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Moscato E, Patronick J, Wade SL. Family functioning and adaptation following pediatric brain tumor: A systematic review. Pediatr Blood Cancer 2022; 69:e29470. [PMID: 34842339 DOI: 10.1002/pbc.29470] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Pediatric brain tumor survivors (PBTS) experience psychosocial difficulties and poor quality of life (QOL). Family functioning may be adversely impacted by the stress of diagnosis and associated symptoms, which may, in turn, affect PBTS outcomes. The objective of this study was to complete a systematic review of family functioning and psychosocial outcomes in PBTS. METHODS We conducted systematic searches of PubMed and PsychInfo. Full-text articles (n = 324) were screened and 14 were included. A risk-of-bias assessment was conducted to evaluate the quality of study conclusions. RESULTS Studies examined associations of family functioning with adaptive, social, emotional, and behavioral outcomes, and QOL. More adaptive family functioning (cohesiveness, effective communication, lower conflict) was associated with better PBTS outcomes. Studies were limited by heterogeneous/small samples and cross-sectional designs. CONCLUSIONS Results provide preliminary support for the relationship between family functioning and psychosocial outcomes. Common outcome measures and prospective research designs can further advance understanding.
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Affiliation(s)
- Emily Moscato
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA.,Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jamie Patronick
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA.,Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Shari L Wade
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA.,Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Al Ghriwati N, Albee M, Brodsky C, Hocking MC. Patterns of family relationships in pediatric oncology: implications for children's adjustment upon treatment completion. Support Care Cancer 2021; 29:6751-6759. [PMID: 33982166 DOI: 10.1007/s00520-021-06280-z] [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: 10/21/2020] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Family characteristics influence children's adaptation following a cancer diagnosis. Little is known about the importance of family relationships on children's social and emotional health immediately after treatment completion. In this study, we identify subtypes of family relationships and evaluate how these profiles relate to child adjustment upon treatment completion. METHODS Youth (N = 77; ages 7-14) who completed cancer treatment within the past 7 months provided their perceptions of their relationships with their caregivers and siblings. Caregivers and teachers rated participants' internalizing and externalizing symptoms, while participants and caregivers reported on child social and overall functioning. Latent profile analyses identified patterns of family relationships, and we examined associations between these patterns and youth outcomes. RESULTS A four-profile solution best characterized families as (1) low closeness/high sibling-only discord (12.4%); (2) low closeness/high discord (6.6%); (3) high closeness/low discord (47.6%); and (4) moderate closeness/moderate discord (33.4%). Family relationship profiles were differentially associated with self, caregiver, and teacher ratings of adaptation. Participants from families characterized by low closeness/high discord reported more difficulties with peer interactions than participants with high closeness/low discord in their families. Caregivers and teachers reported significantly higher externalizing symptoms for participants from low closeness/high discord and low closeness/high sibling discord families in comparison to participants with high closeness/low discord in their family. CONCLUSIONS Findings underscore the importance of assessing children's perceptions of family relationships in pediatric oncology and providing support to the family during and after treatment. Future directions include assessing how these profiles predict outcomes over time.
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Affiliation(s)
- Nour Al Ghriwati
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - May Albee
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Cole Brodsky
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Matthew C Hocking
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. .,Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.
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3
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Wade SL, Narad ME, Moscato EL, LeBlond EI, King JA, Raj SP, Platt A, Thompson AN, Baum KT, Salloum R. A Survivor's Journey: Preliminary efficacy of an online problem-solving therapy for survivors of pediatric brain tumor. Pediatr Blood Cancer 2020; 67:e28043. [PMID: 31724307 DOI: 10.1002/pbc.28043] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Although pediatric brain tumor survivors are at high risk for a variety of psychosocial and neurocognitive late effects, there are few evidence-based interventions to address their needs. The purpose of this study was to test the efficacy of an online problem-solving intervention on improving the quality of life and executive dysfunction among adolescent and young adult brain tumor survivors. PROCEDURE A Survivor's Journey was adapted from a similar intervention for survivors of traumatic brain injuries, and involved self-guided web modules providing training in problem-solving as a tool for coping with everyday challenges, as well as weekly teleconferences with a trained therapist. Survivors (n = 19) between the ages of 13 and 25, and their caregivers, completed standardized measures of their emotional and behavioral functioning, executive functioning, and quality of life before and after the 12- to 16-week intervention. RESULTS Participation in the intervention led to significant improvements in self-reported overall (Mpre = 62.03, SDpre = 17.67, Mpost = 71.97, SDpost = 16.75; d = 0.58, P = 0.01) and physical quality of life (Mpre = 63.13, SDpre = 21.88, Mpost = 75.00, SDpost = 21.33; d = 0.55, P < 0.01) as well as parent-reported emotional quality of life (Mpre = 65.00, SDpre = 28.72, Mpost = 76.15, SDpost = 23.47; d = 0.43, P = 0.03). Greater improvement was noted in those who were diagnosed before the age of seven and those with average or above average estimated IQs. Current age did not moderate outcomes. CONCLUSIONS Online problem-solving therapy may be efficacious in improving pediatric brain tumor survivors' quality of life; however, further research with a comparison group is needed. Online interventions such as Survivor's Journey may decrease barriers to evidence-based psychosocial care for brain tumor survivors.
