ACTA ACUST UNITED AC 2015; 13:492-9. [PMID: 26537509 PMCID: PMC4878620 DOI: 10.1590/s1679-45082015ao3231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 01/23/2015] [Indexed: 11/22/2022]
Abstract
Objective To analyze and compare the health-related quality of life of adult survivors of acute lymphocytic leukemia and Wilms’ tumor amongst themselves and in relation to healthy participants. Methods Ninety participants aged above 18 years were selected and divided into three groups, each comprising 30 individuals. The Control Group was composed of physically healthy subjects, with no cancer history; and there were two experimental groups: those diagnosed as acute lymphocytic leukemia, and those as Wilms’ Tumor. Quality of life was assessed over the telephone, using the Medical Outcomes Study 36-Item Short Form Health Survey. Results Male survivors presented with better results as compared to female survivors and controls in the Vitality domain, for acute lymphocytic leukemia (p=0.042) and Wilms’ tumor (p=0.013). For acute lymphocytic leukemia survivors, in Social aspects (p=0.031), Mental health (p=0.041), and Emotional aspects (p=0.040), the latter also for survivors of Wilms’ tumor (p=0.040). The best results related to the Functional capacity domain were recorded for the experimental group that had a late diagnosis of acute lymphocytic leukemia. There were significant differences between groups except for the Social and Emotional domains for self-perceived health, with positive responses that characterized their health as good, very good, and excellent. Conclusion Survivors of acute lymphocytic leukemia showed no evidence of relevant impairment of health-related quality of life. The Medical Outcomes Study 36-Item Short Form Health Survey (via telephone) can be a resource to access and evaluate survivors.
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Affiliation(s)
| | | | | | - Vicente Odone Filho
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Evelyn Kuczynski
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Yi J, Zebrack B, Kim MA, Cousino M. Posttraumatic Growth Outcomes and Their Correlates Among Young Adult Survivors of Childhood Cancer. J Pediatr Psychol 2015; 40:981-91. [PMID: 26286227 DOI: 10.1093/jpepsy/jsv075] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 07/21/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE This study aims to identify and examine posttraumatic growth (PTG) experiences, and their correlates, among young adult survivors of childhood cancer. METHODS 602 long-term childhood cancer survivors between the ages of 18 and 39 participated. Their demographic (age, gender, race/ethnicity, education, relationship status, employment, and income), cancer-related (diagnosis, current health problem, age at diagnosis, and years since diagnosis), and psychosocial (social support and optimism) PTG correlates were examined using descriptive, correlational, and regression analyses. RESULTS PTG was significantly greater for females and nonwhite survivors, and for those diagnosed at older ages. Survivors diagnosed with solid/soft tissue tumors reported lower PTG. Optimism and social support were positively associated with PTG. CONCLUSION Study findings highlight potential intervention opportunities for increasing PTG by facilitating discussion around growth experiences within an optimistic framework among a supportive network of family members and peers.
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Affiliation(s)
- Jaehee Yi
- College of Social Work, University of Utah,
| | | | - Min Ah Kim
- Department of Social Welfare, Myongji University, and
| | - Melissa Cousino
- Department of Psychiatry, Boston Children's Hospital & Harvard Medical School
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Villadsen KW, Blix C, Boisen KA. More than a break: the impact of a social-pedagogical intervention during young persons' long-term hospital admission--a qualitative study. Int J Adolesc Med Health 2015; 27:19-24. [PMID: 24810557 DOI: 10.1515/ijamh-2014-0009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 03/23/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Critical illness and long-term or repeated hospitalization can affect normal adolescent development. As a result, adolescents may feel isolated and "misplaced" on both pediatric and adult departments. The mission of the Center of Adolescent Medicine is to improve conditions for adolescent patients. To achieve this, the social educator offers an individualized social-pedagogical intervention for young people during long-term or repeated hospitalization. OBJECTIVE The aim of this study was to identify the impact of the social-pedagogical intervention using a qualitative approach. MATERIALS AND METHODS A trained anthropologist interviewed seven adolescents who had individual sessions with a social educator during their hospital stay. The interviews were recorded and transcribed verbatim, and the transcripts were coded and thematized continuously. RESULTS Through qualitative analysis, the following themes emerged: Recreation; Structure, participation, and motivation; and Friends and social network. The social-pedagogical approach is a combination of interpersonal relationships and individually tailored recreational activities. Even small entertaining activities changed the focus from patient identity and contributed to the feeling of being "normal." All young patients reported that the increased opportunities for decision-making and influence on the daily structure supported the feeling of being recognized and respected as an individual person as well as increased their motivation to go through their treatment. The interviewees emphasized the importance of experiencing something that was worth telling their friends about to help them stay in touch. CONCLUSION Although the young patients emphasized the recreational aspects, the time spent with the social educator facilitated training in social competencies as well as conversations about emotional and sensitive topics.
