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Arpaci T, Altay N. Psychosocial interventions for childhood cancer survivors: Systematic review and meta-analysis of randomized control trials. Eur J Oncol Nurs 2024; 69:102541. [PMID: 38460392 DOI: 10.1016/j.ejon.2024.102541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE This study was aimed to review and analyze the evidence of the psychosocial interventions for survivors of childhood cancer. METHODS Electronic databases (PubMed, Embase, Medline, Web of Science, Science Direct, and Scopus) and manuel search were performed for psychosocial randomised controlled trials (RCTs) conducted with survivors who were diagnosed under the age of 18 and have completed treatment. Meta-analyses were performed to evaluate the effects of interventions on psychosocial health outcomes. The trials were published in English between 1 January 2000 to 30 June 2022 were included. Extracted data were analyzed using Review Manager 5.4. RESULTS Ten trials conducted with 955 childhood cancer survivors were included in the systematic review. Meta-analysis of six RCTs showed no difference in the general quality of life (SMD, 0.07; 95% CI: [-0.09 to 0.23], I2 0%, (p > 0.05)) and three RCTs showed no difference in the physical activity self-efficacy (SMD, 0.12; 95% CI: [-0.35 to 0.58], I2 75%, (p > 0.05)) between intervention and control group. Interventions longer than 24 weeks (including follow-up) were effective in the quality of life and physical activity self-efficacy of the survivors. The overall quality of the evidence was low due to overall low risk of bias for only half of the studies (50%). CONCLUSIONS Psychosocial interventions were not effective on quality of life and physical activity self-efficacy of childhood cancer survivors, however, long-term interventions provided improvement in these outcomes. REGISTRATION The protocol for the meta-analysis was registered at PROSPERO (CRD42022375053/22 Nov 2022).
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Affiliation(s)
- Tuba Arpaci
- Department of Nursing, Faculty of Health Sciences, Karamanoglu Mehmetbey University, 70200, Karaman, Türkiye.
| | - Naime Altay
- Department of Pediatric Nursing, Faculty of Nursing, Gazi University, 06490, Ankara, Türkiye.
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Pitt E, Cashion C, Rumble S, Bradford N. Associations between Health Behaviors, Health Self-Efficacy, and Long-Term Outcomes in Survivors of Childhood Cancer: A Cross-Sectional Study. Semin Oncol Nurs 2023; 39:151434. [PMID: 37147151 DOI: 10.1016/j.soncn.2023.151434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/26/2023] [Accepted: 03/29/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES Many survivors of childhood cancer experience multiple long-term chronic health conditions. Health behaviors are important because they contribute to chronic disease yet are highly modifiable. With growing pressure on cancer services, alternative models of care are required to address survivorship care needs. The authors sought to inform the development of a community-based model of cancer survivorship care for young people. This exploratory cross-sectional study aimed to assess the feasibility of study measures and processes, as well as investigate associations between various modifiable health behaviors, health self-efficacy, quality of life, and persistent symptoms. DATA SOURCES Participants were recruited from a long-term follow-up clinic for childhood cancer survivors. A self-report survey was completed, and participants received an activity tracker. Bivariate regression analyses were used to explore the relationship between variables. CONCLUSIONS The study measures and processes were deemed feasible with >70% of eligible survivors enrolling in the study and completing >70% of study measures. Thirty participants (mean age 22 ± 4.4 years) were enrolled; 83.3% finished treatment ≥5 years previously and 36.7% were overweight or obese. Bivariate regression identified those with higher scores of health self-efficacy were more likely to meet physical activity guidelines, as were those who achieved more sleep and consumed greater servings of vegetables. Meeting the physical activity guidelines, was significantly positively associated with higher quality of life and self-efficacy. IMPLICATIONS FOR NURSING PRACTICE Interventions that target health self-efficacy have the potential to improve a range of health behaviors and long-term outcomes for survivors of childhood cancer. Nurses are ideally placed to use this knowledge to support patients with recommendations to optimise their recovery and rehabilitation.
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Affiliation(s)
- Erin Pitt
- Research Fellow, School of Nursing and Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Christine Cashion
- Research Nurse, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Shelley Rumble
- Clinical Nurse Survivorship, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane
| | - Natalie Bradford
- Professor, School of Nursing and Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia.