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Affiliation(s)
- Shari L Wade
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - Megan E Narad
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Emily L Moscato
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Psychology, University of Cincinnati, Cincinnati, Ohio
| | - Elizabeth I LeBlond
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Psychology, University of Cincinnati, Cincinnati, Ohio
| | - Jessica A King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stacey P Raj
- School of Psychology, Xavier University, Cincinnati, Ohio
| | - Amber Platt
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Aimee N Thompson
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,PsychBc, Blue Ash, Ohio
| | - Katherine T Baum
- Department of Child & Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ralph Salloum
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.,Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Hocking MC, Hobbie WL, Deatrick JA, Hardie TL, Barakat LP. Family Functioning Mediates the Association Between Neurocognitive Functioning and Health-Related Quality of Life in Young Adult Survivors of Childhood Brain Tumors. J Adolesc Young Adult Oncol 2016; 4:18-25. [PMID: 25852971 DOI: 10.1089/jayao.2014.0022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Childhood brain tumor (BT) survivors experience significant neurocognitive sequelae that affect health-related quality of life (HRQOL). A model of neurodevelopmental late effects and family functioning in childhood cancer survivors suggests associations between survivor neurocognitive functioning, family functioning, and survivor HRQOL. This study examines the concurrent associations between survivor neurocognitive functioning, family functioning, and survivor emotional HRQOL, and the indirect effects of neurocognitive functioning on survivor emotional HRQOL through family functioning. METHODS Participants included young adult-aged childhood BT survivors (18-30 years old; N=34) who were on average 16 years post-diagnosis, and their mothers. A brief neuropsychological battery assessed working and verbal memory, processing speed, and executive functioning. Survivors and mothers completed measures of family functioning, and mothers completed a proxy-report measure of survivor HRQOL. RESULTS Spearman bivariate correlations examined the associations between indices of survivor neurocognitive functioning and concurrent family functioning and survivor emotional HRQOL. Poorer survivor processing speed, working memory, verbal memory, and executive function were significantly associated with worse survivor- and mother-reported family functioning (r's range: 0.36-0.58). Additionally, worse survivor processing speed and executive function were significantly associated with poorer survivor emotional HRQOL (r's range: 0.44-0.48). Bootstrapping analyses provided evidence for the indirect effects of neurocognitive functioning on survivor emotional HRQOL through family functioning. CONCLUSION These findings suggest that family functioning is an important variable that might mitigate the negative influence of neurocognitive late effects on survivors and is a potential target in future interventions.
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Affiliation(s)
- Matthew C Hocking
- Division of Oncology, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Wendy L Hobbie
- Division of Oncology, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania. ; School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Janet A Deatrick
- School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Thomas L Hardie
- School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Lamia P Barakat
- Division of Oncology, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania. ; Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
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Deatrick JA, Thibodeaux AG, Mooney K, Schmus C, Pollack R, Davey BH. Family Management Style Framework: A New Tool With Potential to Assess Families Who Have Children With Brain Tumors. J Pediatr Oncol Nurs 2016; 23:19-27. [PMID: 16689400 DOI: 10.1177/1043454205283574] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Qualitative studies of families with children who have cancer or other serious illnesses have found that families often come to view their child and their lives as normal. They manage illness-related demands using family management styles that sustain usual patterns of family and child functioning. Few studies have addressed the family management styles of families who express less satisfaction with family and child functioning or who are identified by health care professionals as having difficulty with family functioning. Such families are likely to be overrepresented among those whose children are being treated for brain tumors that entail extremely burdensome treatments as well as a range of unfavorable prognoses and long-term sequelae. In fact, little is known about how these families manage on a day-to-day basis and how the interdisciplinary team can best provide supportive care to optimize their functioning. The purpose of this article is to present the Family Management Styles Framework as a tool that is useful in both clinical practice and research for assessing families who have children with cancer, including those with brain tumors.