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Crom DB, Li Z, Brinkman TM, Hudson MM, Armstrong GT, Neglia J, Ness KK. Life satisfaction in adult survivors of childhood brain tumors. J Pediatr Oncol Nurs 2014; 31:317-26. [PMID: 25027187 DOI: 10.1177/1043454214534532] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adult survivors of childhood brain tumors experience multiple, significant, lifelong deficits as a consequence of their malignancy and therapy. Current survivorship literature documents the substantial impact such impairments have on survivors' physical health and quality of life. Psychosocial reports detail educational, cognitive, and emotional limitations characterizing survivors as especially fragile, often incompetent, and unreliable in evaluating their circumstances. Anecdotal data suggest some survivors report life experiences similar to those of healthy controls. The aim of our investigation was to determine whether life satisfaction in adult survivors of childhood brain tumors differs from that of healthy controls and to identify potential predictors of life satisfaction in survivors. This cross-sectional study compared 78 brain tumor survivors with population-based matched controls. Chi-square tests, t tests, and linear regression models were used to investigate patterns of life satisfaction and identify potential correlates. Results indicated that life satisfaction of adult survivors of childhood brain tumors was similar to that of healthy controls. Survivors' general health expectations emerged as the primary correlate of life satisfaction. Understanding life satisfaction as an important variable will optimize the design of strategies to enhance participation in follow-up care, reduce suffering, and optimize quality of life in this vulnerable population.
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Affiliation(s)
| | - Zhenghong Li
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Zebrack B. Patient-centered research to inform patient-centered care for adolescents and young adults (AYAs) with cancer. Cancer 2014; 120:2227-9. [DOI: 10.1002/cncr.28734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 03/17/2014] [Accepted: 03/28/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Brad Zebrack
- University of Michigan School of Social Work; Ann Arbor Michigan
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Jervaeus A, Lampic C, Johansson E, Malmros J, Wettergren L. Clinical significance in self-rated HRQoL among survivors after childhood cancer - demonstrated by anchor-based thresholds. Acta Oncol 2014; 53:486-92. [PMID: 24160264 DOI: 10.3109/0284186x.2013.844852] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a need to establish clinically relevant thresholds (anchors) for identification of differences in health-related quality of life (HRQoL) and thereby provide stronger evidence regarding the HRQoL of childhood cancer survivors. AIM To investigate HRQoL in childhood cancer survivors with a standardised instrument and to establish thresholds for clinically significant differences by using qualitative interviews as anchors. An additional aim was to investigate survivors' HRQoL in relation to an age-matched comparison group without cancer experience. MATERIAL AND METHODS Self-rated HRQoL (KIDSCREEN-27) was assessed in a national cohort of survivors (n = 63, aged 12-22) and a comparison group (n = 257, aged 11-23). Findings from qualitative interview data were also used (n = 61); three subgroups ("Feeling like anyone else"; "Feeling almost like others"; "Feeling different") were identified based on survivors own perception of influence on daily life. Effect size calculations based on means from the KIDSCREEN-27 dimensions were performed using the subgroups as anchors to indicate clinical importance. Furthermore, standard multiple regression analyses were performed. Results. Effect sizes between the subgroups "Feeling like anyone else" and "Feeling almost like others" and the group "Feeling different" were large for all dimensions (1.04-2.07). The multiple regression models showed that being a survivor was significantly associated with one of the dimensions, School Environment, where survivors scored higher HRQoL. Furthermore, female sex and older age (17-23 years) significantly contributed to lower self-rated HRQoL. Conclusion. In clinical practice the KIDSCREEN-27 could be a useful screening tool to identify survivors of childhood cancer in need of extra support, using KIDSCREEN dimension mean values of 45 or less as thresholds. Larger scale studies are recommended to identify and test thresholds with regard to different age groups and time since diagnosis.
