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Mogensen N, Kreicbergs U, Albertsen BK, Lähteenmäki PM, Heyman M, Harila A. Quality of life in children and adolescents after treatment for acute lymphoblastic leukemia according to the NOPHO ALL2008 protocol. Pediatr Blood Cancer 2024; 71:e31018. [PMID: 38644601 DOI: 10.1002/pbc.31018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/27/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND The improved outcome of childhood acute lymphoblastic leukemia (ALL) over the last decades has increased the importance of assessing late effects and health-related quality of life (HRQoL), particularly when evaluating and comparing outcomes in clinical trials. This study aimed to assess HRQoL in children treated for ALL according to the NOPHO ALL2008 protocol. PROCEDURE Children, aged 1 to less than 18 years at diagnosis, alive in first remission, and their parents, were asked to complete PedsQL 4.0 Generic Core Scales (self- and proxy-report) at ≥6 months after end of therapy. Data on socioeconomic factors and parent-reported toxicity were collected through a study-specific questionnaire, and the NOPHO ALL2008 database was used to identify eligible families and add additional disease- and treatment-related data. HRQoL data were collected during 2013-2019 in Sweden, Finland, and Denmark. RESULTS A total of 299 children were included. The older children (8 years and older) reported similar HRQoL scores compared to Finnish reference data, except lower scores for School Functioning in high-risk patients. Scores from the parent-proxy and self-reports from 5-7-year olds were notably lower than reference. Parent-reported toxicity was associated with lower total and physical HRQoL scores in adjusted models for younger as well as older children in the self-report and parent-proxy versions, and also with lower psychosocial score in the parent-proxy. CONCLUSIONS Self-reported HRQoL was similar to reference population. The most important determinant for HRQoL after end of ALL treatment was parent-reported toxicity during treatment. Thus, minimizing complications is an obvious focus for future treatment protocols.
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Affiliation(s)
- Nina Mogensen
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Louis Dundas Centre for Children's Palliative Care, Great Ormond Street Institute of Child Health, University College London, London, England
| | - Birgitte Klug Albertsen
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Päivi M Lähteenmäki
- Turku University Hospital, University of Turku, and FICAN-West, Turku, Finland
- Swedish Childhood Cancer Registry, Karolinska Institutet, Stockholm, Sweden
| | - Mats Heyman
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Arja Harila
- Department of Women's and Children's Health, Uppsala University and Pediatric Oncology, Uppsala University Hospital, Uppsala, Sweden
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Galtieri LR, Perez MN, Barakat LP. Quality of life of caregivers at the end of their child's pediatric cancer treatment: cancer-specific worry and material hardship. J Pediatr Psychol 2024; 49:348-355. [PMID: 38457310 DOI: 10.1093/jpepsy/jsae014] [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: 09/05/2023] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE Emerging research suggests that completion of pediatric cancer treatment can be challenging for caregivers given shifting roles and responsibilities. Lower caregiver quality of life (QOL) has been associated with cancer-related variables, higher cancer caregiving strain, and more household material hardship during pediatric cancer treatment. Caregiver QOL at the end of treatment has not been fully investigated but has implications for child and family well-being. Using a psycho-oncology framework, this study aimed to understand the cumulative burden of household material hardship and cancer-related factors on caregiver QOL at the end of treatment. METHODS Caregivers (N = 143) of children (Mage=10.51 years) within 1 year of ending active cancer treatment completed self-report questionnaires assessing their QOL, cancer-specific worry, and material hardship (e.g., housing, insurance). Total months of active cancer treatment were extracted from the medical record. Hierarchical linear regression was used to test the relative effects of length of treatment, material hardship, and cancer-specific worry on caregiver QOL. RESULTS Cancer-specific worry was significantly associated with and accounted for significant variance in caregiver QOL, above and beyond the length of treatment and material hardship. Caregivers who endorsed more cancer-specific worry had poorer QOL. Material hardship was also significantly associated with caregivers' QOL, but length of treatment was not. CONCLUSIONS Caregivers with sufficient resources and less worry about cancer have higher QOL. Findings highlight the importance of end-of-treatment screening of caregivers' subjective cancer-specific worry in addition to material hardship, irrespective of their cancer-related stressors, for ongoing psychosocial support.
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Affiliation(s)
- Liana R Galtieri
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Megan N Perez
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lamia P Barakat
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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3
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Hosseinchi P, Ghalibaf E, Kamyab G, Eghbali A, Khatibi A. Health anxiety and the negative interpretation of children's bodily symptoms in mothers of cancer patients. J Cancer Surviv 2024; 18:157-164. [PMID: 37470950 PMCID: PMC10866749 DOI: 10.1007/s11764-023-01431-z] [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: 11/03/2022] [Accepted: 07/11/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE Fear of progression (FoP) is a substantial concern for family caregivers of cancer survivors and is related to a number of adverse outcomes, including increased mental distress and worse quality of life. Previous research has revealed that health anxiety (HA) contributes to fear of relapse, but cognitive factors underlying establishing and maintaining FoP in mothers of cancer patients have not been examined. In this study, we were looking to investigate this association. METHODS We used the computerized interpretation bias (IB) assessment to investigate the biased interpretation of ambiguous bodily information and its association with FoP through HA among 69 mothers of cancer patients and 42 mothers of healthy kids. RESULTS Mothers of cancer patients interpreted more negatively ambiguous bodily symptoms than mothers of healthy kids. Moreover, they had higher levels of HA and FoP and lower quality of life than the healthy group. Also, among mothers of cancer patients, the relationship between negative IB and FoP is mediated by their HA. CONCLUSIONS The findings of this study imply that negative IB may contribute to increased HA, which in turn contributes to higher levels of FoP among the mothers of cancer patients, which may reduce the quality of life of their children. IMPLICATIONS FOR CANCER SURVIVORS From these findings, we propose that changing HA through modification of IB might lower the FoP in mothers of kids with cancer and improve the mother and child's quality of life.
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Affiliation(s)
| | | | - Golnoosh Kamyab
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
- CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
| | - Aziz Eghbali
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
- Ali-Asghar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
- Institute for Mental Health, University of Birmingham, Birmingham, UK.
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Wijaya EA, Solek P, Rachmadi D, Rahayuningsih SE, Tarigan R, Hilmanto D. Effect of Executive Function on Health-Related Quality of Life in Children with Chronic Kidney Disease. Int J Nephrol Renovasc Dis 2024; 17:17-28. [PMID: 38223907 PMCID: PMC10785681 DOI: 10.2147/ijnrd.s428657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/21/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction As the highest function in the brain that regulates our daily activity, executive dysfunction might affect someone's health-related quality of life (HRQoL), especially in those with chronic diseases, including chronic kidney disease (CKD). Neurocognitive functions, including intelligence quotient (IQ) and executive function can be affected through various mechanisms in CKD. However, there was still no specific study regarding how IQ and executive function might affect HRQoL in children with CKD. Purpose To assess Executive Function's impact on HRQoL and to find association between treatment modalities and CKD stages with HRQoL in children with CKD. Methods A cross sectional study was conducted at Pediatric Nephrology Clinic at Hasan Sadikin General Hospital, Bandung, Indonesia from September 2022 to April 2023. We included 38 children whose age range were 6-16 years 11 months old with CKD stage III - V. Assessment tools used were: BRIEF questionnaire for executive function; WISC III tool for IQ; PedsQLTM questionnaire generic module for HRQoL. Data was analyzed using SPSS ver. 26.0. Results Total number of samples was 38. Complete examinations were done on 30 patients. Eight other patients did not undergo the IQ test. There was a negative correlation between executive function components scores (GEC, BRI, MI) with HRQoL scores on parents' proxy in all domains. We found no correlation between HRQoL and IQ scores, but we found a correlation between IQ and CKD stage. There was a significant difference in HRQoL from the children's perspective among the three modalities; children who underwent conservative treatment were having the best HRQoL scores. Conclusion Interventions to improve executive function of children with CKD should be done to improve their HRQoL in the future. Early diagnosis and treatment of CKD should be done at the earliest to improve neurocognitive function and HRQoL.
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Affiliation(s)
- Elrika Anastasia Wijaya
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Purboyo Solek
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dedi Rachmadi
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Sri Endah Rahayuningsih
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Rodman Tarigan
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dany Hilmanto
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
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Rudra S, Ali A, Powell JM, Hastings RP, Totsika V. Psychological distress and convergence of own and proxy health-related quality of life in carers of adults with an intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:74-83. [PMID: 37698226 DOI: 10.1111/jir.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 06/11/2023] [Accepted: 08/24/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND In adults with an intellectual disability, health-related quality of life (HRQoL) is often measured by proxy report. This cross-sectional study investigated whether the mental health of proxy raters impacts the way they rate HRQoL. METHODS In this study, 110 carers of adults with an intellectual disability completed measures of psychological distress (Kessler-6) and HRQoL (EQ-5D-3L) about their own HRQoL and that of the care recipient. Differences between HRQoL scores as rated by the carer about themselves and the care recipient were calculated (convergence scores) and multiple regression models were fitted to estimate the association between proxy psychological distress and convergence scores for subjective/objective HRQoL controlling for support needs of the care recipient, carer age and gender of care recipient. RESULTS There was a significant association between psychological distress and subjective HRQoL convergence scores (r = .92; P = 0.03; 95%; CI: -1.76 to -0.09). There was no association between psychological distress and objective HRQoL convergence scores (r = .01; CI -0.02 to 0.001; P = 0.08). The association between psychological distress and HRQoL scores was no longer present when models did not include convergence scores. CONCLUSIONS Carers experiencing more psychological distress tended to rate their own and the care recipients' subjective HRQoL more similarly. Objective HRQoL measures did not show this convergence in scores with increasing carer psychological distress. Findings differed when the analysis approach was changed, suggesting the results above require replication in future studies.
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Affiliation(s)
- S Rudra
- Division of Psychiatry, University College London, London, UK
| | - A Ali
- Luton and Bedford Disability Service, East London NHS Foundation Trust, London, UK
- Wolfson Institute for Population Health, Queen Mary University, London, UK
| | - J M Powell
- Centre for Research in Health and Social Care, School for Policy Studies, University of Bristol, Bristol, UK
| | - R P Hastings
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - V Totsika
- Division of Psychiatry, University College London, London, UK
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
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Winzig J, Inhestern L, Paul V, Nasse ML, Krauth KA, Kandels D, Rutkowski S, Escherich G, Bergelt C. Parent-reported health-related quality of life in pediatric childhood cancer survivors and factors associated with poor health-related quality of life in aftercare. Qual Life Res 2023; 32:2965-2974. [PMID: 37204653 PMCID: PMC10474174 DOI: 10.1007/s11136-023-03436-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Despite advances in cancer treatment, there is a prevalence of pediatric childhood cancer survivors still at risk of developing adverse disease and treatment outcomes, even after the end of treatment. The present study aimed to (1) explore how mothers and fathers assess the health-related quality of life (HRQoL) of their surviving child and (2) evaluate risk factors for poor parent-reported HRQoL in childhood cancer survivors about 2.5 years after diagnosis. METHODS We assessed parent-reported HRQoL of 305 child and adolescent survivors < 18 years diagnosed with leukemia or tumors of central nervous system (CNS) with the KINDL-R questionnaire in a prospective observational study with a longitudinal mixed-methods design. RESULTS In agreement with our hypotheses, our results show that fathers rate their children's HRQoL total score as well as the condition-specific domains family (p = .013, d = 0.3), friends (p = .027, d = 0.27), and disease (p = .035, d = 0.26) higher than mothers about 2.5 years after diagnosis. Taking variance of inter-individual differences due to family affiliation into account, the mixed model regression revealed significant associations between the diagnosis of CNS tumors (p = .018, 95% CI [- 7.78, - 0.75]), an older age at diagnosis, (p = .011, 95% CI [- 0.96, - 0.12]), and non-participation in rehabilitation (p = .013, 95% CI [- 10.85, - 1.28]) with poor HRQoL in children more than 2 years after being diagnosed with cancer. CONCLUSION Based on the results, it is necessary for health care professionals to consider the differences in parental perceptions regarding children's aftercare after surviving childhood cancer. High risk patients for poor HRQoL should be detected early, and families should be offered support post-cancer diagnosis to protect survivors' HRQoL during aftercare. Further research should focus on characteristics of pediatric childhood cancer survivors and families with low participation in rehabilitation programs.