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Affiliation(s)
- Janet A Deatrick
- Center for Health Disparities Research, University of Pennsylvania School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104-6096, USA.
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Leeman J, Crandell JL, Lee A, Bai J, Sandelowski M, Knafl K. Family Functioning and the Well-Being of Children With Chronic Conditions: A Meta-Analysis. Res Nurs Health 2016; 39:229-43. [PMID: 27128982 DOI: 10.1002/nur.21725] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 11/11/2022]
Abstract
For children with chronic conditions, well-being is closely related to how well their families function. Most prior research syntheses on family functioning and child well-being have focused on children with a single condition, thereby limiting the potential to aggregate and build on what is known across conditions. To address this challenge, research reports were reviewed and meta-analyses conducted of findings on the relationship between family functioning and child well-being across a range of chronic physical conditions. The sample was derived from a larger systematic review study that included 1,028 reports published between January 1, 2000 and March 31, 2014. The current review includes 53 studies in which a relationship between family functioning and child well-being was analyzed using one of four family measures: Family Adaptability and Cohesion Evaluation Scales, Family Environment Scale, Family Relationship Index, or Family Assessment Device. Most studies were cross-sectional and observational (n = 43, 81%). The most frequently studied conditions were diabetes, cancer, sickle cell disease, and asthma. In 37 studies, findings were sufficiently comparable to conduct meta-analyses. Significant correlations were identified between children's psychological health and seven of nine dimensions of family functioning. Significant correlations also were found between dimensions of family functioning and children's problem behaviors, social competence, quality of life, and, to a lesser extent, adherence and physical health. Of the family dimensions, cohesion and conflict were associated most strongly with child outcomes. Understanding the specific family variables, such as conflict, linked to varied child outcomes is key for intervention development. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jennifer Leeman
- Assistant Professor, School of Nursing, University of North Carolina, 5004 Carrington Hall, CB 7460, Chapel Hill, NC, 27599-7460
| | - Jamie L Crandell
- Assistant Professor, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Anna Lee
- Doctoral Candidate, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Jinbing Bai
- Doctoral Candidate, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Margarete Sandelowski
- Cary C. Boshamer Distinguished Professor, School of Nursing, University of North Carolina, Chapel Hill, NC
| | - Kathleen Knafl
- Frances Hill Fox Distinguished Professor, School of Nursing, University of North Carolina, Chapel Hill, NC
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Van Schoors M, Caes L, Verhofstadt LL, Goubert L, Alderfer MA. Systematic Review: Family Resilience After Pediatric Cancer Diagnosis: Figure 1. J Pediatr Psychol 2015; 40:856-68. [DOI: 10.1093/jpepsy/jsv055] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/18/2015] [Indexed: 11/12/2022] Open
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Hocking MC, McCurdy M, Turner E, Kazak AE, Noll RB, Phillips P, Barakat LP. Social competence in pediatric brain tumor survivors: application of a model from social neuroscience and developmental psychology. Pediatr Blood Cancer 2015; 62:375-84. [PMID: 25382825 PMCID: PMC4304946 DOI: 10.1002/pbc.25300] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/16/2014] [Indexed: 12/21/2022]
Abstract
Pediatric brain tumor (BT) survivors are at risk for psychosocial late effects across many domains of functioning, including neurocognitive and social. The literature on the social competence of pediatric BT survivors is still developing and future research is needed that integrates developmental and cognitive neuroscience research methodologies to identify predictors of survivor social adjustment and interventions to ameliorate problems. This review discusses the current literature on survivor social functioning through a model of social competence in childhood brain disorder and suggests future directions based on this model. Interventions pursuing change in survivor social adjustment should consider targeting social ecological factors.