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Affiliation(s)
- Anna Jervaeus
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet,
Stockholm, Sweden
| | - Claudia Lampic
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet,
Stockholm, Sweden
| | - Eva Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet,
Stockholm, Sweden
| | - Johan Malmros
- Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet,
Stockholm, Sweden
- Department of Pediatric Hematology and Oncology, Karolinska University Hospital,
Stockholm, Sweden
| | - Lena Wettergren
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet,
Stockholm, Sweden
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Berbis J, Michel G, Baruchel A, Bertrand Y, Chastagner P, Demeocq F, Kanold J, Leverger G, Plantaz D, Poirée M, Stephan JL, Auquier P, Contet A, Dalle JH, Ducassou S, Gandemer V, Lutz P, Sirvent N, Tabone MD, Thouvenin-Doulet S. Cohort Profile: the French childhood cancer survivor study for leukaemia (LEA Cohort). Int J Epidemiol 2014; 44:49-57. [PMID: 24639445 DOI: 10.1093/ije/dyu031] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The main aim of the Leucémies de l'Enfant et l'Adolescent (LEA) project (Childhood and Adolescent Leukaemia) is to study the determinants (medical, socioeconomic, behavioural and environmental) of medium- and long-term outcomes of patients treated for childhood acute leukaemia (AL). The LEA study began in 2004 and is based on a French multicentric prospective cohort. Included are children treated for AL since January 1980 (incident and prevalent cases), surviving at month 24 for myeloblastic AL and lymphoblastic AL grafted in first complete remission or at month 48 for lymphoblastic AL not grafted in first complete remission. Information is collected during specific medical visits and notably includes the following data: socioeconomic data, AL history, physical late effects (such as fertility, cardiac function and metabolic syndrome) and quality of life. Data are collected every 2 years until the patient is 20 years old and has had a 10-year follow-up duration from diagnosis or last relapse. Thereafter, assessments are planned every 4 years. In active centres in 2013, eligible patients number more than 3000. The cohort has already included 2385 survivors, with rate of exhaustiveness of almost 80%. Data access can be requested from principal coordinators and must be approved by the steering committee.
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Affiliation(s)
- Julie Berbis
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Gérard Michel
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - André Baruchel
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric
| | - Yves Bertrand
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pascal Chastagner
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - François Demeocq
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Justyna Kanold
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Guy Leverger
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Dominique Plantaz
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Marilyne Poirée
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jean-Louis Stephan
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pascal Auquier
- EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Aix-Marseilles University, Marseilles 13385, France, Department of Paediatric Onco-haematology, APHM, La Timone Hospital, Marseilles, France, Department of Paediatric Onco-haematology, APHP, Saint Louis Hospital, Paris, France, Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France, Department of Paediatric Onco-haematology, HCL, Lyon, France, Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France, CHU Clermont-Ferrand, Department of Paediatric Onco-haematology, CIC Inserm 501, Clermont-Ferrand, France, Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France, Department of Paediatric Onco-haematology, University Hospital of Grenoble, Grenoble, France, Department of Paediatric Onco-haematology, University Hospital of Nice, Nice, France and Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Audrey Contet
- Department of Paediatric Onco-haematology, University Hospital of Nancy, Nancy, France
| | - Jean-Hugues Dalle
- Department of Paediatric Onco-haematology, APHP, Robert Debré Hospital, Paris, France
| | - Stéphane Ducassou
- Department of Paediatric Onco-haematology, University Hospital of Bordeaux, Bordeaux, France
| | - Virginie Gandemer
- Department of Paediatric Onco-haematology, University Hospital of Rennes, Rennes, France
| | - Patrick Lutz
- Department of Paediatric Onco-haematology, University Hospital of Strasbourg, Strasbourg, France
| | - Nicolas Sirvent
- Department of Paediatric Onco-haematology, University Hospital of Montpellier, Montpellier, France
| | - Marie-Dominique Tabone
- Department of Paediatric Onco-haematology, APHP, GHUEP, Armand Trousseau Hospital, Paris 75012, France
| | - Sandrine Thouvenin-Doulet
- Department of Paediatric Onco-haematology, University Hospital of Saint-Etienne, Saint-Etienne, France