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Affiliation(s)
- Jana Winzig
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Verena Paul
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Mona L Nasse
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany
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Differences in health-related quality of life in children with chronic kidney disease as reported by children and parent proxies. Pediatr Nephrol 2023; 38:519-528. [PMID: 35678879 DOI: 10.1007/s00467-022-05621-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Correlation between reports of children and parent for health-related quality of life (HRQOL) is not well studied. This study aims to assess the degree of agreement between child self- and parent proxy-rated HRQOL and to identify factors associated with discordance at baseline and during follow-up in Taiwanese children with chronic kidney disease (CKD). METHODS This study includes pediatric patients aged 5-18 years with confirmed CKD. Participants completed the generic version of the Pediatric Quality of Life Inventory (PedsQL) at baseline and every 6 months during follow-up. Child-parent agreement on HRQOL reports was assessed using intraclass correlation coefficient (ICC). Multivariate regression models were used to determine factors associated with child-parent discordance. RESULTS Of the 112 child-parent dyads included in the analysis, 97 dyads with 640 patient visits were assessed in 4.5 years. Children reported higher total scores on the physical and psychosocial domains as compared to their parent proxies. ICC was low (< 0.5) for the psychosocial domain and moderate for the physical health domain at initial assessment and slightly increased for the physical health (0.62) and for school functioning (0.51) during follow-up. Development of mineral bone disorder/anemia (β, 11.75 [3.77-19.72]) and proteinuria (β, 8.48 [1.15-15.81]) in the follow-up were associated with increased discordance in school functioning, and fathers with chronic disease were associated with increased discordance in social functioning (β, 4.21 [0.68-7.74]). CONCLUSIONS Parent proxy consistently estimated lower PedsQL score compared to self-reports of children. Child self-rated psychosocial health domains should be evaluated whenever possible to better elucidate treatment outcome over time. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Yu PK, Cook K, Liu J, Amin RS, Derkay C, Elden LM, Garetz SL, George AS, Ibrahim S, Ishman SL, Kirkham EM, Naqvi SK, Radcliffe J, Ross KR, Shah GB, Tapia IE, Taylor HG, Zopf DA, Redline S, Baldassari CM. Comparison of Caregiver- and Child-Reported Quality of Life in Children With Sleep-Disordered Breathing. Otolaryngol Head Neck Surg 2023; 168:74-81. [PMID: 35259027 DOI: 10.1177/01945998221083288] [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: 11/04/2021] [Accepted: 02/08/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Caregivers frequently report poor quality of life (QOL) in children with sleep-disordered breathing (SDB). Our objective is to assess the correlation between caregiver- and child-reported QOL in children with mild SDB and identify factors associated with differences between caregiver and child report. STUDY DESIGN Analysis of baseline data from a multi-institutional randomized trial SETTING: Pediatric Adenotonsillectomy Trial for Snoring, where children with mild SDB (obstructive apnea-hypopnea index <3) were randomized to observation or adenotonsillectomy. METHODS The Pediatric Quality of Life Inventory (PedsQL) assessed baseline global QOL in participating children 5 to 12 years old and their caregivers. Caregiver and child scores were compared. Multivariable regression assessed whether clinical factors were associated with differences between caregiver and child report. RESULTS PedsQL scores were available for 309 families (mean child age, 7.0 years). The mean caregiver-reported PedsQL score was higher at 75.2 (indicating better QOL) than the mean child-reported score of 67.9 (P < .001). The agreement between caregiver and child total PedsQL scores was poor, with intraclass correlation coefficients of 0.03 (95% CI, -0.09 to 0.15) for children 5 to 7 years old and 0.21 (95% CI, 0.03-0.38) for children 8 to 12 years old. Higher child age and health literacy were associated with closer agreement between caregiver and child report. CONCLUSION Caregiver- and child-reported global QOL in children with SDB was weakly correlated, more so for young children. In pediatric SDB, child-perceived QOL may be poorer than that reported by caregivers. Further research is needed to assess whether similar trends exist for disease-specific QOL metrics.
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Affiliation(s)
- Phoebe Kuo Yu
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA.,Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kaitlyn Cook
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts, USA
| | - Jiayan Liu
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Raouf S Amin
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Craig Derkay
- Department of Otolaryngology, Eastern Virginia Medical School; Department of Pediatric Sleep Medicine, Children's Hospital of The King's Daughters, Norfolk, Virginia, USA
| | - Lisa M Elden
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Susan L Garetz
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Alisha S George
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sally Ibrahim
- Department of Pediatric Pulmonology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Stacey L Ishman
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.,Division of HealthVine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Erin M Kirkham
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - S Kamal Naqvi
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jerilynn Radcliffe
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kristie R Ross
- Department of Pediatric Pulmonology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Gopi B Shah
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ignacio E Tapia
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - H Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - David A Zopf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Cristina M Baldassari
- Department of Otolaryngology, Eastern Virginia Medical School; Department of Pediatric Sleep Medicine, Children's Hospital of The King's Daughters, Norfolk, Virginia, USA
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Hetherington K, Wakefield CE, Kunalan KPK, Donoghoe MW, McGill BC, Fardell JE, Daly R, Deyell RJ, Ziegler DS. Quality of Life (QoL) of Children and Adolescents Participating in a Precision Medicine Trial for High-Risk Childhood Cancer. Cancers (Basel) 2022; 14:5310. [PMID: 36358729 PMCID: PMC9656810 DOI: 10.3390/cancers14215310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/06/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2023] Open
Abstract
Precision medicine is changing the treatment of childhood cancer globally, however little is known about quality of life (QoL) in children and adolescents participating in precision medicine trials. We examined QoL among patients enrolled in PRISM, the Zero Childhood Cancer Program's precision medicine trial for high-risk childhood cancer. We assessed patient QoL via self-report (aged 12-17 years) and parent-proxy (aged 4-17 years) completion of the EQ-5D-Y. We analysed data using descriptive statistics and regression models. Patients (n = 23) and parents (n = 136) provided data after trial enrolment and following receipt of trial results and treatment recommendations (n = 8 patients, n = 84 parents). At enrolment, most patients were experiencing at least some difficulty across more than one QoL domain (81% patient self-report, 83% parent report). We did not find strong evidence of a change in QoL between timepoints, or of demographic or disease factors that predicted parent-reported patient QoL (EQ-VAS) at enrolment. There was strong evidence that receiving a treatment recommendation but not a change in cancer therapy was associated with poorer parent-reported patient QoL (EQ-VAS; Mdiff = -22.5, 95% CI: -36.5 to -8.5, p = 0.006). Future research needs to better understand the relationship between treatment decisions and QoL and would benefit from integrating assessment of QoL into routine clinical care.
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Affiliation(s)
- Kate Hetherington
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Claire E. Wakefield
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Kavitha P. K. Kunalan
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Brittany C. McGill
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Joanna E. Fardell
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Western Sydney Youth Cancer Service, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Rebecca Daly
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | | | - David S. Ziegler
- Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Children’s Cancer Institute, UNSW Sydney, Sydney, NSW 2052, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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10
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Rheel E, Heathcote LC, van der Werff Ten Bosch J, Schulte F, Pate JW. Pain science education for children living with and beyond cancer: Challenges and research agenda. Pediatr Blood Cancer 2022; 69:e29783. [PMID: 35593047 DOI: 10.1002/pbc.29783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/05/2022]
Abstract
Pain in children living with and beyond cancer is understudied and undertreated. Pain science education (PSE) is a conceptual change strategy facilitating patients' understanding of the biopsychosocial aspects of pain. Preliminary studies on the adaptation of PSE interventions to adults with and beyond cancer provide a foundation for pediatric research. PSE could help childhood cancer survivors experiencing persistent pain and pain-related worry after active treatment. PSE may also help children receiving cancer treatment, providing them with a foundation of adaptive pain beliefs and cognitions, and preparing them for procedural and treatment-related pain. We direct this paper toward pediatric oncology clinicians, policy makers, and researchers working with children living with and beyond cancer. We aim to (a) identify challenges in adapting PSE for children living with and beyond cancer, (b) offer possible solutions, and (c) propose research questions to guide the implementation of PSE for children living with and beyond cancer.
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Affiliation(s)
- Emma Rheel
- Pain in Motion research group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Lauren C Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | | | - Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joshua W Pate
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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11
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Mogensen N, Saaranen E, Olsson E, Klug Albertsen B, Lähteenmäki P, Kreicbergs U, Heyman M, Harila‐Saari A. Quality of life in mothers and fathers of children treated for acute lymphoblastic leukaemia in Sweden, Finland and Denmark. Br J Haematol 2022; 198:1032-1040. [PMID: 35852790 PMCID: PMC9543076 DOI: 10.1111/bjh.18350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/28/2022]
Abstract
Acute lymphoblastic leukaemia (ALL) has a high survival rate, but treatment is lengthy with risk of severe side‐effects, which may also impact parents' health‐related quality of life (HRQOL). We present data on 526 parents of 310 children treated for ALL according to the NOPHO ALL2008‐protocol, in Sweden, Finland and Denmark. Parents were asked to complete the 36‐Item Short Form Survey (SF‐36) at least 6 months after end of treatment and data were compared with Norwegian reference data. Parental background factors were collected via a study‐specific questionnaire. Participating parents scored significantly lower than the reference population on both physical and mental summary indexes, but only surpassed a minimal clinically important difference for the mental summary index (Mental Component Summary [MCS]). Mothers scored lower than fathers in the MCS and stopped working and took care of the affected child more often than the fathers. Higher mental HRQOL was associated with male gender and living in Finland or Denmark (compared to Sweden). Correlations within spouses in physical and mental scores were weak to moderate. In conclusion, ALL negatively affects parental HRQOL, especially the mental domains, even after treatment. Findings suggest that mothers are more affected than fathers and may require extra support.
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Affiliation(s)
- Nina Mogensen
- Department of Pediatric Oncology Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
| | - Ella Saaranen
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Erik Olsson
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Birgitte Klug Albertsen
- Department of Pediatrics and Adolescent Medicine Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine, Faculty of Medicine University of Aarhus Aarhus Denmark
| | - Päivi M. Lähteenmäki
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
- Department of Pediatrics and Adolescent Medicine Turku University Hospital, and Turku University Turku Finland
| | - Ulrika Kreicbergs
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
- Department of Health Care Sciences, Palliative Research Centre Marie Cederschiöld University Stockholm Sweden
| | - Mats Heyman
- Department of Pediatric Oncology Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
| | - Arja Harila‐Saari
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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12
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Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor 2022; 4:e0716. [PMID: 35733611 PMCID: PMC9203075 DOI: 10.1097/cce.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
It is unknown which families are at risk for poor outcomes following a child’s critical illness.
