Cognitive and Problem Solving Training in Children with Cancer: A Pilot Project
Cognitive and Problem Solving Training in Children with Cancer: A Pilot Project
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DOI：
10.1097/mph.0b013e3181b25a1d
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发表时间：
2009-09-01
影响因子：
1.2
通讯作者：
Kilian, Shirley
中科院分区：
文献类型：
--
作者：
Patel, Sunita K.;Katz, Ernest R.;Kilian, Shirley
背景：神经认知后遗症是儿童癌症幸存者所经历的最令人衰弱的晚期影响之一，对教育、社会和适应性发展具有深远的影响。需要经过经验验证的干预措施来应对此类疾病和治疗相关的心理社会疾病。过程：我们进行了一项试点研究，以评估参与者对为期15节的临床培训计划的接受度和影响，该培训计划旨在向认知缺陷幸存者传授补偿性学习和解决问题的技能。该干预计划由5个核心部分组成，旨在提高日常问题解决能力、注意力和记忆力以及学习成绩。从干预前到干预后，几乎所有的客观绩效得分都显示出预期的积极方向的增长，尽管只有2个增长具有统计学意义。家长的答复表明，他们认为所教授的技能是有用的，提高了孩子解决问题的能力和学习技能，为家庭提供了具体和实际的干预措施，并增加了父母的知识。同样，孩子们对整个项目的评价很高，并表示对了解更多关于他们相对认知优势和弱点的知识以及解决学习困难的实际问题感到满意。结论：尽管大多数注册家庭完成了至少70%的培训课程，但符合条件的家庭总体参与率较低，这引发了人们对肿瘤诊所对此类项目的广泛接受的担忧。最后讨论了研究设计的局限性和对未来研究的建议。
Background: Neurocognitive sequelae are among the most debilitating late effects experienced by survivors of childhood cancer, with far reaching consequences for educational, social, and adaptive development. Empirically validated interventions to address such disease and treatment related psychosocial morbidities are needed.Procedure: We conducted a pilot study to evaluate participants' acceptance and impact of a 15-session, clinic-based training program to teach compensatory learning and problem-solving skills in survivors with cognitive deficits. The intervention program consisted of 5 core components designed to improve daily problem solving, attention and memory, and academic performance.Results: A sample of 12 survivors completed the program. Virtually all objective performance scores showed gains from preintervention to postintervention in the expected positive direction, although only 2 of the gains were statistically significant. Parent responses indicated they perceived the skills taught to be useful, to have improved the child's problem-solving ability and learning skills, to have provided concrete and practical interventions for the home, and to have increased parental knowledge. Similarly, the children rated the overall program high, and reported satisfaction with learning more about their relative cognitive strengths and weaknesses and practical problem solving for academic difficulties.Conclusions: Although the majority of enrolled families completed at least 70% of the training sessions, the overall low participation rate from eligible families raise concern about widespread acceptance of such programs in the oncology clinic. The limitations of the study design and recommendations for future research are discussed.