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Sievers Y, Roser K, Scheinemann K, Michel G, Ilic A. The information needs of relatives of childhood cancer patients and survivors: A systematic review of quantitative evidence. PATIENT EDUCATION AND COUNSELING 2024; 126:108316. [PMID: 38788309 DOI: 10.1016/j.pec.2024.108316] [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: 01/30/2024] [Revised: 04/04/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE We aimed to: (1) summarize the quantitative evidence on the information needs of relatives of childhood cancer patients, survivors, and children deceased from cancer; and (2) identify factors associated with these needs. METHODS PubMed, PsycINFO, Scopus, and CINAHL were systematically searched. The methodological quality of all included publications was assessed, and the extracted data were analyzed using narrative synthesis. RESULTS Of 5810 identified articles, 45 were included. Information needs were classified as unmet, met (satisfied), and unspecified and categorized into five domains: medical information, cancer-related consequences, lifestyle, family, and support. Most unmet information needs concerned cancer-related consequences (e.g., late effects), while information needs on support were generally met. Migrant background and higher education were associated with higher information needs among parents. Siblings had lower information needs than parents. CONCLUSION This systematic review provides a comprehensive overview of the information needs of relatives in the context of childhood cancer, showing that information on cancer-related consequences is needed most often. The socioeconomic background of the relatives needs continued consideration throughout the cancer trajectory. PRACTICE IMPLICATIONS Our findings suggest the need for personalized information. Healthcare professionals should adapt their communication strategies to respond to the different and evolving needs of all affected relatives.
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Affiliation(s)
- Yara Sievers
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Division of Hematology and Oncology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland; Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Anica Ilic
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Parrillo E, Petchler C, Jacobson LA, Ruble K, Paré-Blagoev EJ, Nolan MT. Integrative review of school integration support following pediatric cancer. J Cancer Surviv 2024; 18:325-343. [PMID: 36318444 PMCID: PMC9628445 DOI: 10.1007/s11764-022-01276-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE This study aims to understand parents' experiences of school integration support for their child's transition to K-12 schooling during or after cancer treatment. METHODS This integrative literature review used PubMed, CINAHL, PsycINFO, and Embase databases and included articles from January 2000 to July 2022 describing parent experiences with support from healthcare providers, school faculty/systems, and school integration programs. This review was guided by an adapted School Re-Entry Model and used constant comparison to identify common themes and guide synthesis. The Johns Hopkins Evidence and Quality Guide was used to appraise article quality and level of evidence. RESULTS Thirty-five articles were included in the final review: seventeen qualitative, fourteen quantitative, and four mixed or multi-method designs. Parents reported experiences receiving support from healthcare providers, school faculty/systems, school integration programs, and "other" sources. Parents reported both facilitators and barriers to communication, knowledge, and the process of receiving school integration support. CONCLUSIONS Parents found neuro/psychologists highly supportive but reported limited support from other healthcare providers. Most parents reported mixed experiences with school faculty and reported many barriers to school system support. Parents reported positive experiences with school integration programs; however, limited programs were available. IMPLICATIONS FOR CANCER SURVIVORS Future programs and research should focus on addressing identified barriers and facilitators of school integration support. Further work is also needed to understand a wider range of parent experiences during school integration.
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Affiliation(s)
- Elaina Parrillo
- Johns Hopkins University School of Nursing, Baltimore, MD, USA.
| | - Claire Petchler
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Lisa A Jacobson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Kathy Ruble
- Division of Pediatric Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Marie T Nolan
- Conway School of Nursing, The Catholic University of America, Washington, DC, USA
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Milner SH, Feltbower RG, Absolom KL, Glaser AW. Identifying social outcomes of importance for childhood cancer survivors: an e-Delphi study. J Patient Rep Outcomes 2024; 8:14. [PMID: 38315438 PMCID: PMC10844160 DOI: 10.1186/s41687-023-00676-7] [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: 06/20/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024] Open
Abstract
PURPOSE Childhood cancer survivors (CCS) are at risk of deficits in their social outcomes, a key aspect of overall health and quality of life. Social outcomes of import are ill-defined leading to potential gaps in research and service provision. In this study, we undertook a preliminary consensus seeking exercise to support the development of a framework of the important social outcomes for CCS. METHODS A modified e-Delphi study was conducted with four groups: CCS, health professionals, social workers and teachers. Round 1, developed from a literature review, included 34 questions rated for importance on a 7-point Likert scale. Rounds 2 and 3 presented items not achieving consensus, additionally proposed items and in round 3, a ranking question. RESULTS Survey 1 was completed by 38 participants, 31 (82%) completed survey 2 and 28 (76%) completed survey 3. A total of 36 items were prioritised across 6 domains (education, independence, work, relationships, community, lifestyle), together forming the final list of social outcomes. Of these, 22 items met consensus for importance. Items rated most important were "having autonomy" and "avoiding social isolation". Quantitative and qualitative results reflected that social outcomes for survivors and general public should be the same. CONCLUSION We have generated initial consensus on important social outcomes for CCS, highlighting the need for these to be matched to those of the general population. It suggests strategies are required to ensure autonomy and appropriate support for independence and relationships are provided through long-term aftercare and beyond. Further work is needed to validate and develop these findings into a framework to support appropriate social aftercare for CCS.