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13
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TAPAK LEILI, CHERAGHI FATEMEH, SADEGHI AMIR, SHIRMOHAMMADI NASRIN, FEIZYBARNAJI AKRAM. Usefulness of the SF-36 Health Survey questionnaire in screening for health-related quality of life among parents of children with cancer: Latent profile analysis. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E142-E151. [PMID: 35647388 PMCID: PMC9121687 DOI: 10.15167/2421-4248/jpmh2022.63.1.2279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 02/08/2022] [Indexed: 11/05/2022]
Abstract
Background Poor health-related quality of life (HRQOL) of parents of children with cancer as their main caregivers can adversely affect child's HRQOL. Short Form-36 Health Survey (SF-36) is a widely used instrument to measure HRQOL. However, there are no clearly defined cut-off points for screening for parents with poor HRQOL. This study aimed to find appropriate cut-off points for the SF-36 questionnaire in a sample of parents of children with cancer using latent profile analysis to add another possibility to use it. Methods In this cross-sectional study, a number of 108 couples (108 mothers and 108 fathers), who had children with cancer, were selected by simple random sampling method from the patients' files. The study was conducted at two settings, pediatric hematology/oncology wards of BESAT hospital (a hospital related to Hamadan University of Medical Sciences, Iran) in 2017. Latent Profile analysis (LPA) method was used to determine appropriate cut-off points for the SF-36 questionnaire. Data was analyzed by Mplus and R3.3.0 software. Results Based on the results, scores ≤ 44, 45-63 and ≥ 64 for mental health, and scores ≤ 43, 44-59 and ≥ 60 for physical health classes indicate weak, medium, and good, respectively. These cut-off points showed acceptable accuracy in classification of individuals. For the total quality of life, correct classification rates were 88%, 65% and 53% for each class respectively. For mental health (physical health), they were 79(63), 50(62) and 52(63) for each class respectively. Conclusions The cut-off points for the classes identified here can be useful in screening parents of children with cancer in clinical setting to provide clinical interventions to protect vulnerable parents from negative outcomes.
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Affiliation(s)
- LEILI TAPAK
- Department of Biostatistics, School of Public Health and Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - FATEMEH CHERAGHI
- Chronic Disease (Home Care) Research Center, Hamadan University of Medial Sciences, Hamadan, Iran
- Correspondence: Fatemeh Cheraghi, Chronic Disease (Home Care) Research CentercHamadan University of Medial Sciences, Hamadan, Iran - E-mail:
| | - AMIR SADEGHI
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - NASRIN SHIRMOHAMMADI
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - AKRAM FEIZYBARNAJI
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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14
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The impact of CNS-directed treatment on quality of life in childhood cancer survivors. Qual Life Res 2022; 31:817-829. [PMID: 34455525 PMCID: PMC8882709 DOI: 10.1007/s11136-021-02984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Pediatric cancer survivors may have lower quality of life (QoL), but most research has assessed outcomes either in treatment or long-term survivorship. We focused on early survivorship (i.e., 3 and 5 years post-diagnosis), examining the impact of CNS-directed treatment on child QoL, as well as sex and age at diagnosis as potential moderators. METHODS Families of children with cancer (ages 5-17) were recruited at diagnosis or relapse (N = 336). Survivors completed the PedsQL at 3 (n = 96) and 5 years (n = 108), along with mothers (101 and 105, respectively) and fathers (45 and 53, respectively). The impact of CNS treatment, sex, and age at diagnosis on child QoL was examined over both time since diagnosis and time since last treatment using mixed model analyses. RESULTS Parent-report of the child's total QoL was in the normative range and stable between 3 and 5 years when examining time since diagnosis, while child reported QoL improved over time (p = 0.04). In terms of time since last treatment, mother and child both reported the child's QoL improved over time (p = 0.0002 and p = 0.0006, respectively). Based on parent-report, males with CNS-directed treatment had lower total QoL than females and males who did not receive CNS-directed treatment. Age at diagnosis did not moderate the impact of treatment type on total QoL. CONCLUSIONS Quality of life (QoL) in early survivorship may be low among males who received CNS-directed treatment. However, this was only evident on parent-report. Interventions to improve child QoL should focus on male survivors who received CNS-directed treatment, as well as females regardless of treatment type.
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15
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Yousef B, Abdelkarim M, AwadElseed R, Alsanosi M, Badi S, Abdulraheem M, Nasser N. Assessment of quality of life among pediatric patients with cancer in khartoum oncology hospital: A cross-sectional pilot study. MATRIX SCIENCE MEDICA 2022. [DOI: 10.4103/mtsm.mtsm_17_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Day M, Harris S, Hussein D, Saka MY, Stride C, Jones M, Makin G, Rowe R. The efficacy of interactive group psychoeducation for children with leukaemia: A randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2021; 104:3008-3015. [PMID: 33985845 DOI: 10.1016/j.pec.2021.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/30/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate an interactive group psychoeducation programme for children treated for leukaemia. METHODS A longitudinal randomised controlled study across four UK hospitals with an immediate (N = 26) and delay control group (N = 32). The intervention covered the pathophysiology of leukaemia, its treatment, side effects and the importance of positive health behaviours. Primary outcomes were parent-reported child health related quality of life (HRQoL) and behavioural difficulties. Secondary outcomes were child-reported HRQoL, cancer-specific HRQoL, child confidence, caregiver burden, and treatment anxiety. Measures were completed pre- and immediately post-intervention, and at 13 and 26-weeks follow-up. Change over time was analysed using multilevel modelling. Acceptability questionnaires rated the intervention on benefits, recommendations, and barriers to participation. RESULTS The intervention significantly improved parent-reported child HRQoL but did not have a significant effect on other outcomes. Acceptability of the intervention was high. CONCLUSIONS This study provides initial evidence that interactive group psychoeducation is acceptable to families and improves HRQoL in children with leukaemia. Difficulties with recruitment removed power to detect effect sizes that are plausible for psychoeducational interventions. PRACTISE IMPLICATIONS Further studies to explore the potential of psychoeducation to improve outcomes for children with leukaemia and an examination of barriers to participation within this population are warranted.
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Affiliation(s)
- Marianne Day
- Department of Psychology, University of Sheffield, UK.
| | - Sally Harris
- Royal Alexandra Children's Hospital, Eastern Road, Brighton BN2 5BE, UK.
| | - Deema Hussein
- King Fahd Medical Research Center, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences King Abdulaziz University, Saudi Arabia.
| | - Mohamad Yassin Saka
- King Fahd Medical Research Center, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences King Abdulaziz University, Saudi Arabia.
| | - Chris Stride
- Institute of Work Psychology, Management School, University of Sheffield, UK.
| | - Myles Jones
- Department of Psychology, University of Sheffield, UK.
| | - Guy Makin
- Division of Cancer Sciences, Faculty of Medicine, Biology and Health, University of Manchester and Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
| | - Richard Rowe
- Department of Psychology, University of Sheffield, UK.
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17
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Hartley J, Bluebond-Langner M, Candy B, Downie J, Henderson EM. The Physical Health of Caregivers of Children With Life-Limiting Conditions: A Systematic Review. Pediatrics 2021; 148:peds.2020-014423. [PMID: 34155131 DOI: 10.1542/peds.2020-014423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Parental caregiving for a child with a life-limiting condition (LLC) is complex physical and mental work. The impact of this caregiving on parents' physical health is unknown. OBJECTIVES (1) To review existing evidence on the physical health of parents caring for a child with a LLC and (2) to determine how physical health of parents is measured. DATA SOURCES Medline, Embase, PsycINFO, and Cumulative Index of Nursing and Allied Health Literature were searched. STUDY SELECTION Peer-reviewed articles were included if they reported primary data on the physical health of a caregiver of a child with a LLC. Studies were excluded if they described only the caregiver's mental health or if the caregivers were bereaved at the time of data collection. DATA EXTRACTION Of 69 335 unique citations, 81 studies were included in the review. RESULTS Caregiver health was negatively impacted in 84% of studies. Pain and sleep disturbance were the most common problems. Ways of measuring the physical health of caregiver varied widely. We found an absence of in-depth explorations of the social and economic contexts, which could potentially mitigate the impact of caregiving. Furthermore, we find health interventions tailored to this group remain largely unexplored. LIMITATIONS Studies were heterogenous in methodology, making comparisons of results across studies difficult. CONCLUSIONS These findings support the need for improving access to interventions aimed at improving physical health in this population. The rate of health-seeking behaviors, preventive health care access and screening for health conditions is understudied and represent important directions for further research.
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Affiliation(s)
- Julie Hartley
- Louis Dundas Centre for Children's Palliative Care, University College London Great Ormond Street Institute of Child Health.,Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, United Kingdom.,Department of Women and Children's Health, King's College London, London, United Kingdom
| | - Myra Bluebond-Langner
- Louis Dundas Centre for Children's Palliative Care, University College London Great Ormond Street Institute of Child Health.,Department of Sociology, Anthropology and Criminal Justice, Rutgers University-Camden, Camden, New Jersey, New Jersey
| | - Bridget Candy
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, United Kingdom
| | - Jonathan Downie
- Louis Dundas Centre for Children's Palliative Care, Great Ormond Street Hospital, National Health System Foundation Trust, London, United Kingdom.,Paediatric Supportive and Palliative Care Team, Royal Hospital for Children, Glasgow, United Kingdom
| | - Ellen M Henderson
- Louis Dundas Centre for Children's Palliative Care, University College London Great Ormond Street Institute of Child Health
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18
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Alabbas F, Elyamany G, Alkhayat N, AlShahrani M, Ibrahim W, Elborai Y, Binhassan A, Hamzi H, Al Thibani N, Alakel S, Alsharif F, Alsuhaibani O, Alsharif O. Assessment of Health-related Quality of Life in Saudi Children with Cancer. Health Serv Insights 2021; 14:11786329211029351. [PMID: 34285506 PMCID: PMC8264724 DOI: 10.1177/11786329211029351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 06/07/2021] [Indexed: 11/15/2022] Open
Abstract
Advances in pediatric cancer treatment and dramatic improvement in long-term survival have made health-related quality of life (HRQOL) a priority. This study describes the HRQOL of Saudi children on cancer treatment, given the paucity of data on the subject. Parents of children undergoing cancer treatment between the ages of 2 and 12 years enrolled to answer the Arabic version of the parent proxy report PedsQL™ 3.0 cancer module. The module items were reverse-scored to a linear scale from 0 to 100, in which higher scores indicated a better HRQOL. Of the 95 study participants, 61 (64.2%) were hematological malignancies and 34 (35.8%) solid malignancies. The mean score of our sample's total HRQOL was 72.3, which is in line with the results of similar studies worldwide. The lowest scores were observed for procedural anxiety (60.14), perceived physical appearance (67.37), and treatment anxiety (67.58), while the highest were for communication (80.21), nausea (78.32), and cognitive problems (78.32). Significant associations were reported between the patients aged younger than 5 years and procedural anxiety, those aged 5 years or older and perceived physical appearance, and frequent hospital visits and worry. Healthcare professionals should consider the poor HRQOL sub-scales and their associated risks to improve treatment outcomes.
