Stam H, Grootenhuis M A, Caron H N, Last B F
Paediatric Psychosocial Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, G8-224 Meibergdreef 9, NL-1105 AZ Amsterdam, The Netherlands.
Psychooncology. 2006 Jan;15(1):31-43. doi: 10.1002/pon.920.
As a result of advances in the treatment of childhood cancer many patients who may previously have had a limited life expectancy, are now surviving into adulthood. More insight is needed into the long-term adjustment of young adult survivors of childhood cancer. The purpose of this study was to (1) assess health-related quality of life (HRQoL), and (2) to explore the role of cognitive coping in relation to HRQoL.
HRQoL of 353 Dutch young adult survivors of childhood cancer was compared with HRQoL of 507 peers. Linear regression analyses predicted survivors' HRQoL by cognitive coping, independent of the impact of demographics and medical variables.
Survivors reported a lower HRQoL than their peers. Health status was the best predictor of the Physical Component Scale of the RAND-36; health status and cognitive coping contributed almost equally well to the Mental Component Scale. The explanatory value of cognitive coping could mainly be attributed to the use of predictive control strategies.
Because current coping seemed to be an important predictor of HRQoL, interventions directed at the coping strategies of survivors should be useful. The strong association between predictive coping and HRQoL stresses the importance of focusing at having positive expectations about the further course of the disease.
由于儿童癌症治疗取得进展,许多以前预期寿命有限的患者现在存活至成年期。对于儿童癌症成年幸存者的长期适应情况,需要有更多了解。本研究的目的是:(1)评估健康相关生活质量(HRQoL),以及(2)探讨认知应对在HRQoL方面的作用。
将353名荷兰儿童癌症成年幸存者的HRQoL与507名同龄人进行比较。线性回归分析通过认知应对来预测幸存者的HRQoL,不受人口统计学和医学变量影响。
幸存者报告的HRQoL低于同龄人。健康状况是兰德36项健康调查简表身体成分量表的最佳预测指标;健康状况和认知应对对心理成分量表的贡献几乎相同。认知应对的解释价值主要可归因于预测性控制策略的使用。
由于当前的应对方式似乎是HRQoL的重要预测指标,针对幸存者应对策略的干预措施应该会有帮助。预测性应对与HRQoL之间的紧密关联强调了对疾病未来进程抱有积极期望的重要性。