1,721,101 research outputs found
Self-Esteem and Social relationships in Preadolescents and Adolescents Who Survived Pediatric Leukemia
No full textIntroduction: Self-esteem refers to the level or degree to which one values or likes oneself. The “self’” evolves through a cognitive developmental
maturation process (Harter, 1985) and continues to be influenced by an individual’s direct and indirect experiences with his/her environment (Bracken, 1996). Adolescents with cancer may face added burdens in the process of creating an identity and self-esteem (Evan et al.,
2006), especially if females (Mertens et al., 2014) who underwent a central nervous system treatment. The literature also showed social
difficulties as a consequence of the illness and of the associated isolation from peers (Tremolada et al., 2016) in this population. This study aims to screen the preadolescents and adolescents more at risk in their self-esteem perception and to evaluate their present social relationships and wellbeing post 5 years from the stop of the therapy and to identify possible disease risk factors. We expected to find a lower
global self-esteem in these boys and girls, in particular in interpersonal and bodily experience areas and a significate association of their own
self-esteem reports with their general social functioning and well-being. Method: Participants: Twenty-five preadolescents and adolescents
healed from leukemia were recruited at the Haematology-Oncologic Clinic of the Department of Child and Woman Health, University of
Padua, during their follow-up after 5 years from the stop of the therapy. Children’s mean age was 13.64 years (SD = 3.08, range = 10-19 years),
mostly treated for Acute Lymphoblastic Leukemia (ALL) (84%) and the 12% treated for Acute Myeloid Leukemia (AML). Children were quite
equally distributed by gender with 11 girls and 14 males. Procedure: This study belongs to an ample longitudinal project that assessed leukemic children’s and families’ adaptation and quality of life throughout their treatment steps. The healed patients were contacted by the clinical psychologist during their check-up and informed consent was asked for. Childhood cancer survivors filled in Multidimensional Self- Esteem test (Bracken 1992; Italian version Mazzeo, 2003) and were interviewed adopting the Ecocultural Family Interview-Cancer (EFI-C) -pediatric cancer survivors’ version. Results: Global self-esteem reported by the ex-patients attested mostly below the 50° percentile (58.5%), especially in the following scales: interpersonal relationships (75%), environmental control competence (62.5%), academic success (62.5%), family life (75%),
bodily experience (50%) and emotionality (37.5%). Mann Whitney U test showed the following significant mean differences in the self-esteem scales considering survivors’ type of leukemia: global scale (U = 14.5; p = 0.04), emotionality (U = 12; p = 0.03) and bodily experience (U = 14.5, p = 0.04). Examining the mean ranks, survivors of AML showed lower scores in the self-esteem scales. Pearson’s correlations showed a significant association of Interpersonal self-esteem reports with two EFI-C dimensions: “Social and love relationship” (r = 0.61; p = 0.001) and “Present wellbeing” (r = 0.42; p = 0.03), showing a good convergent validity of the two different instruments.
Conclusion: Childhood AML preadolescent and adolescent survivors attested at the clinical levels in their self-esteem perceptions, especially
influenced by their low levels of social relationships and by their managing of emotions related to the illness and to the Clinic at the stop therapy
time. Preventive interventions focused on increasing their self-esteem and their social wellbeing should be improved before re-entry to
their daily life
Adaptive functioning of 48 preschooler children with leukemia post 1 year of therapies compared with sane peers
Get PDFBackground: Due to advances in chemotherapy and supportive care, about 83% of childhood cancer survivors aged 0-19 years will survive 5 years. More attention has been paid to understand the impact of cancer treatments on children’s development, in particular with respect to late effects on academic, physical and social functioning, essential for optimization of long-term outcome. Scant literature addresses the functioning of children during acute treatment, mainly focusing on childhood cancer survivors.
Aims: This study was aimed at comparing the adaptive functioning in preschooler children with leukemia post 1 year of treatment and a control group of peers who had no history of serious illness. The link between medical factors and adaptive outcomes were investigated.
Study Design: Case control study.
Place and Duration of Study: Department of Child and Woman Health (Oncology Hematology Division), University of Padua, and pediatricians’ ambulatories in the region of Trentino Alto Adige, between January 2007 and January 2008.
Methodology: The participants in this study included 48 leukemic children and their families, recruited at the Haematology-Oncologic Clinic of the Department of Child and Woman Health, University of Padua. Children’s mean age was 52.35 months (SD = 12.85, range = 23-72 months), 22 males and 26 females. Most children had Acute Lymphoblastic Leukemia (ALL) (N = 44), while 4 had Acute Myeloid Leukemia (AML) with a mean days of hospitalization of 56.13 (SD = 49.36, range: 28-315). Sane peers (N=48) were recruited at pediatricians’ ambulatories in the region of Trentino Alto Adige. Each family was interviewed about their children’s adaptive functioning by Vineland Adaptive Behavior Scales.
