Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Department of Pediatric Oncology/Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Psychooncology. 2024 Oct;33(10):e9313. doi: 10.1002/pon.9313.
This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS).
CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963-2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self-Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self-Rating Scale for Post-Traumatic Stress Disorder, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and Short Form-36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p < 0.004).
A total of 1382 CCS participated, all diagnosed ≥ 15 years ago. The mean age of participating CCS was 36 years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self-esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self-esteem (10×), and perceived burden (9×). Self-esteem (all β ≤ 0.47) and perceived burden (all β ≤ 0.38) demonstrated strongest associations of medium/large size.
Perceptions of childhood cancer, illness cognitions, self-esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio-demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self-esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.
本研究考察了心理社会风险和保护因素与广泛的心理社会结果之间的关联，包括儿童癌症幸存者（CCS）的情感、社会、认知和身体领域。
荷兰儿童癌症幸存者研究（DCCSS）-LATER 队列（诊断时间为 1963 年至 2001 年）第 2 部分的 CCS（年龄≥18 岁，诊断年龄<18 岁，≥5 年自诊断后）完成了心理社会风险和保护因素（受益和负担量表、疾病认知问卷、罗森伯格自尊量表和癌症影响量表）以及心理社会结果（医院焦虑和抑郁量表、创伤后应激障碍自评量表、TNO-AZL 成人健康相关生活质量问卷和简明健康状况调查问卷）的问卷。使用回归分析评估了关联，调整了获得的年龄、性别、健康状况数量和诊断后时间，同时校正了多次检验（p<0.004）。
共有 1382 名 CCS 参与，所有诊断均≥15 年前。参与 CCS 的平均年龄为 36 岁，51%为女性。感知的益处和负担、接受度、无助感、自尊和社会支持与心理社会结果相关。在包括所有心理社会因素的模型中，与心理社会结果最相关的是自尊（10 倍）和感知负担（9 倍）。自尊（所有β≤0.47）和感知负担（所有β≤0.38）显示出中等/大的最强关联。
对儿童癌症的感知、疾病认知、自尊和社会支持在解释 CCS 的心理社会功能方面发挥了作用，超过了社会人口统计学和医学变量的影响。解决负面看法和减轻无助感，同时促进接受度、自尊和社会支持，可为面临心理社会挑战的 CCS 提供干预目标。