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Affiliation(s)
- Sarah H Milner
- Leeds Institute for Data Analytics, University of Leeds, Worsley Building, Clarendon Way, Woodhouse, Leeds, LS2 9NL, UK.
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK.
- Leeds Teaching Hospitals NHS Trust, Leeds, LS1 3EX, UK.
| | - R G Feltbower
- Leeds Institute for Data Analytics, University of Leeds, Worsley Building, Clarendon Way, Woodhouse, Leeds, LS2 9NL, UK
| | - K L Absolom
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - A W Glaser
- Leeds Institute for Data Analytics, University of Leeds, Worsley Building, Clarendon Way, Woodhouse, Leeds, LS2 9NL, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, LS1 3EX, UK
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Ruble K, Carey LB, Paré-Blagoev JE, Thornton CP, Northrup RA, Northman L, Hayashi RJ, Paltin I, Foster R, Greenzang K, Hobbie WL, Jacobson LA. Communicating neurocognitive impacts of childhood cancer: Engaging stakeholders to identify research priorities. PATIENT EDUCATION AND COUNSELING 2023; 116:107935. [PMID: 37579619 DOI: 10.1016/j.pec.2023.107935] [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: 04/13/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE Supporting childhood cancer survivors with neurocognitive late effects is critical and requires additional attention in the research arena. This convening project's aim was to engage parents, healthcare providers, and education stakeholders in order to identify research priorities regarding patient/family-provider communication about neurocognitive impacts associated with childhood cancer. METHODS Specific components of the Stakeholder Engagement in quEstion Development (SEED) method were combined with an online e-Delphi consensus building approach. Multiple modalities were utilized for engagement including in-person/hybrid meetings, email/Zoom/call communications, targeted-asynchronous learning activities by stakeholders, iterative surveys, and hands-on conceptual modeling. RESULTS Twenty-four (parents n = 10, educators n = 5, healthcare providers n = 9) participated in the year-long project, generating 8 research questions in the stakeholder priority domains of training families/caregiver, access of neuropsychological assessment, tools to facilitate communication and training medical providers. CONCLUSIONS This paper illustrates a successful stakeholder convening process using multi-modal engagement to establish research priorities. The resulting questions can be utilized to guide research projects that will fill gaps to providing optimal care to children with neurocognitive late effects. PRACTICE IMPLICATIONS This process can be used as a template for tackling other healthcare issues that span across disciplines and domains, where stakeholders have rare opportunities to collaborate.
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Affiliation(s)
- Kathy Ruble
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
| | - Lisa B Carey
- Kennedy Krieger Institute, Baltimore, MD, USA; Johns Hopkins University, School of Education, Baltimore, MD, USA
| | | | | | | | | | | | - Iris Paltin
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rebecca Foster
- Washington University, School of Medicine, St. Louis, MO, USA
| | | | - Wendy L Hobbie
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lisa A Jacobson
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA; Kennedy Krieger Institute, Baltimore, MD, USA
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Parrillo E, Perrin N, Ruble K, Paré-Blagoev EJ, Jacobson LA. Developing a Tool for Measuring Parent Knowledge and Barriers to Supportive School Integration After Diagnosis of Childhood Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:217-225. [PMID: 36919251 DOI: 10.1177/27527530221140068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background: Children treated for cancer are at risk for long-term neurocognitive late effects that can impact school attainment, employment, and quality of life. Obtaining formal education support can be critical to later success but may depend upon parent knowledge and ability to access needed support. The purpose of this study was to develop and evaluate the psychometric properties of a scale to measure the perceived support that parents received upon their child's return to school during or after cancer treatment. Methods: Exploratory factor analyses evaluated the construct validity of survey items. Cronbach's alpha was used to test the internal consistency and independent t-tests evaluated the concurrent criterion validity of resulting subscales. Results: The exploratory factor analyses resulted in two subscales, Barriers to Supportive School Integration (13 items) and Parent School Integration Knowledge (three items). All items loaded at least 0.49 onto each factor, with Cronbach's alpha values of 0.927 and 0.738, respectively. The Knowledge subscale additionally demonstrated concurrent criterion validity; higher Knowledge subscale scores were found among parents who reported receiving information about treatment-related cognitive/school problems from healthcare providers (p < .001). Discussion: The Parent School Integration Knowledge and Barriers to Supportive School Integration subscales demonstrated preliminary evidence for good construct validity and internal consistency. These subscales may be used in future research to assess parent knowledge, barriers to receiving support, and overall experience of supportive school integration after the diagnosis of pediatric cancer.
