PSYCHOSOCIAL OUTCOMES IN CHILDHOOD CANCER SURVIVORS

本建议的目的是进一步了解儿童癌症长期幸存者的患病率、特征和心理健康状况、健康风险行为和神经系统后遗症的预测因素。本申请中提出的研究将利用儿童癌症幸存者研究，这是一个多机构合作项目，已经建立并跟踪了一个回顾性确定的儿童癌症长期幸存者队列和6000名兄弟姐妹对照。这是迄今为止已知的最大的具有明确特征的儿童癌症幸存者和兄弟姐妹对照样本。先前的研究表明，儿童癌症幸存者的某些亚群容易受到各种身体和心理问题的影响，但这些发现的普遍性受到样本量小、数据来自单一机构以及缺乏对照组的限制。此外，该领域的研究尚未确定影响(1)长期幸存者心理社会问题的关键变量，但这些发现的普遍性受到样本量小、数据来自单一机构以及缺乏对照组的限制。此外，该领域的研究尚未确定影响(1)长期幸存者的社会心理状态/生活质量的关键变量，包括他们的疼痛经历，以及(2)使他们面临未来健康问题风险的行为。在这一职能期间要开展的工作，以及健康行为。将调查可能影响这些结果的生理、心理、社会和神经因素。提出了与这些结果相关的具体假设，并将调查潜在的调节和中介因素。建议在整个连续的护理过程中——从诊断到治疗，再到长期生存——采取社会心理支持干预措施。干预研究计划即将出台。

The purpose of this proposal is to further understanding of the prevalence, characteristics and predictors of the psychosocial health status, health risk behaviors and neurological sequelae of long-term survivors of childhood cancer. The research proposed in this application will make use of the Childhood Cancer Survivor Study, a multi-institutional collaborative project that has established and followed a retrospectively-ascertained cohort of long-term survivors of childhood cancer and 6,000 sibling controls. This is the largest sample of well-characterized childhood cancer survivors and sibling controls known to date. Previous work suggests that certain subsets of childhood cancer survivors are vulnerable to a variety of physical and psychosocial problems, but the generalizability of these findings are limited by small sample sizes, data derived from single institutions, and lack of a control group. Furthermore, study in this field has yet to identify critical variables that influence (1) long-term survivors' psychosocial problems, but the generalizability of these findings are limited by small sample sizes, data derived from single institutions, and lack of a control group. Furthermore, study in this field has yet to identify critical variables that influence (1) long-term survivors' psychosocial status/quality of life, including their experiences with pain, and (2) behaviors that place them at risk for future health problems. The work to be conducted during the period of this functioning, and health behaviors. Physical, psychological, social and neurological factors that potentially influence these outcomes will be investigated. Specific hypotheses related to these outcomes are proposed and potentially moderating and mediating factors will be investigated. Psychosocial support interventions throughout a continuum of care- from diagnosis through treatment and into long-term survivorship-will be suggested. Plans for intervention research will be forthcoming.