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Affiliation(s)
- Fahad Alabbas
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ghaleb Elyamany
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Nawaf Alkhayat
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammad AlShahrani
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Walid Ibrahim
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Yasser Elborai
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Amal Binhassan
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hasna Hamzi
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Nour Al Thibani
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sami Alakel
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Faisal Alsharif
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Omar Alsuhaibani
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Omar Alsharif
- Department of Pediatric Hematology/Oncology and Bone Marrow Transplant, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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19
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Caru M, Perreault S, Levesque A, Sultan S, Desjardins L, Rondeau É, Romo L, Curnier D, Kern L. Validity and reliability of the French version of the Pediatric Quality of Life Inventory™ brain tumor module. Qual Life Res 2021; 30:2387-2404. [PMID: 33723696 DOI: 10.1007/s11136-021-02815-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Assessing health-related quality of life (HRQoL) is an increasingly important aspect of standard care in pediatric oncology. Currently, there is a gap in the availability of French questionnaires to assess the quality of life of French-speaking pediatric brain tumor (PBT) patients, which has important implications in the care of this population. The first aim of this study was to translate the original English Pediatric Quality of Life Inventory™ (PedsQL) brain tumor module version into French. The second aim was to describe the stability, repeatability and convergent validity of the French PedsQL brain tumor module. METHODS A total of 61 PBT patients were included in this study. Among them, 15 children and 20 parents participated in the translation process. As part of the validation study, 48 children and 48 parents answered the PedsQL brain tumor module twice, and the PedsQL generic core scales and the patient-reported outcomes measurement information system (PROMIS-37 pediatric profile v2.0) questionnaire were administered once to the participants. The mean age of the 25 boys and 23 girls was 8.3 ± 4.8 years. For temporal stability, we used intraclass correlation coefficients (ICCs), for repeatability, we used the Bland and Altman method to assess the accuracy at a 1-week interval, and we used Pearson's correlation coefficients for convergent validity between the PedsQL brain tumor module, PedsQL general module and the PROMIS. RESULTS Temporal stability for the parent proxy-reports (average ICC = 0.98) and the child self-reports (average ICC = 0.98) were excellent. There was a high absolute stability over a 1-week interval for the parent proxy-reports (ICC > 0.96) and child self-reports (ICC > 0.96). Convergent validity between parent proxy-reports and child self-reports was supported by positive correlations for five subscales. Children reported higher scores in cognitive problems and the movement and balance parameters than their parents and reported lower scores on the worry parameter than their parents. CONCLUSION The strong psychometric properties of the French version of the PedsQL brain tumor module indicate that it is a validate and reliable questionnaire to measure HRQoL in PBT patients. The availability of a French version of the PedsQL brain tumor module supports the wider dissemination of the assessment of HRQOL in PBT patients.
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Affiliation(s)
- Maxime Caru
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada. .,Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), Department of Psychology, University of Paris Nanterre, Nanterre, France. .,Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.
| | - Sébastien Perreault
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Ariane Levesque
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Serge Sultan
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Leandra Desjardins
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Émélie Rondeau
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Lucia Romo
- Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), Department of Psychology, University of Paris Nanterre, Nanterre, France.,Mental and Brain Diseases Clinic (CMME), INSERM U 1266, University Hospital Group Paris Psychiatry & Neuroscience, Paris, France
| | - Daniel Curnier
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada.,Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Laurence Kern
- Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), Department of Psychology, University of Paris Nanterre, Nanterre, France.,Laboratoire EA 29 31, Laboratoire Interdisciplinaire en Neurosciences, Physiologie et Psychologie: Apprentissages, Activité Physique et Santé (LINP2‑2APS), University of Paris Nanterre, Nanterre, Ile‑de‑France, France
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20
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Vercasson C, Auquier P, Michel G, Bertrand Y, Ansoborlo S, Tabone MD, Leverger G, Gandemer V, Baruchel A, Contet A, Dalle JH, Paillard C, Poirée M, Thouvenin-Doulet S, Sirvent N, Kanold J, Freycon C, Hamidou Z, Berbis J. Quality of life in parents of childhood leukemia survivors. A French Childhood Cancer Survivor Study for Leukemia study. Pediatr Blood Cancer 2020; 67:e28419. [PMID: 32798263 DOI: 10.1002/pbc.28419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Our objectives were to assess the quality of life (QoL) of parents of childhood leukemia survivors compared with population norms and to identify the determinants of parents' long-term QoL. METHODS Parents of minors who had survived childhood leukemia participating in the French LEA cohort (Leucémie de l'Enfant et de l'Adolescent-French Childhood Cancer Survivor Study for Leukemia) were asked to complete the French version of the WHOQOL-BREF. Results were compared with age- and sex-matched values from a French reference population. Parents' and survivors' characteristics likely to be associated with QoL, long after the child's leukemia diagnosis, were explored using multivariate analysis. RESULTS We included 487 parents (mean age 42.9 ± 6.0 years, mean follow-up time from diagnosis 7.3 ± 3.3 years). Compared with the reference population, scores for physical health and social relationships for parents of childhood leukemia survivors were significantly lower (P < 0.001, effect size = 0.24 and P < 0.001, effect size = 0.29, respectively) contrary to scores for psychological health which were significantly higher (P < 0.001, effect size = 0.29). Even if health- and cancer-related characteristics were associated with parents' QoL in some dimensions, the only factor associated with each of the three dimensions (social relationships, physical health, and psychological) in the multivariate analysis was the parent's financial situation. CONCLUSIONS Long after leukemia diagnosis, the parents reported lower scores in the physical health and social relationship domains. Despite the difficulties of actually influencing socioeconomic characteristics, it is important to consider the social situation of each family in the long-term care of survivors and their families.
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Affiliation(s)
- Camille Vercasson
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
| | - Pascal Auquier
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
| | - Gérard Michel
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France.,Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille Univ, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology and Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - André Baruchel
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Audrey Contet
- Department of Pediatric Onco-Haematology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Maryline Poirée
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | | | - Nicolas Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital, Montpellier, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Claire Freycon
- Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, France
| | - Zeinab Hamidou
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France.,National Clinical Research Quality of Life in Oncology Platform, Nancy, France
| | - Julie Berbis
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
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21
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Limbers CA, McCollum C, Greenwood E. Physical activity moderates the association between parenting stress and quality of life in working mothers during the COVID-19 pandemic. Ment Health Phys Act 2020; 19:100358. [PMID: 33072187 PMCID: PMC7548083 DOI: 10.1016/j.mhpa.2020.100358] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 01/07/2023]
Abstract
STATEMENT OF PROBLEM Working mothers are a population experiencing heightened levels of parenting stress during the COVID-19 pandemic. The purpose of the current study was to evaluate the associations between parenting stress, quality of life, and physical activity in a national sample of working mothers who endorsed having been forced to work from home full-time due to the COVID-19 pandemic and examine if physical activity moderates the association between parenting stress and quality of life in this sample of working mothers. METHODS Participants in this cross-sectional study were 200 full-time working mothers from the United States (mean age = 33.50 years; SD = 6.25; 70.0% White). Participants were recruited from a Qualtrics research panel and completed the International Physical Activity Questionnaire Short-Form, the World Health Organization Quality of Life Scale-Brief Version, the Parental Stress Scale, and a demographic questionnaire. RESULTS After controlling for socio-demographic variables (i.e., maternal marital status, annual income, maternal highest level of education), greater parenting stress was associated with poorer maternal quality of life across domains (standardized beta coefficients ranged from -0.26 to -0.47; p < .001). The interaction between parenting stress and moderate intensity physical activity was associated with social relationships quality of life and environment quality of life (standardized beta coefficients ranged from 0.15 to 0.17; p < .05) in our sample of working mothers. The negative effect of parenting stress on maternal social relationships and environmental quality of life was weaker for working mothers who engaged in higher levels of moderate intensity physical activity. CONCLUSIONS Our findings suggest that moderate intensity physical activity may attenuate the negative impact of parenting stress on social relationships and satisfaction with one's environment in working mothers during the COVID-19 pandemic.
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Affiliation(s)
| | - Christina McCollum
- Department of Psychology and Neuroscience, Baylor University, United States
| | - Emma Greenwood
- Department of Psychology and Neuroscience, Baylor University, United States
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22
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Graj E, Muscara F, Anderson V, Hearps S, McCarthy M. Quality of life in parents of seriously Ill/injured children: a prospective longitudinal study. Qual Life Res 2020; 30:193-202. [PMID: 32910402 DOI: 10.1007/s11136-020-02624-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Parents of children with serious childhood illness or injury (SCII) are at risk of experiencing poor quality of life (QoL). This study investigated the nature of parent QoL at the time of child diagnosis and seven months post-diagnosis, the change in parent QoL over time, and early factors influencing short-term and longer-term parent QoL. METHODS The sample was drawn from a prospective longitudinal cohort study conducted within a paediatric hospital setting. Participants comprised 223 parents of 167 children diagnosed with a life-threatening illness and hospitalised in the cardiology, oncology, or intensive care departments. Examined data included QoL ratings completed by parents within four weeks of diagnosis and seven months post-diagnosis, and demographic, illness-related, and psychosocial predictor measures collected within four weeks of diagnosis, or four months post-diagnosis. RESULTS Generalised Estimating Equations were utilised to analyse data. Results indicated poor parent QoL at diagnosis, and normalised parent QoL at seven months. Improvement occurred most noticeably in the psychosocial domain. Reduced acute stress symptomatology and increased psychological flexibility were associated with higher parent QoL at diagnosis. Increased perceived emotional resources predicted enhanced parent QoL at seven months. CONCLUSION Paediatric medical care teams should consider the challenges to QoL experienced by parents of children with SCII. Parents reporting acute stress symptoms during the acute-illness phase should be prioritised for intervention. Further, parent-dyads presenting at post-acute care settings reporting poor emotional resources would benefit from psychosocial and educative support.
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Affiliation(s)
- Ella Graj
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Frank Muscara
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology Services, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology Services, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Stephen Hearps
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Maria McCarthy
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Children's Cancer Centre, Melbourne, Australia
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23
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Peterson RK, Chung J, Barrera M. Emotional symptoms and family functioning in caregivers of children with newly diagnosed leukemia/lymphomas and solid tumors: Short-term changes and related demographic factors. Pediatr Blood Cancer 2020; 67:e28059. [PMID: 31724323 DOI: 10.1002/pbc.28059] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/07/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pediatric oncology diagnoses are distressing to caregivers. However, researchers have not investigated the impact that the type of cancer diagnosis has on caregiver anxiety, depression, distress, and family functioning. The purpose of this study was to longitudinally investigate the early trajectory of caregiver psychological symptoms of anxiety, depression, distress, and family functioning near diagnosis and 6 months later by cancer type, and to examine the demographic factors that may be associated with caregiver emotional and family functioning outcomes. METHODS Caregivers (n = 122) of children with a recent diagnosis of leukemia/lymphoma or solid tumor completed self-report measures of psychological and family functioning (Hospital Anxiety and Depression Scale, Distress Thermometer, and Family Environment Scale). RESULTS In general, caregivers endorsed elevated psychological symptoms at the time of diagnosis, which decreased 6 months later. Caregivers of children with solid tumors endorsed greater anxiety across time than caregivers of children with leukemia/lymphoma did. In addition to caring for a child with a solid tumor, female sex, non-White ethnicity, and non-English language spoken in the home were factors associated with anxious and depressive symptoms and poorer family functioning. CONCLUSION When creating psychosocial interventions for families of children with cancer, the unique demands of solid tumor treatments, the caregiver's sex, and cultural characteristics must be considered to promote coping, resiliency, and problem-solving skills around the time of diagnosis, particularly in more vulnerable families.