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Kang KA, Han SJ, Chun J, Kim HY, Oh Y, Yoon H. Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis. CHILD HEALTH NURSING RESEARCH 2023; 29:111-127. [PMID: 37170490 PMCID: PMC10183760 DOI: 10.4094/chnr.2023.29.2.111] [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: 11/22/2022] [Accepted: 02/17/2023] [Indexed: 05/13/2023] Open
Abstract
PURPOSE This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). METHODS Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. RESULTS Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance. CONCLUSION Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.
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Affiliation(s)
- Kyung-Ah Kang
- Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Suk Jung Han
- Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Jiyoung Chun
- Assistant Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Hyun-Yong Kim
- Researcher, Logos Health Design Institute, Sahmyook University, Seoul, Korea
| | - Yerin Oh
- Researcher, College of Nursing, Sahmyook University, Seoul, Korea
| | - Heejin Yoon
- Researcher, College of Nursing, Sahmyook University, Seoul, Korea
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Ng DQ, Ritt-Olson A, Freyer DR, Miller KA, Thomas SM, Milam J, Chan A. Substance Use Among Young Adult Survivors of Childhood Cancer With Cognitive Impairment: An Analysis of the Project Forward Cohort. JCO Oncol Pract 2023; 19:e345-e354. [PMID: 36508698 PMCID: PMC10022886 DOI: 10.1200/op.22.00458] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Young adult childhood cancer survivors (YACCSs) are often impacted by cancer-related cognitive impairment (CRCI) and psychological distress. Using the Project Forward Cohort, we evaluated the relationship between CRCI and substance use behaviors. METHODS YACCSs were surveyed between 2015 and 2018 (N = 1,106, female = 50.8%, Hispanic = 51.5%, median age = 25.5 years). Associations between CRCI and substance use (tobacco, binge drinking, marijuana, prescription drug misuse, and e-cigarette/vaporizer) were examined in multivariate logistic or log-binomial regressions, adjusting for child at diagnosis (0-14 years), years since diagnosis, sex, race/ethnicity, cancer type, and treatment intensity. Mediation analysis was performed to determine opportunities for interventions. RESULTS CRCI was reported by 144 (13.0%) survivors. The highest prevalence was observed in CNS cancers (25.4%) and leukemia (13.3%) survivors. After covariate adjustment, CRCI was associated with 2.26 times the odds of prior 30-day vaping (95% CI, 1.24 to 4.11; P = .007). Mediators with significant indirect effects in the CRCI-vaping relationship include depressive symptoms (Center for Epidemiological Studies Depression Scale) and having two or more cancer-related late effects (P < .05). CONCLUSION CRCI among YACCSs was associated with reports of vaping. Oncologists should screen for vaping behavior if CRCI is apparent. Increasing access to long-term follow-up clinics, addressing physical and mental health issues, and monitoring and educating on vaping and other substance use behaviors is recommended to improve the long-term health of YACCSs.
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Affiliation(s)
- Ding Quan Ng
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA
| | - Anamara Ritt-Olson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - David R. Freyer
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Children's Hospital Los Angeles, Los Angeles, CA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Kimberly A. Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Stefanie M. Thomas
- Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH
| | - Joel Milam
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Epidemiology and Biostatistics, University of California Irvine, Irvine, CA
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA
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Rotz SJ, Yi JC, Hamilton BK, Wei W, Preussler JM, Cerny J, Deol A, Jim H, Khera N, Hahn T, Hashmi SK, Holtan S, Jaglowski SM, Loren AW, McGuirk J, Reynolds J, Saber W, Savani BN, Stiff P, Uberti J, Wingard JR, Wood WA, Baker KS, Majhail NS, Syrjala KL. Health-Related Quality of Life in Young Adult Survivors of Hematopoietic Cell Transplantation. Transplant Cell Ther 2022; 28:701.e1-701.e7. [PMID: 35872304 PMCID: PMC9547939 DOI: 10.1016/j.jtct.2022.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/06/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022]
Abstract
Young adults (YA), age 18 to 39 years, are at a stage of life that may make them more vulnerable than older adults to impairments in health-related quality of life (HRQOL) during and after hematopoietic cell transplantation (HCT). Health self-efficacy (HSE), the belief that one can implement strategies to produce a desired health outcome, has been associated with health outcomes in oncology research. Little is known about HRQOL or HSE in YA HCT survivors compared with older HCT survivors. Given the age-specific psychosocial challenges facing YA HCT recipients and research on non-transplant YA cancer survivors, we hypothesized that YA survivors would have worse post-HCT HRQOL compared with older adults, and that among YA HCT survivors, higher levels of HSE would be associated with higher levels of HRQOL and lower levels of cancer-related distress. This was a cross-sectional secondary analysis of 2 combined baseline datasets from multicenter studies of HCT survivors approached for participation in clinical trials of survivorship interventions. Participants from 20 transplantation centers in the United States were at 1 to 10 years post-HCT and age ≥18 years at the time of study enrollment, had no evidence of disease relapse/progression or subsequent malignancies, and could read English adequately to consent for and complete assessments. Medical record and patient-reported data were obtained for demographics and HCT-related