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有神经认知障碍主诉的小儿脑肿瘤幸存者的心理社会状况

Psychosocial profile of pediatric brain tumor survivors with neurocognitive complaints.

作者信息

de Ruiter Marieke Anna, Schouten-van Meeteren Antoinette Yvonne Narda, van Vuurden Dannis Gilbert, Maurice-Stam Heleen, Gidding Corrie, Beek Laura Rachel, Granzen Bernd, Oosterlaan Jaap, Grootenhuis Martha Alexandra

机构信息

Pediatric Psychosocial Department, Emma Children's Hospital AMC, Meibergdreef 9, Room A3-241, 1105 AZ, Amsterdam, The Netherlands.

Department of Pediatric Oncology, Emma Children's Hospital AMC, Amsterdam, The Netherlands.

出版信息

Qual Life Res. 2016 Feb;25(2):435-446. doi: 10.1007/s11136-015-1091-7. Epub 2015 Aug 20.

Abstract

PURPOSE

With more children surviving a brain tumor, neurocognitive consequences of the tumor and its treatment become apparent, which could affect psychosocial functioning. The present study therefore aimed to assess psychosocial functioning of pediatric brain tumor survivors (PBTS) in detail.

METHODS

Psychosocial functioning of PBTS (8-18 years) with parent-reported neurocognitive complaints was compared to normative data on health-related quality of life (HRQOL), self-esteem, psychosocial adjustment, and executive functioning (one-sample t tests) and to a sibling control group on fatigue (independent-samples t test). Self-, parent-, and teacher-report questionnaires were included, where appropriate, providing complementary information.

RESULTS

Eighty-two PBTS (mean age 13.4 years, SD 3.2, 49 % males) and 43 healthy siblings (mean age 14.3, SD 2.4, 40 % males) were included. As compared to the normative population, PBTS themselves reported decreased physical, psychological, and generic HRQOL (d = 0.39-0.62, p < 0.008). Compared to siblings, increased fatigue-related concentration problems (d = 0.57, p < 0.01) were reported, although self-reported self-esteem and psychosocial adjustment seemed not to be affected. Parents of PBTS reported more psychosocial (d = 0.81, p < 0.000) and executive problems (d = 0.35-0.43, p < 0.016) in their child than parents of children in the normative population. Teachers indicated more psychosocial adjustment problems for female PBTS aged 8-11 years than for the female normative population (d = 0.69, p < 0.025), but they reported no more executive problems.

CONCLUSIONS

PBTS with parent-reported neurocognitive complaints showed increased psychosocial problems, as reported by PBTS, parents, and teachers.

IMPLICATIONS FOR CANCER SURVIVORS

Systematic screening of psychosocial functioning is necessary so that tailored support from professionals can be offered to PBTS with neurocognitive complaints.

摘要

目的

随着越来越多的儿童在脑肿瘤后存活下来,肿瘤及其治疗的神经认知后果变得明显,这可能会影响心理社会功能。因此,本研究旨在详细评估小儿脑肿瘤幸存者(PBTS)的心理社会功能。

方法

将有家长报告的神经认知问题的PBTS(8至18岁)的心理社会功能与健康相关生活质量(HRQOL)、自尊、心理社会适应和执行功能的规范数据进行比较(单样本t检验),并与兄弟姐妹对照组在疲劳方面进行比较(独立样本t检验)。酌情纳入了自我报告、家长报告和教师报告的问卷,以提供补充信息。

结果

纳入了82名PBTS(平均年龄13.4岁,标准差3.2,49%为男性)和43名健康的兄弟姐妹(平均年龄14.3岁,标准差2.4,40%为男性)。与正常人群相比,PBTS自己报告身体、心理和一般HRQOL下降(d = 0.39 - 0.62,p < 0.008)。与兄弟姐妹相比,报告了与疲劳相关的注意力问题增加(d = 0.57,p < 0.01),尽管自我报告的自尊和心理社会适应似乎未受影响。PBTS的父母报告其孩子的心理社会问题(d = 0.81,p < 0.000)和执行问题(d = 0.35 - 0.43,p < 0.016)比正常人群孩子的父母更多。教师指出,8至11岁的女性PBTS比女性正常人群有更多的心理社会适应问题(d = 0.69,p < 0.025),但他们报告的执行问题并不更多。

结论

如PBTS、家长和教师所报告的,有家长报告的神经认知问题的PBTS显示出心理社会问题增加。

对癌症幸存者的启示

对心理社会功能进行系统筛查是必要的,以便能为有神经认知问题的PBTS提供专业人员的针对性支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/4722086/c70d8ca26467/11136_2015_1091_Fig1_HTML.jpg

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