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Affiliation(s)
- Rachel K Peterson
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joanna Chung
- Department of Psychology, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Maru Barrera
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
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24
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Bakula DM, Sharkey CM, Perez MN, Espeleta HC, Gamwell KL, Baudino M, Delozier AM, Chaney JM, Alderson RM, Mullins LL. The Relationship Between Parent Distress and Child Quality of Life in Pediatric Cancer: A Meta-Analysis. J Pediatr Nurs 2020; 50:14-19. [PMID: 31670136 DOI: 10.1016/j.pedn.2019.09.024] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 12/15/2022]
Abstract
PROBLEM Pediatric cancer places both parents and children at risk for psychosocial difficulties, including a specific risk for diminished quality of life. Previous research has identified relationships between parent and child psychosocial adjustment outcomes (e.g., depression, anxiety), yet the relationships between parent adjustment and child quality of life have yet to be comprehensively evaluated via meta-analysis. ELIGIBILITY CRITERIA A systematic review and meta-analysis were conducted using EBSCO, with PsychINFO, MEDLINE, Academic Search Premiere, and Health Source: Nursing/Academic Edition. SAMPLE Fourteen studies met inclusion criteria. RESULTS Fourteen correlations from 1646 parents of children with cancer were evaluated, resulting in a medium-magnitude correlation between parent psychosocial adjustment and child quality of life (r = 0.23, p < .001). Additional analyses evaluating the relationship between parent psychosocial adjustment and child social/emotional quality of life resulted in a medium-magnitude correlation (r = 0.24, p < .001). CONCLUSIONS A significant relationship exists between parent psychosocial adjustment and child quality of life. However, this relationship appears slightly less strong than those found in meta-analyses evaluating other child psychosocial adjustment outcomes. IMPLICATIONS Parent distress is an important factor to evaluate in the context of pediatric cancer, as it appears to have implications for child quality of life, in addition to other child psychosocial adjustment outcomes.
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Affiliation(s)
- Dana M Bakula
- Department of Psychology, Oklahoma State University, United States of America.
| | - Christina M Sharkey
- Department of Psychology, Oklahoma State University, United States of America
| | - Megan N Perez
- Department of Psychology, Oklahoma State University, United States of America
| | - Hannah C Espeleta
- Department of Psychology, Oklahoma State University, United States of America
| | - Kaitlyn L Gamwell
- Department of Psychology, Oklahoma State University, United States of America
| | - Marissa Baudino
- Department of Psychology, Oklahoma State University, United States of America
| | | | - John M Chaney
- Department of Psychology, Oklahoma State University, United States of America
| | - R Matt Alderson
- Department of Psychology, Oklahoma State University, United States of America
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, United States of America
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25
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Kudubes AA, Bektas M, Mutafoğlu K. The Effect of Fatigue-Related Education on Pediatric Oncology Patients' Fatigue and Quality of Life. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1130-1141. [PMID: 30132265 DOI: 10.1007/s13187-018-1419-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The identification of cancer-related fatigue as a clinical problem in pediatric oncology is an important phenomenon, and there are limited number of studies about raising the awareness of pediatric oncology patients and their parents. Fatigue-related education for patients and their parents before and during cancer treatment reduces the fatigue levels of patients. This study aims to analyze the effect of fatigue-related education for pediatric oncology patients aged 7-12 and their parents on their fatigue and quality of life. This study was conducted with 80 children with cancer and their parents who were assigned to either the control group (n = 40) or the experimental group (n = 40). The experimental group received a fatigue-related educational program. The data were collected three times: prior to the program, 3 months later, and 6 months afterwards. Multidimensional variance analysis, the Bonferroni adjusted t test and regression analysis were used to analyze the data. A significant difference was found among the experimental and the control group for total mean scores and the mean scores of subdimensions of the Scale for the Assessment of Fatigue-Child Form in terms of the interactions of group, time, and group*time (p < 0.05). Significant differences were found among the experimental and control groups' mean scores on the Scale for the Quality of Life-Child and Parents Form in terms of the interactions of group, time, and group*time (p < 0.05). Fatigue-related education is an effective education model as a way to reduce fatigue and increase the quality of life of children with cancer. The use of fatigue-related education by nurses in pediatric oncology clinics will have positive effects on children and their parents.
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Affiliation(s)
- Aslı Akdeniz Kudubes
- Department of Pediatric Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, 35340, Izmir, Turkey.
| | - Murat Bektas
- Department of Pediatric Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, 35340, Izmir, Turkey
| | - Kamer Mutafoğlu
- Department of Pediatrics, Izmir University of Economics Faculty of Medicine, Izmir, Turkey
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26
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Van Dijk-Lokkart EM, Steur LMH, Braam KI, Veening MA, Huisman J, Takken T, Bierings M, Merks JH, Van den Heuvel-Eibrink MM, Kaspers GJL, Van Dulmen-den Broeder E, Van Litsenburg RRL. Longitudinal development of cancer-related fatigue and physical activity in childhood cancer patients. Pediatr Blood Cancer 2019; 66:e27949. [PMID: 31436372 DOI: 10.1002/pbc.27949] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/27/2019] [Accepted: 07/14/2019] [Indexed: 11/05/2022]
Abstract
PURPOSE Cancer-related fatigue is one of the most distressing side effects of childhood cancer treatment. Physical activity can decrease fatigue and has positive effects on other health outcomes. Most research on physical activity pertains to adults, and the few studies that focus on children have limited follow-up time. This study evaluates cancer-related fatigue in children and its association with physical activity over a one-year time period. METHODS Sixty-eight children with cancer (7-18 years) were recruited during or within the first year after treatment. Physical activity (Actical activity monitor) and cancer-related fatigue (Pediatric Quality-of-Life Questionnaire Multidimensional Fatigue Scale (PedsQL-MFS), self- and parent- reports) were assessed at baseline, 4 months, and 12 months. PedsQL-MFS scores were compared with Dutch norms. Longitudinal association of cancer-related fatigue with physical activity was evaluated (No. NTR 1531). RESULTS Generally, PedsQL-MFS scores were worse than norms at baseline and 4 months, and recovered by 12 months except for the parent-proxy scores in adolescents. Younger children (≤12 years) self-reported comparable or better scores than norms. Physical activity generally improved over time, but patients mostly remained sedentary. During follow-up, increased physical activity was associated with less cancer-related fatigue. CONCLUSION Cancer-related fatigue in children improves over time, and increased physical activity is associated with less cancer-related fatigue. Given the sedentary lifestyle of this population, the positive effect of physical activity on cancer-related fatigue, and the many other health benefits of an active lifestyle, it is important to stimulate physical activity in childhood cancer patients and survivors.
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Affiliation(s)
- Elisabeth M Van Dijk-Lokkart
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands
| | - Lindsay M H Steur
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Katja I Braam
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Faculty of Health, University of Applied Science, Amsterdam, the Netherlands
| | - Margreet A Veening
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Jaap Huisman
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina's Children's Hospital, UMC Utrecht, the Netherlands
| | - Marc Bierings
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Pediatric Oncology/Hematology, Wilhelmina Children's Hospital, UMC Utrecht, the Netherlands
| | - Johannes H Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Emma Children's Hospital, Amsterdam UMC, Academic Medical Center, Department of Pediatric Oncology, Amsterdam, The Netherlands
| | - Marry M Van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Gertjan J L Kaspers
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Eline Van Dulmen-den Broeder
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Raphaële R L Van Litsenburg
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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27
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Al-Nassan S, Al-Bitar N, Saad D, Zahran A, Elayyan F, Al-Awadi S, Khaleifeh K, Al-Nassan A. Health- Related Quality of Life Among Jordanian Adolescent Cancer Patients Receiving Active Treatment. Asian Pac J Cancer Prev 2019; 20:3107-3111. [PMID: 31653161 PMCID: PMC6982672 DOI: 10.31557/apjcp.2019.20.10.3107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Indexed: 11/25/2022] Open
Abstract
Aims: The aim of this study was to evaluate quality of life among adolescents diagnosed with malignancies and currently undergoing treatment in the age group of 13-18 years old. Method: The study used a descriptive cross-sectional design. Participants were recruited from the pediatric oncology department at King Hussein Cancer Center in Jordan. The Arabic version of self-report (adolescent 13-18) pediatric quality of life inventory (PedsQLTM ) 4.0 Generic Core Scale was used. Results: Eighty patients were enrolled in the study. The total score of PedsQL 4.0 generic core was 62.0 (SD=16.5). The highest score was for social functioning (mean=85.4, SD=18.4) and the lowest score was school functioning (mean=39.5, SD=28.4). Females had significantly higher scores for health-related quality of life (HRQOL) in school functioning. Type of tumor did not affect HRQOL. Outpatient participants had significantly higher scores for HRQOL in all domains, except in school functioning where inpatients had a significantly higher score. Conclusion: To the best of our knowledge, this is the first study to reveal the HRQOL scores for Jordanian adolescents with cancer. Addressing the special needs in such a unique age group is essential when planning a comprehensive care plan for a better quality of life.
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Affiliation(s)
- Saad Al-Nassan
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Noor Al-Bitar
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Dhuha Saad
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Amani Zahran
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Felasteen Elayyan
- Department of Physical and Occupational Therapy, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Shereen Al-Awadi
- Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Kawther Khaleifeh
- Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Anwar Al-Nassan
- Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan
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28
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Jankowska‐Polańska B, Sliwiński M, Świątoniowska N, Butrym A, Mazur G. Quality of life in children with acute lymphoblastic leukaemia. Scand J Caring Sci 2019; 34:380-389. [DOI: 10.1111/scs.12739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 06/25/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Beata Jankowska‐Polańska
- Faculty of Health Sciences, Department of Clinical Nursing Wroclaw Medical University Wroclaw Poland
| | - Maciej Sliwiński
- Student Scientific Societies of Clinical Nursing, Public Health Department Wroclaw Medical University Wroclaw Poland
| | - Natalia Świątoniowska
- Faculty of Health Sciences, Department of Clinical Nursing Wroclaw Medical University Wroclaw Poland
| | - Aleksandra Butrym
- Faculty of Medicine, Department of Cancer Prevention and Therapy Wroclaw Medical University Wroclaw Poland
| | - Grzegorz Mazur
- Faculty of Medicine, Department and Clinic of Internal and Occupational Diseases and Hypertension Wroclaw Medical University Wroclaw Poland
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29
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Rensen N, Steur LM, Schepers SA, Merks JH, Moll AC, Kaspers GJ, Grootenhuis MA, van Litsenburg RR. Gender-specific differences in parental health-related quality of life in childhood cancer. Pediatr Blood Cancer 2019; 66:e27728. [PMID: 30916456 DOI: 10.1002/pbc.27728] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parents of children with cancer are at risk for impaired health-related quality of life (HRQoL). Most prior research has focused on the HRQoL of mothers. The aim of this study is to describe HRQoL in mothers and fathers, and determine the influence of sociodemographic, medical, and psychosocial factors. PROCEDURE In a cross-sectional study, both parents completed questionnaires on sociodemographics, distress, and HRQoL. Parental HRQoL was compared to healthy population values. Differences between mothers and fathers were evaluated with multilevel analysis. Gender-specific HRQoL determinants were assessed via multiple linear regression analysis. RESULTS Parents (202 mothers, 150 fathers; comprising 121 couples) of 231 children with different cancer diagnoses (mean time since diagnosis 3.3 ± 1.4 years, 90% posttreatment) participated. Compared to healthy women and men, mothers and fathers reported significantly impaired HRQoL on the following domains: cognitive functioning, sleep, daily activities, and vitality (Cohen's d = 0.3-0.9). Additionally, maternal HRQoL was reduced on the domains gross motor functioning, pain, social functioning, sexuality, and depressive emotions. Mothers scored worse than fathers on six of 12 domains. Risk factors for adverse outcomes in both parents were higher distress, emotional and parenting problems, little social support, medication use, and active treatment of the child. Other determinants in mothers were non-Dutch background and unemployment, while lower HRQoL in fathers was predicted by their child's diagnosis type, shorter time since diagnosis, and treatment intensity. CONCLUSION These outcomes illustrate the need for family-centered care. Future interventions aimed at improving parental functioning should take into account gender-specific differences in HRQoL to reach optimal efficacy.
