Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Department of Pediatrics, The Ohio State University, Columbus, Ohio.
Psychooncology. 2019 Jan;28(1):68-75. doi: 10.1002/pon.4911. Epub 2018 Nov 6.
The majority of childhood cancer survivors develop at least one late effect subsequent to treatment (eg, cardiovascular disease and obesity). Consistent engagement in recommended health behaviors may mitigate some of these conditions. Researchers have identified early survivorship as a teachable moment, yet few studies have examined positive health behaviors during this period.
Families of children with cancer (ages 5-17) were initially recruited following a diagnosis or relapse of cancer. Three years post diagnosis, survivors (n = 82, M = 13.3, SD = 3.7) and their mothers (n = 103, M = 41.1, SD = 7.6) completed a questionnaire assessing exercise, dietary, and sleep patterns among survivors. A follow-up assessment was conducted 2 years later. Mixed models tested change in health behavior over time.
At 3- and 5-year post diagnosis, mother and self-report indicated that few survivors engaged in appropriate levels of low-intensity exercise, fruit/vegetable intake, and dairy consumption. However, most survivors engaged in recommended levels of high intensity exercise, fast food restriction, and sleep. Health behaviors remained stable over time, except for mother report of sleep duration, which decreased (b = -0.6, P < 0.001). Brain tumor diagnosis predicted a larger decrease in self-report of sleep duration compared with other diagnoses (P = 0.04). Income predicted fast food intake such that higher income was associated with decreased intake over time, whereas lower income was associated with increased intake (P = 0.04).
During early survivorship, several health behaviors fell short of expectations for exercise and diet and did not improve upon reaching 5-year post diagnosis. Providers should evaluate survivors' health behaviors, including sleep, early and often, intervening when necessary.
大多数儿童癌症幸存者在治疗后至少会出现一种迟发性效应（例如心血管疾病和肥胖症）。持续遵循推荐的健康行为可能会减轻其中一些情况。研究人员已经确定早期生存是一个可教的时刻，但很少有研究在此期间检查积极的健康行为。
在癌症诊断或复发后，最初招募了患有癌症的儿童（5-17 岁）的家庭。在诊断后 3 年，对幸存者（n=82，M=13.3，SD=3.7）及其母亲（n=103，M=41.1，SD=7.6）进行了一项问卷调查，以评估幸存者的运动，饮食和睡眠模式。两年后进行了随访评估。混合模型测试了健康行为随时间的变化。
在诊断后 3 年和 5 年时，母亲和自我报告均表明，很少有幸存者进行适当水平的低强度运动，水果/蔬菜摄入和乳制品摄入。但是，大多数幸存者都进行了高强度运动，限制快餐和睡眠的推荐水平。健康行为随时间保持稳定，只有母亲报告的睡眠时间减少（b=-0.6，P<0.001）。脑肿瘤诊断与自我报告的睡眠时间减少有关，与其他诊断相比，脑肿瘤诊断的预测作用更大（P=0.04）。收入预测了快餐的摄入量，收入较高与随时间减少的摄入量有关，而收入较低与随时间增加的摄入量有关（P=0.04）。
在早期生存期间，一些健康行为在运动和饮食方面未达到预期，并且在达到诊断后 5 年时并未改善。提供者应尽早评估幸存者的健康行为，包括睡眠，必要时进行干预。
