Division of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
J Pediatr. 2013 Jan;162(1):160-5. doi: 10.1016/j.jpeds.2012.06.066. Epub 2012 Jul 24.
To investigate school absenteeism among childhood cancer survivors and their siblings and examine factors related to absenteeism in survivors.
A cross-sectional study was conducted among consecutive cancer survivors attending a large pediatric cancer survivor clinic. Absenteeism rates were obtained for survivors and their closest in age sibling from school report cards. Absenteeism was compared with a population control group of 167752 students using 1-sample t tests. The Child Vulnerability Scale, Pediatric Quality of Life Inventory, and Behavior Assessment System for Children were administered to survivors. Univariate and multiple regression analyses assessed variables associated with days absent.
One hundred thirty-one survivors (median age at assessment: 13.4 years, range 8.0-19.2; median age at diagnosis: 9.4 years, range 4.3-17.3) and 77 siblings (median age at assessment: 13 years, age range 7-18) participated. Survivors and siblings missed significantly more school days than the population control group (mean ± SD: 9.6 ± 9.2 and 9.9 ± 9.8 vs 5.0 ± 5.6 days, respectively, P < .0001). Among matched survivor-sibling pairs (N = 77), there was no difference in absenteeism (9.6 ± 9.2 vs 9.9 ± 9.8 days, P = .85). Absenteeism in survivors was significantly associated with a low Pediatric Quality of Life Inventory Physical Health Summary Score (P = .01). Parents' perception of their child's vulnerability and emotional and social functioning were not associated with absenteeism.
Childhood cancer survivors and siblings miss more school than the general population. The only predictor of absenteeism in survivors is poor physical quality of health. More research should be devoted to school attendance and other outcomes in siblings of childhood cancer survivors.
调查儿童癌症幸存者及其兄弟姐妹的缺课情况，并研究与幸存者缺课相关的因素。
对在一家大型儿科癌症幸存者诊所就诊的连续癌症幸存者进行了横断面研究。从学校报告卡中获得幸存者及其年龄最接近的兄弟姐妹的缺课率。通过 1 样本 t 检验，将幸存者的缺课率与 167752 名学生的人口对照组进行比较。对幸存者进行了儿童易感性量表、儿科生活质量量表和儿童行为评估系统的评估。单变量和多变量回归分析评估了与缺勤天数相关的变量。
131 名幸存者（评估时的中位年龄为 13.4 岁，范围为 8.0-19.2；诊断时的中位年龄为 9.4 岁，范围为 4.3-17.3）和 77 名兄弟姐妹（评估时的中位年龄为 13 岁，年龄范围为 7-18）参与了研究。幸存者和兄弟姐妹的缺课天数明显多于人口对照组（平均±标准差：9.6±9.2 和 9.9±9.8 与 5.0±5.6 天，分别，P<.0001）。在匹配的幸存者-兄弟姐妹对（N=77）中，缺课率无差异（9.6±9.2 与 9.9±9.8 天，P=.85）。幸存者的缺课情况与儿科生活质量量表身体健康综合评分较低显著相关（P=.01）。父母对孩子易感性的看法以及情绪和社会功能与缺课无关。
儿童癌症幸存者及其兄弟姐妹的缺课率高于一般人群。幸存者缺课的唯一预测因素是身体健康质量差。应投入更多的研究关注儿童癌症幸存者的兄弟姐妹的就学情况和其他结果。