clinical factors and complications (eg, total body irradiation, chronic graft-versus-host disease [cGVHD]). Participants completed surveys on HRQOL, including the Short-Form [SF]-12, HSE, and Cancer and Treatment Distress (CTXD), which includes 6 subscales and reports an overall mean score. On the SF-12, both the Mental Component Score (MCS) and Physical Component Score (PCS) were calculated. Two cohorts were compared: YAs (age 18 to 39 years at transplantation) and older adults (age ≥40 years at transplantation). Multiple linear regression analyses identified factors associated with HSE, PCS, MCS, and CTXD in YAs. In this analysis of 979 survivors, compared with the older adults, the YA participants had lower median mental health scores (SF-12 MCS: 48.40 versus 50.23; P = .04) and higher cancer-related distress (CTXD: .96 versus .85; P = .04), but better physical health (SF-12 PCS: 48.99 versus 47.18; P = .049). Greater overall cancer-related distress was driven by higher levels of uncertainty, financial concern, and medical demand subscales for YAs compared with older adults. Young adults also had lower HSE (2.93 versus 3.08; P = .0004). In a multivariate model, HSE was strongly associated with age group (P = .0005) after adjusting for multiple other transplantation-related factors. Among YAs, HSE was associated with the SF-12 MCS and PCS and the CTXD, and HSE remained significant after adjusting for other transplantation-related factors. Overall, the YA HCT survivors had lower mental health, increased cancer-related distress, and lower levels of HSE compared with the older adults. Although the direction of these effects cannot be determined with these data, the strong association between HSE and HRQOL among YAs suggests that targeting interventions to improve HSE may have broad impact on health outcomes.
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Affiliation(s)
- Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
| | - Jean C Yi
- Fred Hutchinson Cancer Center, University of Washington School of Medicine, Seattle, Washington
| | - Betty K Hamilton
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Wei Wei
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Jaime M Preussler
- National Marrow Donor Program/Be The Match; Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Jan Cerny
- University of Massachusetts, Chan Medical School, Department of Medicine, Div. of Hematology/Oncology, Worcester, Massachusetts
| | - Abhinav Deol
- Wayne State University, Karmanos Cancer Institute, Detroit, Michigan
| | - Heather Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | | | - Theresa Hahn
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Shahrukh K Hashmi
- Department of Medicine, SSMC, Abu Dhabi, UAE, Division of Hematology, Department of Medicine, Mayo Clinic, Minnesota
| | - Shernan Holtan
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | | | - Alison W Loren
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph McGuirk
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Cancer Center, Westwood, Kansas
| | - Jana Reynolds
- Blood & Marrow Transplant, Baylor University Medical Center, Dallas, Texas
| | - Wael Saber
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bipin N Savani
- Division of Hematology/ Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Patrick Stiff
- Loyola University Stritch School of Medicine, Maywood, Illinois
| | - Joseph Uberti
- Wayne State University, Karmanos Cancer Institute, Detroit, Michigan
| | | | - William A Wood
- Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Navneet S Majhail
- Sarah Cannon Transplant and Cellular Therapy Network, Nashville, Tennessee
| | - Karen L Syrjala
- Fred Hutchinson Cancer Center, University of Washington School of Medicine, Seattle, Washington
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Lam CS, Au KY, Hung HY, Chou HW, Leung AWK, Li CK, Koon HK, Cheung YT. Integrating Complementary Medicine Into the Care of Childhood Cancer Survivors: A Brief Report on the Preliminary Framework and Implementation of an Educational Program. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:897677. [PMID: 36189053 PMCID: PMC9397837 DOI: 10.3389/fresc.2022.897677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/16/2022] [Indexed: 11/24/2022]
Abstract
Background Existing educational programs typically include limited information on traditional, complementary, and integrative medicine (TCIM) for survivors of childhood cancer. Objectives This brief report presents the preliminary results of an educational program that aims to promote the safe and effective use of Chinese medicine (CM) among survivors in Hong Kong. Methods Survivors of childhood cancer, their caregivers, and oncology practitioners were invited to participate in a program that consists of two didactic seminars and a written educational booklet that disseminated information on the use of CM. A structured questionnaire was used to evaluate participants' receptivity toward and perceived relevance of the program. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to discuss the impact of the intervention. Results Reach: A total of 174 participants attended the seminars, and the seminar recording received over 380 views on social media platforms since April 2021. The hardcopy of the educational booklet was distributed to 43 recipients. The web-version of the booklet was sent to 67 participants and downloaded 143 times. Efficacy: The majority found that the content of the seminar useful (mean score = 5.04/6 points), especially the CM exercise (mean score = 4.88/6 points) and dietary advice (mean score = 4.99/6 points). Intention to adopt: The survivors (or their caregivers) reported that they would adopt advice on food therapies (83.3%) and traditional Chinese health exercises (55.6%) during survivorship. Conclusion The preliminary data on patient preferences will be applied to further develop educational materials and to establish a TCIM referral network within the cancer survivor community.