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Affiliation(s)
- Niki Rensen
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lindsay M Steur
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gertjan J Kaspers
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Raphaële R van Litsenburg
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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30
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Chakraborty B, Rao A, Shenoy R, Davda L, Suprabha BS. Stress-mediated quality of life outcomes in parents of disabled children: A case-control study. J Indian Soc Pedod Prev Dent 2019; 37:237-244. [PMID: 31584022 DOI: 10.4103/jisppd.jisppd_266_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The purpose of the present study was to resolve whether caregiving for a child with disability influences the physical and mental health of the caregivers and whether stress is related to the quality of life of the caregivers. METHODS The Parental Stress Scale questionnaire for the assessment of parental stress and the Short Form-12 version 2 questionnaire for the assessment of physical and mental health quality of life were distributed among 69 parents of developmentally disabled children and 137 parents of healthy children (control group). Various sociodemographic factors were also included. RESULTS A significant difference was seen between the two groups in terms of employment, presence of disabled sibling, smoking, and physical activity. Parents of developmentally disabled children had significantly higher stress levels and worse mental health-related quality of life. Overall physical health quality of life was similar between cases and controls. Stress had a negative correlation with both mental and physical health quality of life of the parents. CONCLUSION Stress related to raising a child with disability negatively influences the parental quality of life. Stress management aiming at its prevention and reduction might be significant aspects of intervention for the improvement of the quality of life of the caregivers.
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Affiliation(s)
- Bhaswati Chakraborty
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Arathi Rao
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ramya Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Latha Davda
- University of Portsmouth Dental Academy, Portsmouth, UK
| | - B S Suprabha
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
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31
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Baran G, Arda Sürücü H, Hülya Üzel V. Resilience, life satisfaction, care burden and social support of mothers with a child with acute lymphoblastic leukaemia: a comparative study. Scand J Caring Sci 2019; 34:340-347. [PMID: 31250939 DOI: 10.1111/scs.12734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/06/2019] [Indexed: 01/05/2023]
Abstract
The study aimed to make comparison between the resilience, life satisfaction, care burden and social support of mothers with a child with acute lymphoblastic leukaemia (ALL) and those with a healthy child. The study was carried out using the comparative and descriptive methods, and the study group included mothers with ALL children hospitalised in the Paediatric Haematology Clinic of a university hospital (n = 51) and those with healthy children who applied to a family health centre (n = 53). While collecting the data, Personal Information Form, Resilience Scale for Adults, Life Satisfaction Scale, Zarit Care Burden Scale and Multidimensional Scale of Perceived Social Support Scale were used. The data were statistically analysed using the SPSS program, percentages, mean scores, standard deviations, Mann-Whitney U test and pearson correlation. For the comparison of the personal information about the mothers with ALL children and about those with healthy children, chi-square or student t test for independent groups depending on the data set was used. When the mothers with ALL children were compared with those with healthy children, it was found that the methods with ALL children had statistically lower mean scores for life satisfaction (13.92 ± 6.26, p < 0.001) and resilience (17.90 ± 7.09, p < 0.001) and statistically higher mean scores for care burden (42.23 ± 16.54, p < 0.05). In this study, when the mothers of ALL children were compared with those of healthy children, it was found that the former had lower levels of resilience and life satisfaction and higher levels of care burden.
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Affiliation(s)
- Gülbeyaz Baran
- Child Health and Pediatric Nursing, Atatürk School of Health, Dicle University, Diyarbakır, Turkey
| | - Hamdiye Arda Sürücü
- Internal Medicine Nursing, Atatürk School of Health, Dicle University, Diyarbakır, Turkey
| | - Veysiye Hülya Üzel
- Faculty of Medicine, The Pediatric Hematology Clinic, Dicle University, Diyarbakır, Turkey
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Does Hope Matter? Associations Among Self-Reported Hope, Anxiety, and Health-Related Quality of Life in Children and Adolescents with Cancer. J Clin Psychol Med Settings 2019; 25:93-103. [PMID: 29453505 DOI: 10.1007/s10880-018-9547-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aimed to examine the direct and indirect effects of hope on health-related quality of life (HRQoL) via anxiety of children/adolescents with cancer. We proposed to test if the mediation model was moderated by the child/adolescent's treatment status. The participants were 211 children/adolescents diagnosed with cancer, divided into two clinical groups according to treatment status: 97 patients on-treatment and 114 off-treatment. Self-reported questionnaires measured the youths' hope, anxiety, and HRQoL perceptions. The results revealed that children/adolescents on- and off-treatment only differed in levels of HRQoL, with a more compromised HRQoL found for the on-treatment group. Hope was positively associated with HRQoL, directly and indirectly via anxiety reduction. Moreover, only the association between anxiety and HRQoL was moderated by clinical group, revealing stronger associations for on-treatment patients. Findings highlight the importance of hope as a decisive resource in pediatric cancer adaptation, which may be strategically targeted in psycho-oncological interventions.
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Academy of Oncologic Physical Therapy EDGE Task Force on Cancer: A Systematic Review of Outcome Measures for Pain in Children. REHABILITATION ONCOLOGY 2019. [DOI: 10.1097/01.reo.0000000000000165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Al-Gamal E, Long T, Shehadeh J. Health satisfaction and family impact of parents of children with cancer: a descriptive cross-sectional study. Scand J Caring Sci 2019; 33:815-823. [PMID: 30866084 DOI: 10.1111/scs.12677] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 02/10/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The impact on parents of coping with a child who has cancer can be both severe and multifarious. Considerable distress persists throughout the treatment phase, persisting even after completion of treatment with heightened anxiety and stress associated with thoughts of recurrence or relapse. AIM The purpose was to investigate the links between parents' satisfaction with the health care offered to their child with cancer and the impact on families of caring for such a child (including their health-related quality of life) in a Middle Eastern country. STUDY DESIGN A descriptive, correlational, cross-sectional design was adopted. Arabic versions of parent-completed, validated instruments were completed by 113 parents whose child had cancer. RESULTS Family relationship was found to be the best functioning domain, and daily activities were seen to be the poorest. In general, parents expressed satisfaction with their child's health care, but inadequate attention had been paid to their emotional needs. Cases in which children were reported to exhibit more emotional and behavioural problems correlated with greater negative impact on the family and disrupted family functioning. DISCUSSION Parental quality of life was more severely affected than family quality of life. This results from mothers taking up most of the caregiver burden, and the impact on mothers was significantly greater than that on fathers. Children were protected from stress and anxiety by their mother. This burden on mothers resulted in deficits in emotional, social and physical functioning. PRACTICE AND POLICY IMPLICATIONS Nurses and other health professionals should redress the balance between family-centred care strategies and child-centred approaches. Effort is needed to provide psychological support to parents by ensuring adequate preparation of staff, especially nurses, to recognise need and provide support in a therapeutic environment. Support may be needed for years after the diagnosis. This is a health professional role that may currently be neglected, and for which training is essential.
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Affiliation(s)
- Ekhlas Al-Gamal
- Psychiatric and Mental Health Nursing, School of Nursing, The University of Jordan, Amman, Jordan.,College of Nursing Al Ahsa, King Saud bin Abdulaziz University for Health Sciences, Al Ahsa, Kingdom of Saudi Arabia
| | - Tony Long
- Child and Family Health, School of Health & Society, University of Salford, Salford, UK
| | - Jumana Shehadeh
- Psychiatric and Mental Health Nursing, School of Nursing, The University of Jordan, Amman, Jordan
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Hawes SW, Byrd AL, Gonzalez R, Cavanaugh C, Bechtold J, Lynam DR, Pardini DA. The Developmental Course of Psychopathic Features: Investigating stability, change, and long-term outcomes. JOURNAL OF RESEARCH IN PERSONALITY 2018; 77:83-89. [PMID: 31105356 PMCID: PMC6519965 DOI: 10.1016/j.jrp.2018.09.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This multi-cohort study delineates developmental trajectories of psychopathic features across childhood and adolescence (ages 7-16) and investigates associations with adult outcomes (ages~23-34). Although most youth demonstrated consistently low levels of psychopathic features, approximately 10%-15% followed a chronically high trajectory. A similar number (~14%) displayed initially high levels that decreased over time, while others (~10%-20%) followed an increasing pattern. Boys in the chronically high trajectory exhibited the most deleterious adult outcomes and some evidence suggested that youth in the decreasing subgroup experienced fewer maladaptive outcomes than those in the increasing and high groups. Findings revealed substantial malleability in the developmental course of psychopathic features and suggest that unique pathways may exert considerable influence on future engagement in antisocial and criminal behaviors.
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Schuele K, Bennett AE, Varughese T, Abel R, Reichenbacher C, Green K, King AA. Information Needs Regarding Cognitive Late Effects of Caregivers of Central Nervous System Tumor Survivors. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2018; 39:159-166. [PMID: 30417736 DOI: 10.1177/1539449218809943] [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: 11/16/2022]
Abstract
Pediatric central nervous system (CNS) tumor survivors are at risk for experiencing cognitive late effects (CLEs). Caregivers of survivors may be unaware of these changes or receive untimely information regarding CLEs. Conversely, health care providers (HCPs) may face barriers to providing education. This study aims to (a) understand the knowledge and resource gap for caregivers regarding CLEs and (b) explore how HCPs currently provide education. Caregivers and HCPs were both interviewed. Qualitative analysis was performed using emergent coding. Fifteen caregivers and eight HCPs participated. Caregivers generally felt confident in assisting their survivor but experienced "information overload" during initial diagnosis and treatment. HCPs reported difficulties in determining appropriate timing for education and perceived that caregivers typically lack understanding of CLEs. Caregivers should be aware of and understand a survivor's risk for CLEs to help survivors manage changes. With increasing survival rates of pediatric CNS tumor patients, HCPs must be prepared to provide appropriate education and referrals regarding CLEs for long-term care.
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Affiliation(s)
- Kara Schuele
- 1 Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Regina Abel
- 1 Washington University School of Medicine, St. Louis, MO, USA
| | | | - Karli Green
- 1 Washington University School of Medicine, St. Louis, MO, USA
| | - Allison A King
- 1 Washington University School of Medicine, St. Louis, MO, USA
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Quality of Life Is Influenced by Body Weight, Education, and Family Income in Adolescents with Chronic Diseases. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8485103. [PMID: 30474043 PMCID: PMC6220409 DOI: 10.1155/2018/8485103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/27/2018] [Accepted: 10/11/2018] [Indexed: 01/22/2023]
Abstract
Objective To evaluate the health-related quality of life (HRQoL) of adolescents diagnosed with different chronic conditions and to identify demographic, socioeconomic, and health-status outcomes associated with the impairment in HRQoL. Study Design Cross-sectional study. Methods We evaluated 276 adolescents (50.7% male) aged 14 ± 2 years that were assisted by healthcare public service and diagnosed with cancer (CA), type 1 diabetes mellitus (DM1), overweight (OW), asthma (AS), and no chronic health condition—control group (CG). Adolescents and parent-proxy completed age-appropriate self-report and/or parent-proxy report on generic HRQoL measures using PedsQL™. Results Adolescents with CA had lower overall HRQoL as well as poorer scores in all dimensions than either healthy participants or other chronic disease sufferers. HRQoL scores reported by parent-proxy were similar to those reported by adolescents across all chronic diseases. CG members reported better scores in all dimensions. Maternal education, family income, and marital status of parents were correlated with HRQoL scores in all dimensions. The risk of having an affected HRQoL score was higher in adolescents with CA than in adolescents with other chronic diseases. Conclusions The likelihood of cancer affecting HRQoL was higher when compared to other chronic diseases, and the OW group had a worse overall score compared to CG. Adolescents with CA, AS, and OW reported worse school dimensions when compared to healthy adolescents. The education of adolescents and their parent-proxy, body weight, and family income influence the dimensions of HRQoL in adolescents with chronic diseases.