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Affiliation(s)
| | - Mark McCurdy
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Psychology, Drexel University
| | - Elise Turner
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Psychology, Drexel University
| | - Anne E. Kazak
- Center for Healthcare Delivery Science, Nemours Children’s Health System
- Department of Pediatrics, Sidney Kimmel School of Medicine at Thomas Jefferson University
| | | | - Peter Phillips
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania
| | - Lamia P. Barakat
- Division of Oncology, The Children’s Hospital of Philadelphia
- Department of Pediatrics, University of Pennsylvania
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McCarthy MC, Ashley DM, Lee KJ, Anderson VA. Predictors of acute and posttraumatic stress symptoms in parents following their child's cancer diagnosis. J Trauma Stress 2012; 25:558-66. [PMID: 23055298 DOI: 10.1002/jts.21745] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This longitudinal study aimed to examine acute and posttraumatic stress symptoms and predictors of traumatic stress symptoms in parents of children recently diagnosed with cancer. The sample comprised 220 parents of 143 children who completed questionnaires at diagnosis (T1) focused on acute stress disorder (ASD); of these, 145 parents of 97 children completed questionnaires 6-8 months later (T2) focused on posttraumatic stress disorder (PTSD). Demographic, psychosocial, and treatment and illness variables were predictors. Results were that 63% of mothers and 60% of fathers met criteria for ASD at T1. At T2, 21% of mothers and 16% of fathers met criteria for PTSD, with 40% of parents reporting significant subthreshold symptoms. Predictors of ASD symptoms were female gender, presence of psychosocial risk factors, trait anxiety, family functioning, and central nervous system tumor diagnosis. Risk factors for PTSD symptoms were younger maternal age, severity of ASD symptoms, and trait anxiety at T1, and parent-reported quality of life of the child at T2. The results suggest that screening for ASD may help identify parents at increased risk of persistent traumatic stress symptoms who could benefit from preventative, evidence-based psychosocial interventions.
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Affiliation(s)
- Maria C McCarthy
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia.
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10
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Adduci A, Jankovic M, Strazzer S, Massimino M, Clerici C, Poggi G. Parent-child communication and psychological adjustment in children with a brain tumor. Pediatr Blood Cancer 2012; 59:290-4. [PMID: 22492656 DOI: 10.1002/pbc.24165] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 03/19/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND Internalizing problems, anxiety, depression, withdrawal, and consequent social problems are frequently observed in children with brain tumors. The objective of this work is to describe the relationship between these psychological problems and the type of parent-child communication established about the disease. PROCEDURES A group of 64 children surviving a brain tumor (aged 4-18 years) underwent psychological assessment by means of parent reports on the Child Behavior Checklist (CBCL) and the Vineland Adaptive Behavior Scales (VABS). A semi-structured interview with each child and their parents enabled us to classify the method of communication regarding the disease as "avoidance," "ineffective," and "effective." Demographic, clinical, and functional data relating to the disease were also collected. RESULTS A significant relationship between the onset of Internalizing problems, withdrawal, anxiety-depression, and social problems and the presence of avoidance or ineffective communication about the disease was observed (P = 0.001, P = 0.001, P = 0.001, and P = 0.01, respectively). These psychological problems did not prove to be associated to demographic or clinical variables; however, they were found to be related to the children's residual functional problems. By contrast, the method of communication proved to be unrelated to clinical or functional variables, but it was associated to demographic variables such as sex and age at assessment. CONCLUSIONS Effective (complete, truthful, consistent, comprehensible, gradual and continuous, and tailored) communication to the child about his/her condition proved to be associated with a better psychological outcome.
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Hovén EI, Lannering B, Gustafsson G, Boman KK. Persistent impact of illness on families of adult survivors of childhood central nervous system tumors: a population-based cohort study. Psychooncology 2011; 22:160-7. [DOI: 10.1002/pon.2067] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 08/10/2011] [Accepted: 08/10/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Emma I. Hovén
- Karolinska Institutet; Department of Women's and Children's Health; Childhood Cancer Research Unit; Stockholm; Sweden
| | - Birgitta Lannering
- University of Gothenburg; Department of Clinical Sciences, Pediatric Oncology; Gothenburg; Sweden
| | - Göran Gustafsson
- Karolinska Institutet; Department of Women's and Children's Health; Childhood Cancer Research Unit; Stockholm; Sweden
| | - Krister K. Boman
- Karolinska Institutet; Department of Women's and Children's Health; Childhood Cancer Research Unit; Stockholm; Sweden
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Abstract
This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer, were written in English, and were published between 1996 and 2009. Overall, qualitative findings show that families alter roles, responsibilities, and day-to-day functioning to accommodate the needs of children with cancer. Although some degree of family reorganization is normative, the extent and impact of these changes varies. Quantitative work shows that mean levels of family functioning (e.g., cohesion, flexibility) are similar between families facing cancer and normative or comparison samples. However, families follow different trajectories of improvement, decline, or stability in family closeness and marital quality. Parenting has received limited quantitative research attention, but qualitative work suggests that parents perceive deeper bonds with ill children and may spoil or overprotect them. Conclusions support future work examining the influence of family-level variables on the adjustment of individual family members.