Results: The two samples were homogeneous both for children’s characteristics (age in months and gender) and for their parents’ socio-demographic characteristics. Paired-sample t-tests revealed that parents of children with leukemia reported in their children significantly less adaptive functioning both composite and in three of the four domains: Communication, Socialization and Motor Abilities. The results of a series of ANCOVAs showed that the adaptive functioning in children with leukemia had the following at-risk factors: children aged 37-48 months, major days of hospitalization and the high risk therapy.
Conclusion: Future studies should understand better, with an ampler sample and using a multimethod approach, these lower adaptive outcomes in children with leukemia. These findings can guide specific interventions for parents and for children to support the potential developmental delay due to therapies, such as occupational therapy and socialization/educational programs during hospitalization, in occasion of day-hospital follow-ups and at school
Health Locus of Control in Parents of Children with Leukaemia
No full textIntroduction: Health locus of control is defined as the set of beliefs a person has about his or her personal influence on health. There are no
specific studies on Parental Health Locus of Control in the context of children with cancer. Basing on the previous studies, we expect parents to
have higher scores both in the Internal Locus of Control and in the External Locus of Control (such as health professionals or God). In particular, we wanted to identify possible factors that could increase the parental beliefs belonging to Internal Locus of Control.
Method: Participants: Parents of 104 leukemic children post 1 month from the diagnosis were recruited at the Haematology-Oncologic Clinic of
the Department of Child and Woman Health, University of Padua. All parents were Caucasian with a mean age of 37.28 years (SD = 5.89), mostly mothers (87.5%) and with a mean years of schooling of 12.16 (SD = 3.82). Parents’ incomes were average (55.3%), high (23.3%) and
low (21.4%) for Italian norms, but above poverty. Children’s mean age was 5.94 years (SD = 4.12, range = 1 year-17 years), 50 females and 54 males.
Procedure: The parents were contacted by a clinical psychologist during the first hospitalization of their children, in the second week after
the diagnosis. Project aims were explained, informed consent was asked for and the Ladder of Life questionnaire (CCSS) was filled in (T1). The
PHLOC (DeVellis et al., 1993) was compiled post 1 month from the diagnosis (T2).
Results: Current life perception was really low (Mean = 4.33), even if there was a big standard deviation (SD = 2.31) that underlined the variability of parent’s emotive state. Descriptive statistics on the several beliefs of parental locus of control on child’s illness showed the Parental
influence as the most used (Mean = 4.35; SD = 0.79).Hierarchical regression analysis model (R2 = 0.18; F4 = 5.41p = 0.001)
identified parental current life perception as a significantly (ß = 0.40; p = 0.0001) predictor on Parental influence. Another regression analysis model (R2 = 0.24; F = 3.14; p = 0.03) showed that Child’s Age (β = 0.36; p = 0.002) and parental current life perception (β = 0.32; p =
0.006) impacted upon Child’s influence on the illness. An ANOVA showed that perceived economic condition impacted significantly on the Media influence (F2 = 5.15; p = 0.007) with the parents belonging to the average condition that had higher scores in this subscale (Mean=2.91; DS = 1.29), than those in the high condition (2.05; DS = 0.97).
Conclusion: Parental internal locus of control is the most present belief. Parent’s current life perception tested in the second week after the diagnosis communication is the best predictor of Parental influence post one month. The current life perception just at the beginning of child’s
treatment gives a measure to identify parents more in difficulty in their parental role and self-esteem to care the child during the illness. Parents
that declared an average economic condition believed mostly in Media influence on their child’s health
Psychological Well-Being, Cognitive Functioning, and Quality of Life in 205 Adolescent and Young Adult Childhood Cancer Survivors Compared to Healthy Peers
Get PDFThe majority of the studies underlined how adolescent and young adult (AYA) Cancer Survivors had no significant differences in their well-being and quality of life compared with a control group of healthy counterparts, although French et al. (2013) found less years of education among cancer survivors. The present study aimed at comparing AYA cancer survivors and a control group of peers who had no history of serious illness, in terms of well-being, cognitive functioning, and perceptions of life. Participants in this study were 205 AYA cancer survivors, 126 males, off therapy from a mean of 10.87 years (SD = 4.91), with a mean age of 18.96 (SD = 3.08), recruited during follow-up visits and healthy counterparts (n = 205), matched for age and gender. They all completed self-report questionnaires: Ladder of Life, BSI-18 and Cognitive problems. Paired t test evidenced significant differences between survivors (Mean = 6.19; SD = 2.07) and controls (Mean = 6.88; SD = 2.02) in perceptions of quality of life regarding 5 years before the current time [t(204) = −3.39; p = 0.001], with a lower level for childhood cancer survivors. Specifically, Hierarchical regression (R2 = 0.05, p = 0.04) identified a shorter time since the completion of treatment (β = 0.18, p = 0.03) and a trend of stem cell transplantation experience (β = −0.11, p = 0.06) as factors associated with negative perception of precedent quality of life. The AYA cancer survivors reported lower cognitive difficulties (Mean = 1.46) than controls (Mean = 1.56) [t(204) = −3.41; p = 0.001]: in memory (Meanclinical = 1.32 vs Meancontrol = 1.50) [t(204) = −4.52; p = 0.001], in concentration (Meanclinical = 1.36 vs Meancontrol = 1.54) [t(204) = −4.66; p = 0.001] and in mental organization skills (Meanclinical = 1.47 vs Meancontrol = 1.56) [t(204) = −2.56; p = 0.01], even if they had a lower educational attainment [X2(9) = 131.28; p = 0.001]. They showed similar satisfaction with their psychological well-being and their lives as healthy counterparts, except for past life perceptions associated with the cancer period. Important recommendations for future research and clinical suggestions could be given
Perceived social support and health related quality of life in AYA cancer survivors of childhood and controls
No full textBackground: This study compared education levels, health-related quality of life (HRQoL) and perceived
social support of adolescent and young adult (AYA) cancer survivors with those of a control group of
peers with no history of serious illness. The links between socio-demographic and medical factors and
AYA cancer survivor outcomes were investigated.
