Adolescents’ Psychosocial Health-Related Quality of Life Within 6 Months After Cancer Treatment Completion

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Abstract

Background:

Health-related quality of life (HRQOL) may be affected by cure-directed therapy given to pediatric oncology patients. Identification of HRQOL risk/protective factors may facilitate the development of clinical interventions.

Objective:

The study purpose was to assess adolescents’ psychosocial HRQOL soon after treatment completion using patient-reported outcome measures.

Methods:

Subjects were recruited from May 2005 to February 2007 to participate in a structured interview that collected information on demographics, symptoms, HRQOL (PedsQL 4.0), and coping (Adolescent Coping Orientation for Problem Strategies Questionnaire). Disease/treatment information was abstracted from medical records. Data analysis included descriptive approaches for data summarization and regression modeling for estimation and testing.

Results:

A total of 94 participants were included in the analyses. Their mean psychosocial functioning summary scores fell between the means reported for healthy children and children with cancer; 18% were more than 1 standard deviation below the mean. In the univariate analyses, lower psychosocial HRQOL was associated with central nervous system tumors (P = .01), radiation therapy (P = .01), and treatment duration of 13 to 24 months (P < .01). Protective factors identified in multivariable analyses included older age and use of humor for coping; risk factors included symptoms of pain, fatigue, and posttraumatic stress.

Conclusion:

Although most patients rated their psychosocial HRQOL as good, a subset (18%) may have increased risk for impaired HRQOL.

Implications for Practice:

Clinical assessment of psychosocial HRQOL using patient-reported outcome measures during the early posttreatment phase is recommended. Longitudinal studies are needed to further explore risk/protective factors and to identify targeted interventions to minimize the adverse psychosocial effects of cancer treatment and maximize healthy survivorship.

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