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Hocking MC, Hobbie WL, Deatrick JA, Lucas MS, Szabo MM, Volpe EM, Barakat LP. Neurocognitive and family functioning and quality of life among young adult survivors of childhood brain tumors. Clin Neuropsychol 2011; 25:942-62. [PMID: 21722062 DOI: 10.1080/13854046.2011.580284] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Many childhood brain tumor survivors experience significant neurocognitive late effects across multiple domains that negatively affect quality of life. A theoretical model of survivorship suggests that family functioning and survivor neurocognitive functioning interact to affect survivor and family outcomes. This paper reviews the types of neurocognitive late effects experienced by survivors of pediatric brain tumors. Quantitative and qualitative data from three case reports of young adult survivors and their mothers are analyzed according to the theoretical model and presented in this paper to illustrate the importance of key factors presented in the model. The influence of age at brain tumor diagnosis, family functioning, and family adaptation to illness on survivor quality of life and family outcomes is highlighted. Future directions for research and clinical care for this vulnerable group of survivors are discussed.
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Affiliation(s)
- Matthew C Hocking
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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14
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Social competence in childhood brain tumor survivors: a comprehensive review. Support Care Cancer 2010; 18:1499-513. [DOI: 10.1007/s00520-010-0963-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 07/20/2010] [Indexed: 10/19/2022]
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Long LA, Wodrich DL, Levy R, Etzl MM, Gieseking AT. Students with brain tumors: their post-treatment perceptions of teachers, peers, and academics and retrospective views on school during treatment. J Child Health Care 2010; 14:111-25. [PMID: 20147566 DOI: 10.1177/1367493509355531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this pilot study was: (1) to determine how students surviving brain tumors (BTs) perceive their teachers' responses to them, their own academic performance, and their interactions with peers at school using a new measure; and (2) to describe students' retrospective perceptions of schooling while undergoing treatment. Using a sample of 22 students treated for a BT (ages 9-18) and 22 comparison (ages 8-19), no significant BT-control group differences regarding perceptions of teacher response, academic performance, and interactions with peers at school were found. Generally, students with BTs reported positive school experiences during treatment including favorable perceptions of their teachers' effectiveness, enjoyment of schoolwork, and the quality of their schooling. Additionally, they felt that completing schoolwork during treatment was important. The results of this study may provide insight into the perceived psychosocial adjustment and academic performance of students with BTs during and after treatment.
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Affiliation(s)
- Lori A Long
- School Psychology, Arizona State University, Tempe, AZ 85287-0101, USA.
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Penn A, Lowis SP, Stevens MCG, Hunt LP, Shortman RI, McCarter RJ, Pauldhas D, Curran AL, Sharples PM. Family, demographic and illness-related determinants of HRQL in children with brain tumours in the first year after diagnosis. Pediatr Blood Cancer 2009; 53:1092-9. [PMID: 19743518 DOI: 10.1002/pbc.22157] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIMS To evaluate the relationship between parent- and child-report Health-Related Quality of Life (HRQL) and demographic, tumour and family variables in children with a brain tumour in the first year after diagnosis and to identify determinants of HRQL at 12 months. PROCEDURE Longitudinal prospective study: Semi-structured interviews took place approximately 1, 6 and 12 months after diagnosis. HRQL was measured using the self- and parent-report PedsQL 4.0 Total Scale Score. Tumour and treatment variables considered included tumour site and grade, hydrocephalus at diagnosis, chemotherapy and radiotherapy. Family variables included measures of family function, family support and family stress, the primary carer's coping strategies and symptoms of depression and anxiety. Univariate analyses were used at all three time points, and to identify potential early predictors of HRQL at 1 year. Regression analysis was then used to identify the most important determinants of HRQL at 1 year. RESULTS Thirty-five patients completed the 12-month interviews. There were consistent significant negative correlations between concurrent family impact of illness and parent and self-report HRQL, and positive correlations between concurrent family support and parent-report HRQL. Treatment with radio- or chemotherapy correlated with child-report HRQL only at some time points. Multivariate analysis showed infratentorial tumour site, and poor HRQL at 1 month best predicted poor self- and parent-report HRQL at 12 months. CONCLUSION Children with infratentorial tumours and poor HRQL early after diagnosis tend to have poor HRQL at 1 year. While family factors are important modulators of concurrent HRQL, they do not appear important in predicting HRQL.
