Predicting and modifying substance use in childhood cancer survivors: Application of a conceptual model
Predicting and modifying substance use in childhood cancer survivors: Application of a conceptual model
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DOI：
10.1188/06.onf.51-60
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发表时间：
2006-01-01
影响因子：
1.9
通讯作者：
Hudson, MM
中科院分区：
文献类型：
--
作者：
Cox, CL;McLaughlin, RA;Hudson, MM
目的/目标：确定预测或改变儿童癌症幸存者物质使用的因素，并描述风险咨询干预如何减少年轻幸存者的物质使用。设计：临床试验数据的次要分析和医疗记录数据的主要分析。设置：门诊诊所。样本：149名女性和118名男性，年龄12 - 18岁，癌症缓解至少两年，被随机分配到干预组（n = 132）和标准治疗组（n = 132）。135）groups.Methods：自我报告问卷，摘要病历数据，验证性因素分析，和结构方程modeling.Main研究变量：吸烟，饮酒，知识，风险认知，动机，担心癌症和治疗effects. Findings：三个因素直接预测物质使用在基线：在学校的年级更高（与年龄无关），更容易受到癌症治疗的后期影响，更担心癌症及其治疗。在一年后的随访中，学校成绩和担忧预示着物质使用的增加。此外，受干预措施和性别影响的改变健康行为的愿望预测了物质使用的减少。干预的影响的机制是显而易见的：干预导致需要改变，这沉淀了改变的愿望，并最终导致减少substance use.Conclusions：年轻的幸存者的担忧和关注他们的癌症和治疗相关的后期影响是一个新的干预目标。动机是敏感的行为改变干预和积极影响风险reduction.Implications护理：两个新的干预策略，以解决幸存者的关注，他们的癌症和治疗的影响是隐含的：（a）以新的应对方法取代药物使用，以减少恐惧和焦虑，以及（B）定制动机-基于年龄和性别的干预措施，以图形和现实的方式向幸存者传达行为改变在修改后期影响的风险。
Purpose/Objectives: To identify factors that predict or modify substance use in childhood cancer survivors and to describe how a risk-counseling intervention reduced young survivors' substance use.Design: Secondary analysis of clinical trial data and primary analysis of medical record data.Setting: Outpatient clinic.Sample: 149 females and 118 males 12-18 years of age whose cancer had been in remission for at least two years were randomly assigned to intervention (n = 132) and standard care (n = 135) groups.Methods: Self-report questionnaires, abstracted medical record data, confirmatory factor analysis, and structural equation modeling.Main Research Variables: Smoking, alcohol consumption, knowledge, risk perceptions, motivation, and worry about cancer and treatment effects.Findings: Three factors directly predicted substance use at baseline: being in a higher grade in school (independent of age), feelings of being more susceptible to late effects of cancer therapy, and worrying more about cancer and its treatment. At follow-up a year later, grade in school and worry predicted increased substance use. In addition, a desire to change health behavior, influenced by the intervention and gender, predicted decreased substance use. The mechanism of influence of the intervention was evident: The intervention led to a need to change, which precipitated a desire to change and ultimately resulted in decreased substance use.Conclusions: Young survivors' worries and concerns about their cancer and treatment-related late effects are a new intervention target. Motivation is sensitive to behavioral change interventions and positively affects risk reduction.Implications for Nursing: Two new intervention strategies to address the impact of survivors' concerns about their cancer and its treatment are implied: (a) Replace substance use with new coping methods to reduce fear and anxiety, and (b) tailor motivation-based interventions to age and gender to communicate graphically and realistically to survivors the personal importance of behavioral change in modifying the risks of late effects.