儿童癌症幸存者成年后的健康相关生活质量和心理困扰，及其与治疗、教育和人口统计学因素的关系。
Health-related quality of life and psychological distress in young adult survivors of childhood cancer and their association with treatment, education, and demographic factors.
机构信息
Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.
Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway.
出版信息
Qual Life Res. 2018 Feb;27(2):529-537. doi: 10.1007/s11136-017-1716-0. Epub 2017 Oct 31.
PURPOSE
This study investigated health-related quality of life (HRQOL) and psychological distress among young adult (YA) survivors of childhood cancer and the association of these measures with treatment, education, and demographic factors ≥ 5 years post diagnosis.
METHODS
Participants included cancer survivors (n = 91) recruited through the Cancer Registry of Norway (CRN) and healthy controls (n = 223) recruited from a student population. All participants completed self-report questionnaires, and the Pediatric Quality of Life Inventory (PedsQL™) 4.0 and the Hopkins Symptom Checklist-10 (HSCL-10) as a measure of HRQOL and distress, respectively.
RESULTS
Survivors reported HRQOL at the same level as controls, except for poorer physical functioning. Survivors in general, and female survivors specifically, had higher odds than controls of reporting symptoms of distress above cut-off, but survivors did not have higher mean levels of distress compared to controls. Survivors reporting distress levels above the cut-off had significantly poorer HRQOL regarding physical functioning and lower total PedsQL scores than controls scoring above the cut-off. Age (for HRQOL only), female gender, low educational level, and perceived low economic status significantly predicted HRQOL and distress. Education interacted with the effect of cranial radiation in predicting HRQOL.
CONCLUSIONS
Survivors reported similar mean levels of HRQOL and distress as controls, except for physical functioning. For cancer survivors, demographic variables predicted HRQOL and distress. Some groups of survivors require closer follow-up, and more attention should be paid to factors associated with poor HRQOL and psychological distress in survivors, including female gender, lower education level, and lower income. Survivors treated with cranial radiation may be particular vulnerable in combination with low education regarding HRQOL.
目的
本研究调查了儿童癌症后青年幸存者的健康相关生活质量（HRQOL）和心理困扰，以及这些措施与≥5 年后诊断的治疗、教育和人口统计学因素的关联。
方法
参与者包括通过挪威癌症登记处（CRN）招募的癌症幸存者（n=91）和从学生人群中招募的健康对照者（n=223）。所有参与者都完成了自我报告问卷，以及儿科生活质量量表（PedsQL™）4.0 和霍普金斯症状清单-10（HSCL-10），分别作为 HRQOL 和困扰的测量工具。
结果
幸存者报告的 HRQOL 水平与对照组相同，除了身体功能稍差。与对照组相比，一般幸存者，特别是女性幸存者，报告有症状困扰的可能性更高，但幸存者的困扰平均水平并不高于对照组。报告有症状困扰的幸存者在身体功能方面的 HRQOL 显著较差，总 PedsQL 得分也低于有症状困扰的对照组。年龄（仅针对 HRQOL）、女性性别、低教育水平和感知经济状况不佳，显著预测了 HRQOL 和困扰。教育与颅辐射的影响相互作用，预测了 HRQOL。
结论
幸存者报告的 HRQOL 和困扰的平均水平与对照组相似，除了身体功能。对于癌症幸存者，人口统计学变量预测了 HRQOL 和困扰。一些幸存者群体需要更密切的随访，应更加关注与幸存者 HRQOL 和心理困扰相关的因素，包括女性性别、低教育水平和低收入。接受颅辐射治疗的幸存者可能与低教育水平相结合，在 HRQOL 方面特别脆弱。
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