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Affiliation(s)
- Chun Sing Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kwok Yin Au
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hing Yu Hung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ho Wing Chou
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Alex Wing Kwan Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China
| | - Chi Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ho Kee Koon
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Ho Kee Koon
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Yin Ting Cheung
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Bradford N, Pitt E, Rumble S, Cashion C, Lockwood L, Alexander K. Persistent Symptoms, Quality of Life, and Correlates with Health Self-Efficacy in Adolescent and Young Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2021; 11:410-418. [PMID: 34582267 DOI: 10.1089/jayao.2021.0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: The numbers of adolescent and young adult (AYA) survivors of childhood cancer are exponentially growing. To ensure suitable services are available to meet the needs of this growing population, understanding the experience of late effects, quality of life, and potentially modifiable factors, such as self-efficacy, is required. Methods: AYA survivors of childhood cancer recruited through an After Cancer Therapy Service at a Children's Hospital rated their symptoms experience, quality of life, and self-efficacy using the Patient Reported Outcome Common Terminology Criteria for Adverse Events, Functional Assessment of Cancer Therapy-General (FACT-G), and Patient-Reported Outcomes Measurement Information System (PROMIS®), respectively. Descriptive statistics were used to characterize the sample. Quality-of-life scores were compared with population norms. Regression analyses were used to explore the relationships between symptom experience, quality of life, and self-efficacy. Results: Thirty participants (mean age 22 ± 4.4 years) reported an average of nine symptoms as persistently experienced at moderate or higher rated intensity among participants (standard deviation ±8.7; range: 0-32; interquartile range: 2-16); over half (n = 17, 56.7%) had finished treatment 10 or more years ago. Participants scored lower on the FACT-G Physical Well-being and Emotional Well-being, and higher on Social Well-being subscales than the general population. Around two-thirds of participants were confident in their ability to self-manage their health based on their health self-efficacy score. Bivariate linear regression identified a statistically significant increase in the overall quality of life with increased self-efficacy, adjusted for age and sex (0.60, 95% confidence interval [CI] 0.30-0.90, p < 0.01). Higher symptom burden was associated with a lower overall quality of life after adjusting for age and sex (-0.95, 95% CI: -1.35 to -0.54, p < 0.001). Conclusion: Young cancer survivors experience a substantial number of persistent symptoms related to their cancer treatment that may negatively impact aspects of their quality of life. Health self-efficacy is a potential target for future interventions.
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Affiliation(s)
- Natalie Bradford
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Erin Pitt
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shelley Rumble
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Christine Cashion
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Liane Lockwood
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Kimberly Alexander
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Demers C, Brochu A, Higgins J, Gélinas I. Complex behavioral interventions targeting physical activity and dietary behaviors in pediatric oncology: A scoping review. Pediatr Blood Cancer 2021; 68:e29090. [PMID: 33991403 DOI: 10.1002/pbc.29090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022]
Abstract
As cancer and its treatment negatively impacts the long-term health and quality of life of survivors, there is a need to explore new avenues to prevent or minimize the impact of adverse effects in children with cancer and cancer survivors. Therefore, this scoping review aimed to report on the state of the evidence on the use and effects of complex behavioral interventions (CBI) targeting physical activity and/or dietary behaviors in pediatric oncology. Fourteen quantitative studies were included, evaluating interventions that used a combination of two or three different treatment modalities. Overall, studies demonstrated that it is feasible to implement CBI and that they can potentially improve physical activity and dietary behaviors as well as patient outcomes such as physical and psychological health. Unfortunately, due to a paucity of studies and the heterogeneity of the studies included in this review, no conclusive evidence favoring specific interventions were identified.
