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父母对儿童癌症幸存者进展的恐惧:一项对偶数据分析。

Fear of progression in parents of childhood cancer survivors: A dyadic data analysis.

机构信息

Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Department of Pediatrics, Pediatric Hematology & Oncology, Klinik Bad Oexen, Bad Oeynhausen, Germany.

出版信息

Psychooncology. 2020 Oct;29(10):1678-1685. doi: 10.1002/pon.5508. Epub 2020 Aug 24.

Abstract

OBJECTIVE

Fear of progression (FoP), also referred to as fear of cancer recurrence, is gaining increasing interest in survivorship research as it constitutes a great burden for patients and relatives. However, only little is known about FoP in parents of childhood cancer survivors. The objective of this study was to investigate the impact of FoP on quality of life (QoL) in parental couples.

METHODS

We analyzed dyadic data of 197 couples parenting childhood cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system tumor) after the end of intensive cancer treatment. The actor-partner interdependence model calculated by structural equation modelling was used to examine actor effects (effect of one's own FoP on one's own QoL) and partner effects (effect of one's own FoP on the partner's QoL).

RESULTS

Eighty-one percentage of the parents reported moderate or high FoP levels. Mothers reported higher FoP levels (p < .01) and lower overall QoL levels than fathers (p < .01). The results revealed a significantly positive intra-dyadic correlation between FoP of mothers and fathers of the same dyad (r = .431, p < .001). We found significantly negative actor effects for both mothers and fathers for the overall QoL (p < .001) as well as for several QoL subscales. No significant partner effects were found.

CONCLUSIONS

Most parents reported elevated levels of FoP. Our results show that FoP in parents of childhood cancer survivors is strongly negatively associated with QoL. Parental FoP should therefore be explored in future research and needs to be targeted by health care providers.

摘要

目的

恐惧进展(Fear of progression,FoP),也称为对癌症复发的恐惧,在生存研究中越来越受到关注,因为它给患者及其亲属带来了巨大的负担。然而,人们对儿童癌症幸存者父母的 FoP 知之甚少。本研究的目的是调查 FoP 对父母双方生活质量(Quality of life,QoL)的影响。

方法

我们分析了 197 对父母的数据,这些父母的孩子在诊断为白血病或中枢神经系统肿瘤后(诊断时年龄为 0-17 岁)完成了强化癌症治疗。采用结构方程模型中的演员-伙伴相互依存模型来检验演员效应(一个人自身的 FoP 对自身 QoL 的影响)和伙伴效应(一个人自身的 FoP 对伴侣 QoL 的影响)。

结果

81%的父母报告了中度或高度的 FoP 水平。母亲报告的 FoP 水平较高(p<0.01),整体 QoL 水平低于父亲(p<0.01)。结果显示,同一对父母之间的 FoP 存在显著的正内对偶相关性(r=0.431,p<0.001)。我们发现母亲和父亲的 FoP 对整体 QoL (p<0.001)以及几个 QoL 子量表都有显著的负演员效应。未发现显著的伙伴效应。

结论

大多数父母报告了 FoP 水平升高。我们的研究结果表明,儿童癌症幸存者父母的 FoP 与 QoL 呈强烈的负相关。因此,未来的研究应探讨父母的 FoP,并由医疗保健提供者针对 FoP 进行干预。

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