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Affiliation(s)
- Elaina Parrillo
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Kathy Ruble
- Division of Pediatric Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Lisa A Jacobson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
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Ruble K, Paré-Blagoev J, Carey LB, Milla K, Thornton CP, Henegan S, Jacobson LA. Strategies to improve communication about neurocognitive impacts in pediatric oncology: Quality improvement findings. Pediatr Blood Cancer 2023; 70:e30072. [PMID: 36326122 DOI: 10.1002/pbc.30072] [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: 07/06/2022] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Neurocognitive deficits are common among children who receive central nervous system (CNS)-directed therapy for childhood cancer. Parents report that they lack information from and communication with oncology providers about neurocognitive impacts of therapy. Furthermore, oncology providers report they lack training and institutional support to appropriately address the neurocognitive needs of these patients/families. METHODS A parent/provider stakeholder informed, quality improvement (QI) project was conducted to educate providers about neurocognitive impacts, increase parent/provider communication, and improve adherence to supportive care guidelines for neuropsychological assessment for children receiving CNS-directed therapy. A 1-h Continuing Medical Education (CME) course was developed to educate providers about neurocognitive impacts and their relation to schooling. A provider-focused electronic medical record (EMR) strategy was used to deliver parent stakeholder-informed return-to-school "roadmaps," with prompts to scaffold parent/provider communication and enhance documentation of findings. RESULTS Hospital-based CME sessions were attended by 76% (41 out of 54) of providers from our institution. Among the 34 who completed both pretest and posttest, the mean knowledge score improved from 56% at pretest to 74% at posttest. Compliance with the EMR strategy was 80% and there was a 42% increase in neuropsychological assessment referrals. CONCLUSIONS We conclude that this QI project is an example of a successful parent/provider stakeholder collaboration that achieved demonstrable positive change in the areas of provider knowledge, patient/provider communication, and alignment of neuropsychological assessment referrals with existing guidelines. Our results confirm that improving knowledge, communication, and compliance with neuropsychological standards of care is possible with this evidence-based approach.
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Affiliation(s)
- Kathy Ruble
- Division of Pediatric Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Juliana Paré-Blagoev
- Division of Advanced Studies in Education, Johns Hopkins University School of Education, Baltimore, MD, United States
| | - Lisa B Carey
- Division of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Kimberly Milla
- Division of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Clifton P Thornton
- Center for Pediatric Nursing Research and Evidence-Based Practice, Children's Hospital of Phildelphia, Philadelphia, United States
| | - Sydney Henegan
- Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, MD, United States
| | - Lisa A Jacobson
- Division of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States.,Division of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, United States
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Thornton CP, Ruble K, Jacobson LA. Education for Children With Chronic Illness: Moving Forward in Online and Virtual Learning. JAMA Pediatr 2022; 176:341-342. [PMID: 34982143 DOI: 10.1001/jamapediatrics.2021.5643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Clifton P Thornton
- PhDcandidate, Johns Hopkins School of Nursing, Herman & Walter Samuelson Children's Hospital at Sinai, Baltimore, Maryland
| | - Kathy Ruble
- Survivorship Clinic, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lisa A Jacobson
- Kennedy Krieger Institute, Department of Neuropsychology, Johns Hopkins School of Medicine, Baltimore, Maryland
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Stavinoha PL, Trinh-Wong T, Rodriguez LN, Stewart CM, Frost K. Educational Pain Points for Pediatric Brain Tumor Survivors: Review of Risks and Remedies. CHILDREN 2021; 8:children8121125. [PMID: 34943320 PMCID: PMC8700207 DOI: 10.3390/children8121125] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 01/29/2023]
Abstract
Evolving treatment paradigms have led to increased survival rates for children diagnosed with a brain tumor, and this has increasingly shifted clinical and research focus to morbidity and quality of life among survivors. Among unfavorable outcomes, survivors of pediatric brain tumors are at risk for academic failure and low educational attainment, which may then contribute to lower health related quality of life, lower income and vocational status, and a greater likelihood of dependence on others in adulthood. Several specific risk factors for lower educational performance and attainment have been investigated. These are typically examined in isolation from one another which clouds understanding of the full range and potential interplay of contributors to educational difficulties. This review integrates and summarizes what is known about the direct and indirect barriers to educational success and performance (i.e., educational pain points) to enhance clinician knowledge of factors to consider when working with pediatric brain tumor survivors. Specific barriers to educational success include neurocognitive difficulties, school absences, psychosocial challenges, challenges to knowledge and communication, and physical and sensory difficulties. Finally, we discuss the current state of educational interventions and supports and offer recommendations for future research to improve educational outcomes for pediatric brain tumor survivors.