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Affiliation(s)
- Catherine Demers
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Division of Haematology-Oncology, CHU Ste-Justine, Montreal, Quebec, Canada.,Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital Research Site, Laval, Quebec, Canada
| | - Annie Brochu
- Division of Haematology-Oncology, CHU Ste-Justine, Montreal, Quebec, Canada.,School of rehabilitation, University of Montreal, Montreal, Quebec, Canada
| | - Johanne Higgins
- Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital Research Site, Laval, Quebec, Canada.,School of rehabilitation, University of Montreal, Montreal, Quebec, Canada
| | - Isabelle Gélinas
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital Research Site, Laval, Quebec, Canada
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Cheung AT, Li WHC, Ho LLK, Chan GCF, Chung JOK. Parental perspectives on promoting physical activity for their children surviving cancer: A qualitative study. PATIENT EDUCATION AND COUNSELING 2021; 104:1719-1725. [PMID: 33234443 DOI: 10.1016/j.pec.2020.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/04/2020] [Accepted: 11/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Physical activity is vital for the healthy development of pediatric cancer survivors. We aimed to explore parental perception on the importance, the barriers to and facilitators of participating in physical activity for their children surviving cancer. METHODS A qualitative study, using a descriptive phenomenological approach, was conducted. Purposive sample of parents of pediatric cancer survivors aged 9-16 years and had completed treatment at least six months previously were participated in one-to-one semi-structured interviews conducted by two trained research nurses. Data analysis followed Colaizzi's descriptive phenomenology method. RESULTS Twenty-eight parents (64.3 % female) of pediatric cancer survivors were interviewed. Most parents lacked awareness and knowledge regarding the importance and benefits of physical activity in their child's survivorship. Major barriers identified were parental concern about their child performing physical activity, time constraints and lack of recreational facilities and activity provision. Parents reported that parental support, family involvement and child's interests and enjoyment appeared to be crucial facilitators of survivors' physical activity. CONCLUSION This study identified the barriers to and facilitators of engaging in physical activity of pediatric cancer survivors from the parental perspectives. PRACTICAL IMPLICATIONS The findings of the study is important for the development of health education to promote regular physical activity among pediatric cancer survivors.
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Affiliation(s)
- Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
| | | | | | | | - Joyce Oi Kwan Chung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Physical activity for pediatric cancer survivors: a systematic review of randomized controlled trials. J Cancer Surviv 2021; 15:876-889. [PMID: 33389553 PMCID: PMC7778568 DOI: 10.1007/s11764-020-00981-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
Purpose To collate evidence and evaluate the effects of physical activity interventions on physical activity level among pediatric cancer survivors who had completed active cancer treatment. Methods Relevant published studies were identified in May 2020 via five databases and reference checking. Searches were limited to randomized controlled trials or controlled clinical trials, published in English involving pediatric cancer survivors aged 18 years or below. Interventions were related to promote physical activity among the survivors. Included studies were assessed using the revised version of the Cochrane’s Risk of Bias Tool. Results Eight randomized controlled trials (620 pediatric cancer survivors and 53 caregivers of pediatric cancer survivors) were included. All studies investigated interventions for pediatric cancer survivors to increase their physical activity level. The interventions used varied across the eight included studies: three mHealth—medical and public health practice supported by mobile devices; two eHealth—the use of information and communication technologies to improve health care; two adventure-based training; and one educational program. Measures of physical activity level also varied: five used various objective measurements (i.e., accelerometer, pedometer, multisensory activity monitor); three used different self-reported questionnaires. Owing to high variability of the interventions and measures, it was impossible to perform meta-analysis. Overall, eHealth and mHealth interventions showed effectiveness and feasibility to promote physical activity among pediatric cancer survivors. Conclusions eHealth and mHealth interventions appear to be increasingly important strategies to promote physical activity among pediatric cancer survivors. Implications for Cancer Survivors Future larger-scale studies using a core-set of assessment tools are warranted to further promote regular physical activity in pediatric cancer survivors.
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