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Affiliation(s)
- Anthony Penn
- Department of Paediatric Neurology, Frenchay Hospital, Bristol, UK.
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Wolfe-Christensen C, Mullins LL, Stinnett TA, Carpentier MY, Fedele DA. Use of the Behavioral Assessment System for Children 2nd Edition: Parent Report Scale in Pediatric Cancer Populations. J Clin Psychol Med Settings 2009; 16:322-30. [DOI: 10.1007/s10880-009-9174-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Factors Influencing Depressive Symptoms of Children Treated for a Brain Tumor. J Psychosoc Oncol 2008; 26:1-16. [DOI: 10.1300/j077v26n01_01] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Poggi G, Liscio M, Galbiati S, Adduci A, Massimino M, Gandola L, Spreafico F, Clerici CA, Fossati-Bellani F, Sommovigo M, Castelli E. Brain tumors in children and adolescents: cognitive and psychological disorders at different ages. Psychooncology 2005; 14:386-95. [PMID: 15386759 DOI: 10.1002/pon.855] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cognitive and psychological disorders are among the most frequently observed sequelae in brain tumor survivors. The goal of this work was to verify the presence of these disorders in a group of children and adolescents diagnosed with brain tumor before age 18 years, differentiate these disorders according to age of assessment, identify correlations between the two types of impairments and define possible associations between these impairments and clinical variables. The study involved 76 patients diagnosed with brain tumor before age 18 years. Three age groups were formed, and all the patients received a standardized battery of age-matched cognitive and psychological tests. According to our findings, all three groups present with cognitive and psychological-behavioral disorders. Their frequency varies according to age of onset and is strongly associated to time since diagnosis. The performance intelligence quotient (PIQ) was more impaired than the verbal intelligence quotient (VIQ). Internalizing problems, withdrawal and social problems were the most frequent psychological disorders. Correlations were found between cognitive impairment and the onset of the main psychological and behavioral disorders. These findings are relevant as they point out the long-term outcome of brain tumor survivors. Hence, the recommendation to diversify psychological interventions and rehabilitation plans according to the patients' age.
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Affiliation(s)
- Geraldina Poggi
- IRCCS Eugenio Medea, Via Don Luigi Monza 23842, Bosisio Parini (LC), Italy.
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Risk Factors Associated with Long-Term Social and Behavioral Problems Among Children with Brain Tumors. J Psychosoc Oncol 2003. [DOI: 10.1300/j077v21n01_04] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Fuemmeler BF, Elkin TD, Mullins LL. Survivors of childhood brain tumors: behavioral, emotional, and social adjustment. Clin Psychol Rev 2002; 22:547-85. [PMID: 12094511 DOI: 10.1016/s0272-7358(01)00120-9] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This paper reviews the literature on the psychological adjustment and quality of life in children who survive brain tumors. A total of 31 studies were reviewed. Findings are discussed in terms of the rates of general psychological adjustment, internalizing behavior problems, externalizing behavior problems, social competence, correlates or predictors of adjustment, and quality of life among survivors. Although these survivors appear to be at risk for compromised social competence and long-term quality of life, reports in the literature on rates of psychological adjustment in this population vary widely. Limitations in the current literature are discussed including inadequate assessment techniques, lack of appropriate comparison groups, and small sample sizes. Directions for future research are offered.
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Fuemmeler BF, Mullins LL, Marx BP. Posttraumatic Stress and General Distress Among Parents of Children Surviving a Brain Tumor. CHILDRENS HEALTH CARE 2001. [DOI: 10.1207/s15326888chc3003_1] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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