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Exploring Factors that Influence Childhood Cancer Survivorsʼ Choice of Occupation and Choice to Attend College. REHABILITATION ONCOLOGY 2014. [DOI: 10.1097/01893697-201432040-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Sansom-Daly UM, Wakefield CE. Distress and adjustment among adolescents and young adults with cancer: an empirical and conceptual review. Transl Pediatr 2013; 2:167-97. [PMID: 26835313 PMCID: PMC4729076 DOI: 10.3978/j.issn.2224-4336.2013.10.06] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Adolescents and young adults (AYAs) with cancer must simultaneously navigate the challenges associated with their cancer experience, whilst striving to achieve a number of important developmental milestones at the cusp of adulthood. The disruption caused by their cancer experience at this critical life-stage is assumed to be responsible for significant distress among AYAs living with cancer. The quality and severity of psychological outcomes among AYAs remain poorly documented, however. This review examined the existing literature on psychological outcomes among AYAs living with cancer. All psychological outcomes (both distress and positive adjustment) were included, and AYAs were included across the cancer trajectory, ranging from newly-diagnosed patients, to long-term cancer survivors. Four key research questions were addressed. Section 1 answered the question, "What is the nature and prevalence of distress (and other psychological outcomes) among AYAs living with cancer?" and documented rates of clinical distress, as well as evidence for the trajectory of this distress over time. Section 2 examined the individual, cancer/treatment-related and socio-demographic factors that have been identified as predictors of these outcomes in this existing literature. Section 3 examined current theoretical models relevant to explaining psychological outcomes among AYAs, including developmental models, socio-cognitive and family-systems models, stress-coping frameworks, and cognitive appraisal models (including trauma and meaning making models). The mechanisms implicated in each model were discussed, as was the existing evidence for each model. Converging evidence implicating the potential role of autobiographical memory and future thinking systems in how AYAs process and integrate their cancer experience into their current sense of self and future goals are highlighted. Finally, Section 4 addressed the future of psycho-oncology in understanding and conceptualizing psychological outcomes among AYAs living with cancer, by discussing recent empirical advancements in adjacent, non-oncology fields that might improve our understanding of psychological outcomes in AYAs living with cancer. Included in these were models of memory and future thinking drawn from the broader psychology literature that identify important mechanisms involved in adjustment, as well as experimental paradigms for the study of these mechanisms within analogue, non-cancer AYA samples.
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Affiliation(s)
- Ursula M Sansom-Daly
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia;; School of Psychology, The University of New South Wales, Sydney, Australia; School of Women's and Children's Health, The University of New South Wales, Sydney, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia;; School of Women's and Children's Health, The University of New South Wales, Sydney, Australia
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Lipshultz SE, Adams MJ, Colan SD, Constine LS, Herman EH, Hsu DT, Hudson MM, Kremer LC, Landy DC, Miller TL, Oeffinger KC, Rosenthal DN, Sable CA, Sallan SE, Singh GK, Steinberger J, Cochran TR, Wilkinson JD. Long-term cardiovascular toxicity in children, adolescents, and young adults who receive cancer therapy: pathophysiology, course, monitoring, management, prevention, and research directions: a scientific statement from the American Heart Association. Circulation 2013; 128:1927-95. [PMID: 24081971 DOI: 10.1161/cir.0b013e3182a88099] [Citation(s) in RCA: 373] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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44
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Phillips F, Jones BL. Understanding the lived experience of Latino adolescent and young adult survivors of childhood cancer. J Cancer Surviv 2013; 8:39-48. [DOI: 10.1007/s11764-013-0310-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 09/13/2013] [Indexed: 10/26/2022]
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45
