Arpawong T Em, Oland Alyssa, Milam Joel E, Ruccione Kathleen, Meeske Kathleen A
Department of Preventive Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA.
Children's Center for Cancer and Blood Diseases, Division of Hematology-Oncology, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Psychooncology. 2013 Oct;22(10):2235-44. doi: 10.1002/pon.3286. Epub 2013 Apr 2.
Although some survivors of childhood cancer report significant psychosocial distress, many also report having derived benefits, or post-traumatic growth (PTG), from their cancer experience. This study examines PTG and its correlates among an ethnically diverse sample of adolescent/young adult (AYA) cancer survivors who have recently completed treatment.
Survivors of childhood cancer (n = 94; 47% Hispanic), ages 11-21 and within 6 months of completing cancer therapy, were recruited from three pediatric cancer centers. Participants completed a structured interview that assessed demographics, PTG, post-traumatic stress symptoms, health-related quality of life, optimism, and depressive symptoms. Diagnosis/treatment information was collected from each patient's medical record. Multiple regression analyses were used to identify significant correlates of PTG.
The majority of survivors reported positive growth. PTG was positively associated with psychosocial functioning and post-traumatic stress symptoms and inversely associated with physical functioning and depressive symptoms. PTG was significantly lower among survivors of bone tumors (vs. survivors of other cancers) and Hispanic survivors who primarily spoke English at home (vs. Hispanics who primarily spoke Spanish at home and non-Hispanics). PTG was not significantly related to age, sex, optimism, cancer treatment modality, duration of treatment, or treatment intensity.
The AYA survivors commonly reported PTG in the immediate aftermath of cancer treatment. Findings regarding PTG among more acculturated Hispanic and bone tumor AYA survivors may help to inform risk-adapted clinical interventions, among those transitioning from active treatment to post-treatment surveillance, to mitigate negative long-term sequelae and enhance positive psychosocial adaptation from the cancer diagnosis and treatment.
尽管一些儿童癌症幸存者报告有显著的心理社会困扰,但许多人也报告从他们的癌症经历中获得了益处,即创伤后成长(PTG)。本研究调查了近期完成治疗的不同种族青少年/青年成人(AYA)癌症幸存者中的PTG及其相关因素。
从三个儿科癌症中心招募了94名年龄在11至21岁之间、完成癌症治疗后6个月内的儿童癌症幸存者(47%为西班牙裔)。参与者完成了一项结构化访谈,评估人口统计学、PTG、创伤后应激症状、健康相关生活质量、乐观主义和抑郁症状。从每位患者的病历中收集诊断/治疗信息。采用多元回归分析确定PTG的显著相关因素。
大多数幸存者报告有积极的成长。PTG与心理社会功能和创伤后应激症状呈正相关,与身体功能和抑郁症状呈负相关。骨肿瘤幸存者(与其他癌症幸存者相比)以及在家主要说英语的西班牙裔幸存者(与在家主要说西班牙语的西班牙裔和非西班牙裔相比)的PTG显著较低。PTG与年龄、性别、乐观主义、癌症治疗方式、治疗持续时间或治疗强度无显著相关性。
AYA幸存者在癌症治疗后不久普遍报告有PTG。关于文化适应程度较高的西班牙裔和骨肿瘤AYA幸存者中PTG的研究结果,可能有助于为从积极治疗过渡到治疗后监测的人群提供风险适应性临床干预措施,以减轻负面长期后遗症,并增强从癌症诊断和治疗中获得的积极心理社会适应。