Psychological Status in Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study
Psychological Status in Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study
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DOI：
10.1200/jco.2008.21.1433
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发表时间：
2009-05-10
影响因子：
45.3
通讯作者：
Krull, Kevin
中科院分区：
文献类型：
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作者：
Zeltzer, Lonnie K.;Recklitis, Christopher;Krull, Kevin
在儿童癌症幸存者研究(CCSS)中，对大量幸存者和兄弟姐妹的心理生活质量(QOL)、健康相关生活质量(HRQOL)、生活满意度结果及其相关危险因素进行了综述。这篇综述包括以前发表的使用CCSS数据的手稿，这些数据侧重于心理结果测量，包括简明症状问卷(BSI-18)、医疗结果调查简表(SF-36)、坎特里尔生活阶梯和其他自我报告问卷。根据人口统计/健康信息和从医疗记录中提取的数据，在兄弟姐妹和幸存者之间进行比较和对比，并与可获得的标准数据进行比较。这些研究表明，相当大比例的幸存者报告了更多的全球痛苦症状，以及HRQOL中较差的身体领域，但不是情感领域。除了脑瘤幸存者，大多数幸存者都报告了良好的现在和预期的未来生活满意度。女性、教育程度低、未婚、家庭年收入低于20,000美元、失业、没有医疗保险、患有重大疾病以及接受头颅放射治疗和/或手术是心理困扰和生活质量差的危险因素。颅脑照射影响了神经认知结果，尤其是脑瘤幸存者。心理困扰也预示着不良的健康行为，包括吸烟、饮酒、疲劳和睡眠改变。心理困扰和疼痛预示着补充和替代药物的使用。总体而言，大多数幸存者心理健康，对生活感到满意。然而，某些儿童癌症幸存者群体有很高的心理压力、神经认知功能障碍和较低的HRQOL，尤其是在身体领域。这些发现建议针对不良结果的高风险人群进行干预，并检查尽管受到儿童癌症创伤仍保持正增长。
Psychological quality of life (QOL), health-related QOL (HRQOL), and life satisfaction outcomes and their associated risk factors are reviewed for the large cohort of survivors and siblings in the Childhood Cancer Survivor Study (CCSS). This review includes previously published manuscripts that used CCSS data focused on psychological outcome measures, including the Brief Symptom Inventory (BSI-18), the Medical Outcomes Survey Short Form-36 (SF-36), the Cantril Ladder of Life, and other self-report questionnaires. Comparisons and contrasts are made between siblings and survivors, and to normative data when available, in light of demographic/health information and abstracted data from the medical record. These studies demonstrate that a significant proportion of survivors report more symptoms of global distress and poorer physical, but not emotional, domains of HRQOL. Other than brain tumor survivors, most survivors report both good present and expected future life satisfaction. Risk factors for psychological distress and poor HRQOL are female sex, lower educational attainment, unmarried status, annual household income less than $20,000, unemployment, lack of health insurance, presence of a major medical condition, and treatment with cranial radiation and/or surgery. Cranial irradiation impacted neurocognitive outcomes, especially in brain tumor survivors. Psychological distress also predicted poor health behaviors, including smoking, alcohol use, fatigue, and altered sleep. Psychological distress and pain predicted use of complementary and alternative medicine. Overall, most survivors are psychologically healthy and report satisfaction with their lives. However, certain groups of childhood cancer survivors are at high risk for psychological distress, neurocognitive dysfunction, and poor HRQOL, especially in physical domains. These findings suggest targeting interventions for groups at highest risk for adverse outcomes and examining the positive growth that remains despite the trauma of childhood cancer.