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Kanellopoulos A, Hamre HM, Dahl AA, Fosså SD, Ruud E. Factors associated with poor quality of life in survivors of childhood acute lymphoblastic leukemia and lymphoma. Pediatr Blood Cancer 2013; 60:849-55. [PMID: 23335116 DOI: 10.1002/pbc.24375] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 09/27/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Previous studies of health-related quality of life (QoL) in childhood cancer survivors have hardly focused on factors associated with poor QoL. THE AIMS OF OUR STUDY WERE (1) to assess QoL in long-term survivors (LTSs) of childhood acute lymphoblastic leukemia (ALL) and lymphomas compared to age-matched controls from the general population (NORMs). (2) To investigate factors associated with poor QoL in LTSs. PROCEDURE This population-based cross-sectional study enrolled 285 LTSs of ALL and lymphomas diagnosed between 1970 and 2002 at age <18 years. The LTSs completed an extensive mailed questionnaire including the Short Form 36 (SF-36) as QoL-measure. NORMs consisted of five age-matched controls for each LTS (N = 1,425). Poor QoL was defined as SF-36 physical or mental component summary score <40. RESULTS The median age of LTSs' at survey was 30 years (range: 18-54), median follow-up time 21 years (range: 7-39). Compared to NORMs, LTSs scored significantly lower on 7 of 8 SF-36 subscales. Among LTSs 32% reported poor QoL versus 19% among NORMs (P < 0.001). Among LTSs, psychosocial, lifestyle- and health-related variables, but not type of malignancy, treatment factors or socio-demographic factors were clinically significantly associated with poor QoL in bivariate regression analyses. In multivariate analysis, levels of fatigue, anxiety and depression, as well as obesity and insomnia remained significantly associated with poor QoL. CONCLUSION Significantly more LTSs than age-matched NORMs experienced poor QoL. Clinically significant associations with fatigue, anxiety, depression, obesity and insomnia were observed, which may be amenable for interventions, and thereby improvement of QoL in LTSs.
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Affiliation(s)
- Adriani Kanellopoulos
- Department of Paediatric Medicine, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
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46
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Murphy MH. Health promotion in adolescent and young adult cancer survivors: mobilizing compliance in a multifaceted risk profile. J Pediatr Oncol Nurs 2013; 30:139-52. [PMID: 23625640 DOI: 10.1177/1043454213486194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
With rising cure rates of childhood cancer, nurse practitioners have an increased chance of encountering a large survivor cohort in practice. A variety of late effects programs exist; however, funding is limited for these programs and is not accessible for all patients. Primary providers may increasingly act as a medical home for childhood cancer survivors (CCS). Understanding the inherent risks of cytotoxic treatment and the progressive consequences of late effects is vital to limit morbidity and mortality. Adolescent and young adult survivors (AYA) are particularly apt to make health behavior decisions that create risks for comorbidities. Developmentally appropriate experimentation with drug, alcohol, or tobacco use and increased ultraviolet ray exposure intensifies the risk for secondary malignancies and novel diseases. The paucity of evidence-based surveillance guidelines and survivor-specific health promotion programs cumulatively widen the gap in noncompliance and misinformation. This article overviews the risk profile of CCS. It explores health practices, as well as emerging health promotion techniques, within the AYA survivor population and the role nurse practitioners have in enhancing health maintenance.
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47
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Hagan TL, Donovan HS. Self-advocacy and cancer: a concept analysis. J Adv Nurs 2013; 69:2348-59. [PMID: 23347224 DOI: 10.1111/jan.12084] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2012] [Indexed: 11/30/2022]
Abstract
AIM To report an analysis of the concept of self-advocacy among individuals with cancer to clarify its meaning, to differentiate this meaning with related concepts, and to unify understanding of the concept in cancer research and practice. BACKGROUND Cancer survivors are increasingly required to assume an active role in their health care. A thorough analysis of how survivors advocate for themselves is a crucial aspect in supporting survivors' ability to engage and manage their care throughout all stages of cancer survivorship. DESIGN Walker and Avant's eight-step process of conducting a concept analysis was used. DATA SOURCES PubMed, PsycINFO, and CINAHL databases were searched for articles, reviews, editorials, and grey literature directly addressing self-advocacy. REVIEW METHODS A broad inquiry into the literature from 1960 to 2012 that produces a definition of self-advocacy. Model and contrary cases of self-advocacy demonstrate the concept's application and intricacies. RESULTS Antecedents to self-advocacy include particular personal characteristics, learned skills, and attainable support. The essential element of self-advocacy and what differentiates it from related concepts, is the internalization of these antecedent resources into self-advocacy thoughts and actions while incorporating personal values and priorities in a way that upholds the survivors' goals and beliefs. A full realization of self-advocacy facilitates a cancer survivor attaining a strong self-concept, sense of control, and adaptation to a life with cancer. CONCLUSIONS Self-advocacy is a process of internalizing skills and resources to act in a way that supports survivors' needs and goals.