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Stenmarker E, Mellgren K, Matus M, Schroder Hakansson A, Stenmarker M. Health-related quality of life, culture and communication: a comparative study in children with cancer in Argentina and Sweden. J Patient Rep Outcomes 2018; 2:49. [PMID: 30467612 PMCID: PMC6192945 DOI: 10.1186/s41687-018-0075-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 10/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant disorders in childhood are life-threatening conditions, and issues regarding the children's health-related quality of life (HRQOL) are crucial in paediatric oncology. The overall aim of this study was to explore HRQOL in children with cancer in two countries, Argentina and Sweden, which have different cultural contexts. The specific aims were: to determine HRQOL by gender, age, diagnosis, treatment modality, time since diagnosis, and parental education/employment across cultures. Further aims were to assess the child/parent relationship in HRQOL and the influence of demographic variables in psychosocial and physical HRQOL in each country. METHODS A cross-sectional study was performed in 2014, including 58 children (24 females, 34 males) and 62 parents/guardians. The instrument, the Pediatric Quality of Life Inventory™ (PedsQL™, generic, cancer and fatigue modules), and medical records were used. The response rate was 97%. RESULTS The mean age of the children was 8.67 years (SD 5.1, range 2-18 years) and the mean time on treatment was 10.7 months (SD 8.7, range 1-30 months). The most common diagnosis was leukaemia (57%). In Argentina, in comparison with Sweden, a higher estimation of generic HRQOL was reported among adolescents (p = 0.022) and more cancer-related problems among school-age children (p < 0.0001). Children and parents in both countries confirmed the major problem with fatigue and multimodality therapy regimes, but lower levels of fatigue were reported in Argentina. Adolescents and children with solid tumours appeared as vulnerable groups. In Sweden, children whose mothers had post-secondary education reported less cancer-related problems (p = 0.031). Good relationships were found between child/parent reports in Argentina regarding the fatigue module (p = 0.034) and physical subscale (p = 0.014), and in Sweden regarding generic health (p = 0.004), including psychosocial (p = 0.006) and physical subscales (p = 0.042), and cancer (p = 0.001), and fatigue (p < 0.0001) modules. In Sweden, psychosocial health (OR 7.5; p = 0.007) and physical health (OR 6.2; p = 0.011) were positively influenced by being a school-age child. CONCLUSIONS Fatigue is as a major problem across cultures. Still, being in school facilitates recovery. Good relationships in psychosocial HRQOL highlight professional challenges regarding severe issues and open communication, and the need of performing comparative studies of HRQOL of children with cancer from different cultural backgrounds.
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Affiliation(s)
- Emelie Stenmarker
- Department of Orthopaedics, Sodra Alvsborg Hospital, Bramhultsvägen 53, SE-501 82, Boras, Sweden
| | - Karin Mellgren
- Department of Paediatrics, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 416 85, Gothenburg, Sweden
| | - Mónica Matus
- Instituto de Hematologia y Oncologia del Rosario, San Juan 2395 (2000), Rosario, Pcia Santa Fe, Argentina
| | - Anna Schroder Hakansson
- Department of Paediatrics, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 416 85, Gothenburg, Sweden
| | - Margaretha Stenmarker
- Department of Paediatrics, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 416 85, Gothenburg, Sweden. .,Department of Paediatrics, Futurum - the academy for health and care, Region Jonkoping Council, SE-551 85, Jonkoping, Sweden.
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40
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Halliday GC, Miles GCP, Marsh JA, Kotecha RS, Alessandri AJ. Regular exercise improves the well-being of parents of children with cancer. Pediatr Blood Cancer 2017. [PMID: 28627013 DOI: 10.1002/pbc.26668] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM Parents of children with cancer describe impaired physical and social functioning, sleep disturbance and poor mental health. Exercise-related interventions impact positively on these quality of life domains, but have not been examined in this population. The aim of this longitudinal pilot study was to explore the feasibility of a 12-week pedometer-monitored walking intervention among parents of children with cancer, assessing adherence to a set activity target of 70,000 steps per week, and to explore the benefits of physical activity on mental and physical health. METHODS Parents were provided with a pedometer and requested to achieve a daily step count of 10,000 steps per day for 12 weeks. Mood, well-being and psychological distress were examined using validated questionnaires (Profile of Mood States 2nd edition [POMS-2], Distress Thermometer for Parents [DT-P] and Depression Anxiety Stress Scales [DASS-42]) at baseline, midpoint (6 weeks) and endpoint (12 weeks) to identify changes in these domains with increased activity. RESULTS Fifteen parents were recruited. The majority increased their counts during the first 4 weeks of the study and maintained this to week 8 (n = 12). Time-dependent improvements were identified in the following psychometric test outcomes at week 12: DT-P score (likelihood ratio test [LRT] P = 0.02), POMS-2 total mood disturbance (LRT P = 0.03), fatigue inertia (LRT P = 0.009), tension anxiety (LRT P = 0.007) and vigour activity (LRT P = 0.001). CONCLUSIONS Mental health benefits of a pedometer-based exercise intervention for parents of children with cancer were identified. Such programs should be included in a holistic approach to improve the psychological outcomes of parents whose children are receiving treatment for cancer.
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Affiliation(s)
- Gail C Halliday
- Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - Gordon C P Miles
- Department of Haematology and Oncology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Julie A Marsh
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Rishi S Kotecha
- Department of Haematology and Oncology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Angela J Alessandri
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
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Eiser C, Stride CB, Vora A, Goulden N, Mitchell C, Buck G, Adams M, Jenney MEM. Prospective evaluation of quality of life in children treated in UKALL 2003 for acute lymphoblastic leukaemia: A cohort study. Pediatr Blood Cancer 2017; 64. [PMID: 28475268 DOI: 10.1002/pbc.26615] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 03/19/2017] [Accepted: 03/27/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) from diagnosis until end of treatment for children with acute lymphoblastic leukaemia was investigated, examining effects of age, gender, risk-stratified treatment regimen, and therapy intensity (one vs. two 'delayed intensifications' [DIs]). METHOD In a multi-centre prospective study, parents reported their child's generic and disease-specific HRQoL and their own care-giving burden at five time points. From 1,428 eligible patients, 874 parents completed questionnaires at least once during treatment. RESULTS At each time point, generic HRQoL was significantly lower than equivalent norm scores for healthy children. HRQoL decreased significantly at the start of treatment, before recovering gradually (but remained below pre-treatment levels). Parents reported that older children worried more about side effects and their appearance, but showed less procedural anxiety than younger children. Concern for appearance was greater among girls than boys. Compared to Regimen B (i.e. additional doxorubicin during induction and additional cyclophosphamide and cytarabine during consolidation chemotherapy), patients receiving Regimen A had fewer problems with pain and nausea. There were no statistically significant differences in HRQoL by number of DI blocks received. INTERPRETATION HRQoL is compromised at all stages of treatment, and is partly dependent on age. The findings increase understanding of the impact of therapy on children's HRQoL and parental care-giving burden, and will contribute to the design of future trials.
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Affiliation(s)
- C Eiser
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - C B Stride
- Department of statistics, Management School, Conduit Road, University of Sheffield, Sheffield, United Kingdom
| | - A Vora
- Department of Paediatric Haematology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, United Kingdom
| | - N Goulden
- Department of paediatric haematology, Great Ormond Street Hospital, London, United Kingdom
| | - C Mitchell
- Department of Paediatric Haematology/Oncology, John Radcliffe Hospital, Oxford, United Kingdom
| | - G Buck
- Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom
| | - M Adams
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
| | - M E M Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
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Dobrozsi S, Panepinto J. Child and parent preferences for graphical display of patient-reported outcome data. Pediatr Blood Cancer 2017; 64. [PMID: 28409886 DOI: 10.1002/pbc.26499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 11/07/2022]
Abstract
Patient-reported outcome measures (PROs) generate reproducible, objective measures of patient functioning and symptoms. Clinical PRO use has proven benefits. Parent and child preferences for the graphical display of PRO data are not known. We conducted a qualitative study to determine preferences for graphical display of PRO data for use in the clinical setting. Participants were shown line graphs depicting a patient's PRO score with variations in orientation, shading and text. Final consensus graphs were elicited. Participants selected the graph with the highest level of visual and text interpretation of PRO scores.
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Affiliation(s)
- Sarah Dobrozsi
- Department of Pediatric Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Julie Panepinto
- Department of Pediatric Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.,Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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Benefit Finding and Quality of Life in Caregivers of Childhood Cancer Survivors: The Moderating Roles of Demographic and Psychosocial Factors. Cancer Nurs 2017; 40:E28-E37. [PMID: 27472189 DOI: 10.1097/ncc.0000000000000419] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Benefit finding, or finding positive outcomes in the face of adversity, may play a role in predicting quality of life (QoL) among caregivers, but mixed results suggest that other factors may moderate this relationship. OBJECTIVE This study examined demographic and psychosocial moderators of the association between benefit finding and QoL among caregivers of childhood cancer survivors. METHODS Caregivers of childhood cancer survivors (n = 83) completed measures of benefit finding, QoL, coping, optimism, social support, caregiving demand, posttraumatic stress, and demographics. RESULTS The relationship between benefit finding and QoL was moderated by caregiver age, marital status, socioeconomic status, geographic location, acceptance and emotion-focused coping, optimism, caregiving demand, and posttraumatic stress. Benefit finding was more strongly related to QoL among caregivers with fewer demographic/psychosocial resources. CONCLUSIONS Results suggest that finding benefits in the cancer experience may have a greater positive impact for caregivers with relatively fewer demographic and psychosocial resources and may have less of an impact for caregivers with relatively greater resources. Findings further point to the complex nature of QoL among caregivers of childhood cancer survivors. IMPLICATIONS FOR PRACTICE Results may aid clinicians in identifying caregivers at particular risk for low QoL. They may be counseled to find benefits in their experience or provided with resources to strengthen other factors that impact QoL.
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Quast LF, Turner EM, McCurdy MD, Hocking MC. Health-related quality of life in parents of pediatric brain tumor survivors at the end of tumor-directed therapy. J Psychosoc Oncol 2017; 34:274-90. [PMID: 27070180 DOI: 10.1080/07347332.2016.1175535] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study examines theoretical covariates of health-related quality of life (HRQL) in parents of pediatric brain tumor survivors (PBTS) following completion of tumor-directed therapy. METHODS Fifty PBTS (ages 6-16) completed measures of neurocognitive functioning and their parents completed measures of family, survivor, and parent functioning. RESULTS Caregiving demand, caregiver competence, and coping/supportive factors were associated with parental physical and psychosocial HRQL, when controlling for significant background and child characteristics. CONCLUSION Study findings can inform interventions to strengthen caregiver competence and family functioning following the completion of treatment, which may improve both parent and survivor outcomes.
