Department of Psychology, Logan Hall, University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA.
Private practice, Albuquerque, NM, USA.
Health Qual Life Outcomes. 2020 May 18;18(1):142. doi: 10.1186/s12955-020-01387-z.
A unique and limiting component in the research on functional impairment among children has been the exclusive use of parent proxy reports about child functioning; and there is limited information regarding the impact of pediatric cancer treatment on children's day-to-day functioning and how this is related to neurocognitive functioning. The objective of the current study was to examine a novel measure of self-reported functional impairment, and explore the relationship between self-reported and parent-reported child functional impairment in pediatric cancer survivors compared to controls.
A cross-sectional cohort of survivors (n = 26) and controls (n = 53) were recruited. Survivors were off treatment an average of 6.35 years (SD = 5.38; range 1-15 years) and demonstrated an average "medium" Central Nervous System treatment intensity score. Participants completed measures of functional impairment (FI), intellectual assessment (RIST) and executive functions (NIH Examiner), while parents reported on children's functional impairment.
Survivors were similar to controls in functional impairment. Regardless of group membership, self-reported FI was higher than parent-reported FI, although they were correlated and parent report of FI significantly predicted self-reported FI. Across groups, increased impairment was associated with four of seven Examiner scores.
Research regarding self-reported functional impairment of cancer survivors and its association with parent-reported functional impairment and neurocognitive deficits has been limited. Our results suggest that self-reported FI appears to be a reasonable and viable outcome measure that corresponds with and adds incremental validity to parent reported FI. While low treatment intensity may confer relative sparing of functional impairment among survivors, children report higher FI levels than parents, suggesting that FI can be of clinical utility. In conclusion, pediatric cancer survivors should be screened for self-reported functional difficulties.
儿童功能障碍研究中一个独特且受限的因素是仅使用父母代表报告儿童的功能；关于儿科癌症治疗对儿童日常功能的影响以及这与神经认知功能的关系，信息有限。本研究的目的是检验一种新的自我报告功能障碍测量方法，并探讨与对照组相比，儿科癌症幸存者中自我报告和父母报告的儿童功能障碍之间的关系。
我们招募了一个横断面队列的幸存者（n=26）和对照组（n=53）。幸存者平均在治疗结束后 6.35 年（SD=5.38；范围 1-15 年），表现出平均“中度”中枢神经系统治疗强度评分。参与者完成了功能障碍（FI）、智力评估（RIST）和执行功能（NIH 检查者）的测量，而父母则报告了儿童的功能障碍。
幸存者在功能障碍方面与对照组相似。无论组别的成员身份如何，自我报告的 FI 都高于父母报告的 FI，尽管它们相关，并且父母报告的 FI 显著预测了自我报告的 FI。在所有组中，增加的损伤与 7 个检查者评分中的 4 个相关。
关于癌症幸存者自我报告的功能障碍及其与父母报告的功能障碍和神经认知缺陷的关系的研究有限。我们的结果表明，自我报告的 FI 似乎是一种合理且可行的结果测量方法，与父母报告的 FI 相对应，并增加了其有效性。虽然低治疗强度可能会使幸存者的功能障碍相对减轻，但儿童报告的 FI 水平高于父母，这表明 FI 具有临床应用价值。总之，儿科癌症幸存者应接受自我报告的功能障碍筛查。