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Affiliation(s)
- Teresa L Hagan
- Department of Acute and Tertiary Care, The University of Pittsburgh School of Nursing, PA, USA
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McNicol K, Salmon P, Young B, Fisher P. Alleviating Emotional Distress in a Young Adult Survivor of Adolescent Cancer. Clin Case Stud 2012. [DOI: 10.1177/1534650112461298] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A substantial proportion of adolescent and young adult cancer survivors experience persistent emotional distress, but little research has evaluated psychological interventions in this population. Metacognitive therapy (MCT), a transdiagnostic intervention, is an effective treatment for depression and a range of anxiety disorders in mental health settings, but its efficacy in cancer populations is unknown. This study used an AB design with 6-month follow-up to evaluate the potential efficacy of MCT for reducing symptoms of depression, anxiety, and posttraumatic stress in a young adult female survivor of adolescent leukemia. Clinician-rated and self-report measures demonstrated large, clinically meaningful, improvements on all outcome measures over seven treatment sessions, and these gains were maintained at 6-month follow-up. The case study demonstrates the potential applicability of MCT to treating emotional distress in young adult survivors of childhood cancer.
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Chung OKJ, Li HCW, Chiu SY, Lopez V. Predisposing Factors to the Quality of Life of Childhood Cancer Survivors. J Pediatr Oncol Nurs 2012; 29:211-20. [PMID: 22797683 DOI: 10.1177/1043454212451367] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to examine the predisposing factors to the quality of life of Hong Kong Chinese childhood cancer survivors. A cross-sectional study was conducted with 153 survivors (9-16 years of age) during follow-up at the oncology outpatient clinic. The study found that depressive symptoms are a strong predictor of quality of life in childhood cancer survivors and that systematic screening of this population is important. It is essential for health care professionals to develop, plan, and evaluate interventions with the aim of alleviating depressive symptoms for childhood cancer survivors so as to enhance their quality of life.
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50
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Zebrack B, Isaacson S. Psychosocial Care of Adolescent and Young Adult Patients With Cancer and Survivors. J Clin Oncol 2012; 30:1221-6. [DOI: 10.1200/jco.2011.39.5467] [Citation(s) in RCA: 293] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The delivery of quality care for adolescent and young adult (AYA) patients with cancer and survivors requires an understanding of the unique qualities of this group—the shared norms, attitudes, and beliefs that determine their behavior as well as the unique stresses they face on a day-to-day basis. All AYAs have typical concerns about being comfortable with who they are and who they want to become (identity development, including sexual identity), their bodies (body image), initiating intimate and emotional relationships, separating from parents, and making independent decisions about future goals such as career, higher education, and/or family (autonomy). Yet efforts of AYA patients with cancer and survivors to mature are often confounded by restrictions and limitations placed on them by their disease and treatment. This article promotes understanding of psychosocial challenges faced by AYAs when diagnosed with and treated for cancer. It reviews evidence-based psychosocial support interventions for AYAs with cancer and other life-threatening or chronic diseases, particularly the positive effects of peer support, technology-based interventions, and skill-based interventions. The article concludes with recommendations for clinical care that are intended to promote the ability of AYAs to cope with cancer.
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Affiliation(s)
- Brad Zebrack
- Brad Zebrack, University of Michigan School of Social Work, Ann Arbor, MI; and Sineéad Isaacson, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Sinéad Isaacson
- Brad Zebrack, University of Michigan School of Social Work, Ann Arbor, MI; and Sineéad Isaacson, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
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