Pierce Lisa, Hocking Matthew C, Schwartz Lisa A, Alderfer Melissa A, Kazak Anne E, Barakat Lamia P
The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Psychooncology. 2017 Oct;26(10):1555-1561. doi: 10.1002/pon.4171. Epub 2016 Jun 20.
Reports of acceptability of psychosocial screening are limited, and the utility of screening in identifying risk factors for health-related quality of life (HRQL) of children with cancer has not been established. This study aimed to assess acceptability of screening for parents and evaluate associations between family risk factors and patient HRQL in the first year post-diagnosis.
Sixty-seven parents of children with cancer completed the Psychosocial Assessment Tool (family risk), Distress Thermometer (caregiver distress), Posttraumatic Stress Disorder Checklist-Civilian 6 (caregiver traumatic stress), PedsQL 4.0 (parent-proxy report of patient HRQL) and four acceptability questions via a tablet (iPad).
Patients (Mage = 9.5 SD = 5.5 years) were equally distributed across major pediatric cancer diagnoses. The majority of parents endorsed electronic screening as acceptable (70%-97%). Patient gender, diagnosis, intensity of treatment and time since diagnosis were not significantly correlated with family risk, caregiver distress, traumatic stress, or patient HRQL. The full regression model predicting total HRQL was significant (R = .42, F(4,64) = 10.7, p = .000). Age (older) was a significant covariate, family risk and caregiver distress were significant independent predictors of poorer total HRQL. The full regression models for physical and psychosocial HRQL were significant; age and caregiver distress were independent predictors of physical HRQL, and age and family risk were independent predictors of psychosocial HRQL.
Screening is acceptable for families and important for identifying risk factors associated with poorer patient HRQL during childhood cancer treatment. Targeted interventions addressing family resource needs as well as parent distress identified through screening may be effective in promoting patient HRQL. Copyright © 2016 John Wiley & Sons, Ltd.
关于社会心理筛查可接受性的报告有限，且筛查在识别癌症患儿健康相关生活质量（HRQL）风险因素方面的效用尚未确立。本研究旨在评估家长对筛查的可接受性，并在诊断后的第一年评估家庭风险因素与患者HRQL之间的关联。
67名癌症患儿的家长通过平板电脑（iPad）完成了社会心理评估工具（家庭风险）、苦恼温度计（照顾者苦恼）、创伤后应激障碍检查表 - 平民版6（照顾者创伤应激）、儿童生活质量量表4.0（家长代理报告的患者HRQL）以及四个关于可接受性的问题。
患者（平均年龄 = 9.5岁，标准差 = 5.5岁）在主要儿科癌症诊断中分布均匀。大多数家长认可电子筛查是可接受的（70% - 97%）。患者性别、诊断、治疗强度和诊断后的时间与家庭风险、照顾者苦恼、创伤应激或患者HRQL均无显著相关性。预测总HRQL的完整回归模型具有显著性（R = 0.42，F(4,64) = 10.7，p = 0.000）。年龄（较大）是一个显著的协变量，家庭风险和照顾者苦恼是总HRQL较差的显著独立预测因素。身体和社会心理HRQL的完整回归模型具有显著性；年龄和照顾者苦恼是身体HRQL的独立预测因素，年龄和家庭风险是社会心理HRQL的独立预测因素。
筛查对家庭来说是可接受的，并且对于识别儿童癌症治疗期间与患者较差HRQL相关的风险因素很重要。针对筛查中确定的家庭资源需求以及家长苦恼的有针对性干预措施可能对促进患者HRQL有效。版权所有© 2016约翰威立父子有限公司。