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Carey LB, Ruble K, Paré-Blagoev J, Milla K, Thornton CP, Henegan S, Jacobson LA. Childhood Cancer Survivors and Distance Education Challenges: Lessons Learned From the COVID-19 Pandemic. J Pediatr Psychol 2021; 47:15-24. [PMID: 34643698 DOI: 10.1093/jpepsy/jsab103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Pediatric cancer survivors have historically struggled to receive adequate educational supports. In Spring 2020, the COVID-19 pandemic forced an emergency switch from traditional in-person education models to distance education, but little information is available regarding experiences of pediatric survivors' coping with schooling since that time. METHODS This article presents exploratory mixed methods findings from a quality improvement project including qualitative interviews and a quantitative survey conducted with parents of pediatric oncology survivors identified through neuropsychological assessment, and the use of school-based services as having educationally relevant neurocognitive impacts of disease or treatment. The interviews explored experiences of education and instructional delivery during the COVID-19 school closures in spring of 2020 and the beginning of the 2020-2021 school year and served as the foundation for a quantitative survey to determine the generalizability of findings. RESULTS Qualitative interviews highlighted 3 emergent themes regarding the shared experiences of distance schooling for children with cancer during the COVID-19 school closures: (a) attention, (b) mental health, and (c) access to instruction. A follow-up quantitative survey supported the qualitative findings and their generalizability to the schooling experiences of other children with cancer during the pandemic. CONCLUSION This article describes and explores each theme and offers suggestions for pediatric supports and changes to provider service delivery (including weblinks to access project-developed resources) as a result of ongoing pandemic-related schooling needs.
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Affiliation(s)
- Lisa B Carey
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School of Education, Baltimore, MD, USA
| | - Kathy Ruble
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Kimberly Milla
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Clifton P Thornton
- Johns Hopkins University School of Nursing, Herman & Walter Samuelson Children's Hospital, Baltimore, MD, USA
| | - Sydney Henegan
- Johns Hopkins University School of Nursing, Herman & Walter Samuelson Children's Hospital, Baltimore, MD, USA
| | - Lisa A Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Oswald K, Bitensky D, Stuchell E, Edmonds A, Richard A, Hodges E, Heinrich K. Neuropsychological assessment in pediatric oncology survivorship care: utilization of services, results of evaluation, and educational and behavioral health outcomes. Support Care Cancer 2021; 29:7965-7974. [PMID: 34213645 DOI: 10.1007/s00520-021-06401-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 06/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Neuropsychological evaluation has become a standard component of long-term follow-up care for survivors of pediatric cancer. The purpose of the present study was to examine access to, and benefits of, neuropsychological evaluation for survivors. METHODS A retrospective chart review was conducted on cancer survivors who were referred for neuropsychological evaluation from a multidisciplinary long-term follow-up (LTFU) clinic approximately 5 years following treatment cessation. Descriptive statistics were calculated, and t-tests and chi-square analyses were utilized to examine variables that may impact survivors' access to neuropsychological services. RESULTS One hundred seven survivors between 6 and 26 years old were referred for a neuropsychological evaluation. Referred male patients were less likely than female patients to schedule an evaluation. Consultation with a neuropsychologist in the LTFU clinic was related to more referrals but did not improve attrition rates (55%). Twenty-four percent of evaluated patients displayed severe cognitive impairment and 75% were diagnosed with a psychological disorder. Utilization of educational and behavioral health services did not significantly change following evaluation. CONCLUSION Survivors' utilization of neuropsychological services is lower for males than females. The presence of a neuropsychologist in a multidisciplinary team clinic can improve identification of survivors that may benefit from neuropsychological evaluation. Many survivors did not receive recommended services, suggesting patients and families may need additional supports following evaluation. Future research should focus on improving survivors' access to neuropsychological services and identifying barriers to receiving recommended services.
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Affiliation(s)
- Kaitlin Oswald
- Department of Psychiatry, Neuropsychology Section, University of Michigan, Ann Arbor, MI, USA.
| | - Dylan Bitensky
- Department of Psychiatry, Neuropsychology Section, University of Michigan, Ann Arbor, MI, USA
| | - Elizabeth Stuchell
- Department of Psychiatry, Neuropsychology Section, University of Michigan, Ann Arbor, MI, USA
| | - Amy Edmonds
- Department of Psychiatry, Neuropsychology Section, University of Michigan, Ann Arbor, MI, USA
| | - Annette Richard
- Department of Psychiatry, Neuropsychology Section, University of Michigan, Ann Arbor, MI, USA
| | - Elise Hodges
- Department of Psychiatry, Neuropsychology Section, University of Michigan, Ann Arbor, MI, USA
| | - Kimberley Heinrich
- Department of Psychiatry, Neuropsychology Section, University of Michigan, Ann Arbor, MI, USA
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