Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS, Utrecht, The Netherlands.
Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Support Care Cancer. 2021 Aug;29(8):4751-4761. doi: 10.1007/s00520-021-06009-y. Epub 2021 Feb 1.
This study aimed to increase our understanding of the psychosocial well-being of young adult childhood cancer survivors (YACCS) as well as the positive and negative impacts of cancer.
YACCS (aged 18-30, diagnosed ≤ 18, time since diagnosis ≥ 5 years) cross-sectionally filled out the "Pediatric Quality of Life Inventory Young Adults" (PedsQL-YA), "Hospital Anxiety and Depression Scale" (HADS), and "Checklist Individual Strengths" (CIS-20R) to measure fatigue and survivor-specific "Impact of Cancer - Childhood Survivors" (IOC-CS), which measures the long-term impact of childhood cancer in several domains. Descriptive statistics (IOC-CS), logistic regression (HADS, CIS-20R), and ANOVA (PedsQL-YA, HADS, CIS-20R) were performed. Associations between positive and negative impacts of childhood cancer and psychosocial outcomes were examined with linear regression analyses.
YACCS (N = 151, 61.6% female, mean age 24.1 ± 3.6, mean time since diagnosis 13.6 ± 3.8) reported lower HRQOL (- .4 ≤ d ≤ - .5, p ≤ .001) and more anxiety (d = .4, p ≤ .001), depression (d = .4, p ≤ .01), and fatigue (.3 ≤ d ≤ .5, p ≤ .001) than young adults from the general Dutch population. They were at an increased risk of experiencing (sub)clinical anxiety (OR = 1.8, p = .017). YACCS reported more impact on scales representing a positive rather than negative impact of CC. Various domains of impact of childhood cancer were related to psychosocial outcomes, especially "Life Challenges" (HRQOL β = - .18, anxiety β = .36, depression β = .29) and "Body & Health" (HRQOL β = .27, anxiety β = - .25, depression β = - .26, fatigue β = - .47).
YACCS are vulnerable to psychosocial difficulties, but they also experience positive long-term impacts of childhood cancer. Positive and negative impacts of childhood cancer were associated with psychosocial outcomes in YACCS. Screening of psychosocial outcomes and offering targeted interventions are necessary to optimize psychosocial long-term follow-up care for YACCS.
本研究旨在增进我们对青年癌症幸存者（YACCS）的社会心理福祉的理解，以及癌症的积极和消极影响。
YACCS（18-30 岁，18 岁以下诊断，诊断后时间≥5 年）采用横断面研究，填写“儿科生存质量量表青年成年人”（PedsQL-YA）、“医院焦虑和抑郁量表”（HADS）和“个体力量检查表”（CIS-20R），以衡量疲劳和特定于幸存者的“癌症对儿童幸存者的影响”（IOC-CS），该量表衡量了儿童癌症在多个领域的长期影响。进行描述性统计分析（IOC-CS）、逻辑回归（HADS、CIS-20R）和方差分析（PedsQL-YA、HADS、CIS-20R）。使用线性回归分析检查儿童癌症的积极和消极影响与社会心理结果之间的关联。
YACCS（N=151，61.6%为女性，平均年龄 24.1±3.6，平均诊断后时间 13.6±3.8）报告的 HRQOL 较低（-.4≤d≤-.5，p≤.001），焦虑（d=.4，p≤.001）、抑郁（d=.4，p≤.01）和疲劳（.3≤d≤.5，p≤.001）高于荷兰普通青年成年人。他们患（亚）临床焦虑的风险增加（OR=1.8，p=.017）。YACCS 在代表癌症积极而非消极影响的量表上报告了更多的影响。儿童癌症的各个影响领域与社会心理结果相关，尤其是“生活挑战”（HRQOLβ= -.18，焦虑β=.36，抑郁β=.29）和“身体和健康”（HRQOLβ=.27，焦虑β= -.25，抑郁β= -.26，疲劳β= -.47）。
YACCS 容易出现社会心理困难，但他们也经历了儿童癌症的积极长期影响。儿童癌症的积极和消极影响与 YACCS 的社会心理结果相关。对社会心理结果进行筛查并提供有针对性的干预措施，对于优化 YACCS 的心理社会长期随访护理是必要的。
