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Zucchetti G, Bellini S, Bertolotti M, Biasin E, Brignardello E, Fagioli F. The biopsychosocial condition of childhood cancer survivors in the transition towards adult care: a national survey from the joint pediatric and adult transition care group. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0189/ijamh-2018-0189.xml. [PMID: 30864415 DOI: 10.1515/ijamh-2018-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 10/04/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND To provide successful transfer from childhood to adult-oriented healthcare is one of the priorities of survivorship care plans. PURPOSE This study describes adolescent and young adult childhood cancer survivors' conditions at the moment of the transition to adult care deepening their biological, psychological, social and assistant state and their associations with socio-demographic and clinical characteristics. METHODS A biopsychosocial check-list in four health domains (biological, psychological, social and assistant) was filled in by healthcare professionals (oncologists, psychologists, social workers and nurses) through qualitative interviews and clinical observations of 79 survivors (58% boys; Mage = 20 years old) at the moment of the transition from the Pediatric Oncology Unit to the Transition Unit of the Childhood Cancer Survivors. RESULTS At the moment of transition, 38% of survivors showed a positive condition in all the four health domains without any kind of impairment. Biological (37%) and psychological areas (44%) were found to be those with major incidence of impairments. Association phenomena were found between psychological and social condition (p < 0.05) and between social and assistant condition (p < 0.05). Biological condition was also significantly associated with the type of cancer (χ = 6,2414, p < 0.05). CONCLUSION Although many survivors entered in adult care system without any impairment, the biopsychosocial approach highlighted that there is a presence of impairments in at least one of the main health domains.
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Affiliation(s)
- Giulia Zucchetti
- Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Simona Bellini
- Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Marina Bertolotti
- Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Eleonora Biasin
- Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
| | - Enrico Brignardello
- Transition Unit for Childhood Cancer Survivors, City of Science and Health of Turin, Turin, Italy
| | - Franca Fagioli
- Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children's Hospital, Turin, Italy
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Kam V, Hendershot E, Anderson L, Marjerrison S. Evaluation of a joint adult and pediatric clinic for cancer survivorship care. Pediatr Blood Cancer 2017; 64. [PMID: 28150383 DOI: 10.1002/pbc.26476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/30/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The best model of care for long-term follow-up of survivors of childhood cancer is uncertain. We describe the care experience provided by the joint adult/pediatric AfterCare Clinic at the McMaster Children's Hospital. Secondary outcomes include an evaluation of cancer worry, self-management skills, and loss to follow-up rates. METHODS AfterCare Clinic patients aged 19-29 years were approached for study participation between January and March 2016. Data were collected from a cross-sectional survey, consisting of the Cancer Care Experience Questionnaire (CCEQ), Cancer Worry Scale (CWS), and Self-Management Skills Scale (SMSS). Responses were analyzed using descriptive statistics. RESULTS Seventy-three (40%) patients participated in the survey, 17 (23%) anonymously. Demographic characteristics of the nonanonymous participants were representative of the total clinic cohort. Most respondents were satisfied with the quality of care and anticipatory guidance provided, demonstrated by the CCEQ responses. Respondents had a high degree of cancer worries (mean score 50.6 [±18.4]), but good self-management skills (72.0 [±10.9]). Our 5-year loss to follow-up rate was 3.8%. Sensitivity analyses showed no difference in responses between the total cohort and the nonanonymous participants. CONCLUSIONS This sample of young adult survivors of childhood cancer had a higher degree of cancer worries and higher self-management skills scores than a younger cohort of survivors of childhood cancer in the literature. Given this, along with the positive care experience reported, and the low loss to follow-up rate, the joint adult/pediatric model of survivorship care appears to be meeting the needs of this population.