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Affiliation(s)
- Lauren F Quast
- a Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Elise M Turner
- b Department of Psychology , Drexel University , Philadelphia , PA , USA
| | - Mark D McCurdy
- b Department of Psychology , Drexel University , Philadelphia , PA , USA
| | - Matthew C Hocking
- a Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia , PA , USA.,c Division of Psychiatry, Perelman School of Medicine at the University of Pennsylvania , Philadelphia , PA , USA
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Schulte F, Russell KB, Cullen P, Embry L, Fay-McClymont T, Johnston D, Rosenberg AR, Sung L. Systematic review and meta-analysis of health-related quality of life in pediatric CNS tumor survivors. Pediatr Blood Cancer 2017; 64. [PMID: 28266804 DOI: 10.1002/pbc.26442] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/10/2016] [Accepted: 12/12/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pediatric central nervous system (CNS) tumor survivors are at high risk for numerous late effects including decreased health-related quality of life (HRQOL). Our objective was to summarize studies describing HRQOL in pediatric CNS tumor survivors and compare HRQOL outcomes in studies that included a comparison group. PROCEDURE EMBASE, MEDLINE, and PsychINFO were used to identify relevant articles published until August, 2016. Eligible studies reported outcomes for pediatric CNS tumor survivors diagnosed before age 21, at least 5 years from diagnosis and/or 2 years off therapy and used a standardized measure of HRQOL. All data were abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. RESULTS Of 1,912 unique articles identified, 74 were included in this review. Papers described 29 different HRQOL tools. Meta-analyses compared pediatric CNS tumor survivors to healthy comparisons and other pediatric cancer survivors separately. HRQOL was significantly lower for CNS (n = 797) than healthy comparisons (n = 1,397) (mean difference = -0.54, 95% confidence interval [CI] = -0.72 to -0.35, P < 0.001, I2 = 35%). HRQOL was also significantly lower for CNS (n = 244) than non-CNS survivors (n = 414) (mean difference = -0.56, 95% CI = -0.73 to -0.38, P < 0.00001, I2 = 0%). CONCLUSIONS Pediatric CNS tumor survivors experience worse HRQOL than healthy comparisons and non-CNS cancer survivors. Future HRQOL work should be longitudinal, and/or multisite studies that examine HRQOL by diagnosis and treatment modalities.
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Affiliation(s)
- Fiona Schulte
- Departments of Oncology and Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Haematology, Oncology and Transplant Program, Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - K Brooke Russell
- Haematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.,Departments of Oncology and Psychology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Patricia Cullen
- Loretto Heights School of Nursing, Regis University, Denver, Colorado
| | - Leanne Embry
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Taryn Fay-McClymont
- Departments of Oncology and Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna Johnston
- Department of Haematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Abby R Rosenberg
- Department of Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington
| | - Lillian Sung
- Department of Haematology/Oncology, SickKids Hospital, Toronto, Ontario, Canada
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Dobrozsi S, Yan K, Hoffmann R, Panepinto J. Patient-reported health status during pediatric cancer treatment. Pediatr Blood Cancer 2017; 64. [PMID: 27808460 DOI: 10.1002/pbc.26295] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Changes in patient function and factors affecting pediatric patients with cancer during treatment are largely unknown. The purpose of this study was to measure patient-reported outcomes (PROs) in children during the initial 6 months of therapy to characterize function and explore factors associated with function including type of cancer, intensity of therapy, age, and gender. PROCEDURE We conducted a prospective cohort study of children aged 5-21 newly diagnosed with cancer. PROs were obtained twice monthly over the first 6 months of treatment. The Patient-Reported Outcome Measurement Information System (PROMIS) was used to measure patient mobility, fatigue, pain interference, peer relationships, anxiety, and depressive symptoms. A generalized linear mixed model was used to analyze changes by domain over time. RESULTS Forty patients completed the study with a mean age of 11.7 years (standard deviation [SD] 4.7), 60% had leukemia/lymphoma. All patients report improved pain over time (P = 0.008). Patients with central nervous system (CNS)/solid tumor report better mobility (P < 0.001), less fatigue (P < 0.001), less pain (P < 0.001), less anxiety (P < 0.001), fewer depressive symptoms (P < 0.001), and better peer relationships (P = 0.0036). Younger patients report worse mobility (P = 0.017), more fatigue (P = 0.032), more pain (P < 0.001), more anxiety (P = 0.017), and more depressive symptoms (P = 0.005). CONCLUSIONS Pain improved for all patients over the first 6 months of cancer treatment. Age and tumor type also affected patient-reported function for all domains. Understanding the burden of cancer treatment is critical to refine supportive care interventions to minimize the burden of pediatric cancer treatment.
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Affiliation(s)
- Sarah Dobrozsi
- Department of Pediatric Hematology/Oncology, The Medical College of Wisconsin, Wisconsin
| | - Ke Yan
- Quantitative Health Sciences, Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Raymond Hoffmann
- Quantitative Health Sciences, Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Julie Panepinto
- Department of Pediatric Hematology/Oncology, The Medical College of Wisconsin, Wisconsin.,Quantitative Health Sciences, Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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Kobayashi K, Nakagami-Yamaguchi E, Hayakawa A, Adachi S, Hara J, Tokimasa S, Ohta H, Hashii Y, Rikiishi T, Sawada M, Kuriyama K, Kohdera U, Kamibeppu K, Kawasaki H, Oda M, Hori H. Health-related quality of life in Japanese children with acute lymphoblastic leukemia during and after chemotherapy. Pediatr Int 2017; 59:145-153. [PMID: 27422759 DOI: 10.1111/ped.13092] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 07/01/2016] [Accepted: 07/13/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Quality of life (QOL) as a treatment outcome has not yet been evaluated among patients receiving a specific treatment regimen by treatment phase in a consistent manner. This exploratory cross-sectional study evaluated the QOL of children with acute lymphoblastic leukemia (ALL) receiving one of the most popular treatment regimens in Japan (Japan Association of Childhood Leukemia Study ALL-02 revised protocol). METHODS Children aged 5-18 years with newly diagnosed B-cell precursor ALL were included. The Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL-J) were completed by children with ALL and their siblings, as well as by age- and sex-matched healthy controls. PedsQL Cancer Module (PedsQL-C) scores were also collected from children with ALL. RESULTS QOL in children with ALL of the consolidation phase group was significantly decreased compared with that of healthy controls, except in the area of emotional functioning. Regarding the maintenance phase group, QOL impairment was noted in the physical and school functioning, but no differences were noted in social functioning. The off-treatment group had a large effect size only for physical functioning, and the social functioning score was even better in children with ALL than in matched controls. QOL of children with ALL differed with treatment phase. Effect size varied with function and treatment phase. CONCLUSIONS QOL may change with the progression of treatment, and the timing of these changes varied according to function and problem.
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Affiliation(s)
- Kyoko Kobayashi
- Department of Child Health Nursing, St Luke's International University Graduate School of Nursing Science, Chuo, Japan
| | - Etsuko Nakagami-Yamaguchi
- Department of Medical Quality and Safety Science, Osaka City University Graduate School of Medicine, Abeno, Japan
| | - Akira Hayakawa
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Souichi Adachi
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan
| | - Junichi Hara
- Department of Pediatric Hematology Oncology, Children's Medical Cancer Osaka City General Hospital, Toshima, Japan
| | - Sadao Tokimasa
- Department of Pediatrics, Osaka City University Graduate School of Medicine, Abeno, Japan
| | - Hideaki Ohta
- Department of Pediatrics, Higashitoyonaka Watanabe Hospital, Toyonaka City, Japan
| | - Yoshiko Hashii
- Department of Developmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takeshi Rikiishi
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Machiko Sawada
- Department of Pediatrics, Takashima Municipal Hospital, Takashima, Shiga, Japan
| | - Kikuko Kuriyama
- Aichi Children's Health and Medical Cancer, Obu, Aichi, Japan
| | | | - Kiyoko Kamibeppu
- Department of Family Nursing, Graduate School of Medicine, University of Tokyo, Bunkyo, Tokyo, Japan
| | - Hirohide Kawasaki
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Megumi Oda
- Graduate School of Health Sciences, Okayama University, Kita, Okayama, Japan
| | - Hiroki Hori
- Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Sutan R, Al-Saidi NA, Latiff ZA, Ibrahim HM. Coping Strategies among Parents of Children with Acute Lymphoblastic Leukemia. Health (London) 2017. [DOI: 10.4236/health.2017.97071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Results of a Pilot Yoga Intervention to Improve Pediatric Cancer Patients' Quality of Life and Physical Activity and Parents' Well-being. REHABILITATION ONCOLOGY 2017. [DOI: 10.1097/01.reo.0000000000000052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Schepers SA, Haverman L, Zadeh S, Grootenhuis MA, Wiener L. Healthcare Professionals' Preferences and Perceived Barriers for Routine Assessment of Patient-Reported Outcomes in Pediatric Oncology Practice: Moving Toward International Processes of Change. Pediatr Blood Cancer 2016; 63:2181-2188. [PMID: 27511830 PMCID: PMC6347376 DOI: 10.1002/pbc.26135] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 06/13/2016] [Accepted: 06/16/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Using patient-reported outcomes (PROs) in clinical practice has been shown to enhance detection of health-related quality of life problems and satisfaction with care in children with cancer. This study seeks to identify which PRO information healthcare professionals (HCPs) find useful and what the perceived barriers for routinely assessing PROs are. PROCEDURE A total of 352 pediatric HCPs (43% male) from 52 countries completed a semistructured online 28-item questionnaire. Descriptive statistics (percentages) were used to identify highly important PRO information and perceived barriers. HCPs' perceived barriers were compared according to gender, years of work experience, and country using a Fishers exact test. RESULTS The five highest ranked PRO topics relevant in routine assessment by HCPs were as follows: pain (98%), feeling sad or depressed (96%), overall physical symptoms (95%), problems with therapy adherence (94%), and overall emotional issues (93%). Five lowest ranked topics were as follows: difficulties praying (50%), other spiritual concerns (55, 56, and 60%), and feeling bored (60%). Barriers for assessing PROs included: time (58%), insufficient staff (49%), logistics (32%), and financial resources (26%). Providers from developing countries more often reported barriers concerning insufficient staff, logistics, and financial resources. CONCLUSIONS HCPs strongly value the use of physical and psychosocial PROs within pediatric oncology practice, but mainly perceive organizational barriers for routine assessment. To successfully integrate PROs, efforts should be made to address HCP-perceived barriers, such that patient-reported problems can be detected and timely referrals made.
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Affiliation(s)
- Sasja A. Schepers
- Division of Pediatrics, Psychosocial Department, Academic Medical Centre/Emma Children’s Hospital, Amsterdam, the Netherlands,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Lotte Haverman
- Division of Pediatrics, Psychosocial Department, Academic Medical Centre/Emma Children’s Hospital, Amsterdam, the Netherlands
| | - Sima Zadeh
- Behavioral Health Core, Pediatric Psychosocial Support and Research Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Martha A. Grootenhuis
- Division of Pediatrics, Psychosocial Department, Academic Medical Centre/Emma Children’s Hospital, Amsterdam, the Netherlands,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Lori Wiener
- Behavioral Health Core, Pediatric Psychosocial Support and Research Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
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