The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
The Ohio State University, Columbus, Ohio, USA.
Pediatr Blood Cancer. 2024 Jul;71(7):e31001. doi: 10.1002/pbc.31001. Epub 2024 Apr 21.
While most research has largely focused on medical risks associated with reduced health-related quality of life (HRQOL) in survivors, sociodemographic and family factors may also play a role. Thus, we longitudinally examined sociodemographic factors and family factors associated with survivor HRQOL, including adolescent's cancer-specific stress, mother's general stress, and mother-adolescent communication.
Mothers (N = 80) and survivors (ages 10-23, N = 50) were assessed 5 years following initial diagnosis. Mothers completed measures regarding sociodemographic background adolescent's cancer-specific stress, mother's general stress, mother-adolescent communication, and adolescent HRQOL. Survivors also reported on their own HRQOL. Two hierarchical multiple regressions examined predictors of (a) mother's report of adolescent HRQOL, and (b) survivor's self-report of HRQOL.
The final model predicting mother-reported adolescent HRQOL was significant, F(5,74) = 21.18, p < .001, and explained 59% of the variance in HRQoL. Significant predictors included adolescent stress (β = -.37, p < .001), mothers' stress (β = -.42, p < .001), and communication (β = .19, p = .03). The final model predicting survivor-reported HRQOL was also significant, F(5,44) = 5.16, p < .01 and explained 24% of the variance in HRQOL. Significant predictors included adolescent stress (β = -.37, p = .01) and communication (β = -.31, p = .04). Sociodemographic factors were not a significant predictor of HRQOL in any model.
Family stress and communication offer potential points of intervention to improve HRQOL of pediatric cancer survivors from mother and survivor perspectives. While additional research is needed, healthcare professionals should encourage stress management and strong mother-child communication to enhance survivors' long-term HRQOL. Such interventions may be complimentary to efforts targeting the known sociodemographic factors that often affect health.
虽然大多数研究主要集中在与幸存者健康相关的生活质量降低相关的医学风险上，但社会人口学和家庭因素也可能发挥作用。因此，我们从纵向角度研究了与幸存者健康相关的生活质量相关的社会人口学因素和家庭因素，包括青少年的癌症特异性压力、母亲的一般压力以及母亲-青少年沟通。
母亲（N=80）和幸存者（年龄在 10-23 岁之间，N=50）在初次诊断后 5 年进行了评估。母亲完成了关于社会人口学背景、青少年癌症特异性压力、母亲一般压力、母亲-青少年沟通以及青少年健康相关生活质量的测量。幸存者还报告了自己的健康相关生活质量。两个层次的多元回归分析了（a）母亲报告的青少年健康相关生活质量和（b）幸存者自我报告的健康相关生活质量的预测因素。
预测母亲报告的青少年健康相关生活质量的最终模型是显著的，F（5，74）=21.18，p<.001，解释了 HRQoL 方差的 59%。显著的预测因素包括青少年压力（β=-.37，p<.001）、母亲的压力（β=-.42，p<.001）和沟通（β=-.19，p=.03）。预测幸存者报告的健康相关生活质量的最终模型也是显著的，F（5，44）=5.16，p<.01，解释了 HRQoL 方差的 24%。显著的预测因素包括青少年压力（β=-.37，p=.01）和沟通（β=-.31，p=.04）。在任何模型中，社会人口学因素都不是健康相关生活质量的显著预测因素。
家庭压力和沟通为从母亲和幸存者的角度改善儿科癌症幸存者的健康相关生活质量提供了潜在的干预点。虽然还需要进一步的研究，但医疗保健专业人员应该鼓励压力管理和强大的母子沟通，以提高幸存者的长期健康相关生活质量。这些干预措施可能与针对经常影响健康的已知社会人口学因素的努力相辅相成。