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Affiliation(s)
- Vicki Kam
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Eleanor Hendershot
- Division of Hematology/Oncology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Loretta Anderson
- Division of Hematology/Oncology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Stacey Marjerrison
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,Division of Hematology/Oncology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
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Ishida Y, Tezuka M, Hayashi M, Inoue F. Japanese childhood cancer survivors' readiness for care as adults: a cross-sectional survey using the Transition Scales. Psychooncology 2016; 26:1019-1026. [PMID: 27598031 DOI: 10.1002/pon.4276] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND Childhood cancer survivors' (CCSs') readiness for adult care has not been evaluated in Japan. We conducted a survey to examine transition barriers and facilitators in CCSs and compared the results with those of CCSs in Canada. METHODS Participants were selected from the Heart Link mutual-aid health insurance membership directory and the Millefeuille Childhood Cancer Frontiers. We conducted a cross-sectional survey (self-report questionnaire) via mail, using the Transition Scales. RESULTS In total, 268 questionnaires were collected by January 2016 (response rate, 42.5%). After confirming the reliability and validity of the Transition Scales, we analyzed 242 questionnaires. After excluding questionnaires for CCSs younger than 15 or older than 26 years, we compared scales scores between Japanese and Canadian CCSs. Relative to that of Japanese CCSs, Canadian CCSs showed greater cancer-related worry for 4 items (P < .001) and preference for self-management in 3 items (P < .001). Japanese CCSs showed greater preference for self-management, relative to that of Canadian CCSs, in 5 items (P < .001). In the expectation scale, Japanese CCSs showed lower levels of expectation concerning adult care in 6 of 12 items (P < .001). Relative to that of Canadian CCSs, a significantly higher number of Japanese CCSs preferred to visit the same doctor for long-term care as adults (P < .001). CONCLUSIONS The results confirmed the reliability and validity of the Transition Scales and showed that Japanese CCSs expressed fewer cancer concerns, but a higher number of Japanese CCSs preferred to visit the same doctor for long-term care as adults.
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Affiliation(s)
- Yasushi Ishida
- Department of Pediatrics, Ehime Prefectural Central Hospital, Ehime, Japan.,Heart Link Working Project, Niigata, Japan
| | - Mari Tezuka
- Department of Pediatrics, Ehime Prefectural Central Hospital, Ehime, Japan
| | | | - Fumiko Inoue
- Millefeuille Childhood Cancer Frontiers, Chiba, Japan
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Bergler-Klein J. Right from the heart: survivors of childhood cancer and the right ventricle. Eur Heart J Cardiovasc Imaging 2016; 17:742-3. [DOI: 10.1093/ehjci/jew052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Lown EA, Phillips F, Schwartz LA, Rosenberg AR, Jones B. Psychosocial Follow-Up in Survivorship as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S514-84. [PMID: 26700918 PMCID: PMC5242467 DOI: 10.1002/pbc.25783] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 01/08/2023]
Abstract
Childhood cancer survivors (CCS) have a high risk of medical late effects following cancer therapy. Psychosocial late effects are less often recognized. Many CCS do not receive long-term follow-up (LTFU) care, and those who do are rarely screened for psychosocial late effects. An interdisciplinary team conducted a systematic review of qualitative and quantitative studies to assess social, educational, vocational, psychological, and behavioral outcomes along with factors related to receipt of LTFU care. We propose that psychosocial screening be considered a standard of care in long-term follow-up care and that education be provided to promote the use LTFU care starting early in the treatment trajectory.
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Affiliation(s)
- E. Anne Lown
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
| | - Farya Phillips
- School of Social Work, The University of Texas at Austin, Austin, Texas
| | - Lisa A. Schwartz
- The Children’s Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abby R. Rosenberg
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Barbara Jones
- School of Social Work, The University of Texas at Austin, Austin, Texas
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Meacham LR, Williamson RS, Forehand RL, DeLoach BM, Rabinovitz SR, Huey MJ, Olson ML, Cottrell L, Edwards PJ, Cherven BO, Mertens AC. University Health Centers and Young Adult Survivors of Pediatric Cancer: Changes in Providers' Familiarity with and Practice of Survivor Care. J Adolesc Young Adult Oncol 2014. [DOI: 10.1089/jayao.2013.0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lillian R. Meacham
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
- Department of Pediatrics, Emory University, Atlanta, Georgia
| | - Rebecca S. Williamson
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | | | - Brian M. DeLoach
- University Health Services, Georgia Southern University, Statesboro, Georgia
| | | | - Michael J. Huey
- Student Health and Counseling Service, Emory University, Atlanta, Georgia
| | - Maureen L. Olson
- Stamps Health Services, Georgia Institute of Technology, Atlanta, Georgia
| | - Leslie Cottrell
- Student Health Services, University of West Georgia, Carrollton, Georgia
| | | | - Brooke O. Cherven
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Ann C. Mertens
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
- Department of Pediatrics, Emory University, Atlanta, Georgia
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