Methods: The participants included AYA cancer survivors (n = 205) recruited during follow-up
visits, and AYA peers (n = 205) recruited from the secondary schools, youth groups and universities.
All of the participants filled in self-report questionnaires regarding HRQoL and perceived social
support. In addition, medical and socio-demographic information was collected.
Results: There were statistically significant differences between survivors and controls in terms of
education level, HRQoL and perceived social support. Cancer survivors attended school for fewer years
had a more positive perception of their health and a lower level of perceived social support provided by
family, friends and significant others than controls. The results showed that female gender, the diagnosis
of haematological disorder, haematopoietic stem cell transplantation and a shorter off-treatment period
are risk variables for poorer HRQoL and social functioning in AYA cancer survivors.
Conclusions: Adolescent and young adult cancer survivors perceived a better quality of life than
controls, especially those treated for haematological disorders or with a shorter off-treatment period.
Future studies should aim to understand better this positive self-reported phenomenon, as well as
investigating post-traumatic growth using qualitative narratives
Prognostic factors in paediatric anaplastic large cell lymphoma: role of ALK
No full textEvent-free survival of children and adolescents with ALK-positive anaplastic large cell lymphoma (ALCL) reaches 65-75% with current chemotherapy regimen. Risk stratification of children with ALCL was, until now, based on clinical parameters. More recently, pathological and biological risk factors have been described in trials applying BFM-type chemotherapy. Histological subtypes containing small-cell or lymphohistiocytic components indicate a high risk of failure. Minimal disseminated disease (MDD) detected by qualitative RT-PCR for NPM-ALK in bone marrow or blood is associated with a relapse risk of 50%. Quantification of MDD and persistent minimal residual disease (MRD) characterize very high risk patients. Serum ALK-autoantibody titres inversely correlate with relapse risk. The combination of MDD and ALK-antibody titre separates both low and very high risk patients from those with standard risk. In relapse, the time of relapse/progression, central nervous system and bone marrow involvement are major risk factors. In conclusion, MDD, MRD, ALK-antibody titres and histological subtype are strong biological risk factors in childhood ALCL. The combination of MDD and ALK-antibody titre may serve for patient stratification in upcoming clinical trials
Patient Satisfaction in Italian Childhood Cancer Survivors: Human Aspects of Treatment as a Key Factor in Patients' Quality of Life
No full textThe purpose of this study was to illustrate childhood cancer survivors’ perceptions about
their experience with the health services and their perceived quality of life. Participants were
213 Northeast Italian childhood cancer survivors with a mean age of 19.4 years (SD = 2.95).
Survivors were mostly affected by hematologic disorders (n = 114); 99 had different types of
solid tumors. A 30-item questionnaire assessing patient satisfaction was given to the survivors,
who had finished treatment on average 9.8 years previously (SD = 4.13). Socioeconomic,
medical, and health-related quality of life (HRQOL) data were also collected. The authors
ran a varimax rotated factor analysis on patient satisfaction questions and identified four
psychometrically robust dimensions (58.15 percent of variance): medical communication
and technical quality of care, accessibility and physical environment satisfaction, interpersonal
manner, and empathy. Childhood cancer survivors over 18 years old mostly declared that
they had a worse HRQOL compared with controls. Patients with the greatest number of
years since treatment and who declared that they had more energy at present were also more
satisfied with the health care they received. The questionnaire is a promising research tool
to give direct voice to childhood cancer survivors
COPING WITH PAIN IN CHILDREN WITH LEUKEMIA
No full textBackground: Children’s reactions to painful events vary widely but there is a fairly wide consensus on the fact that children with leukemia may have special difficulties in dealing with the stressful medical procedures needed for the treatment of their disease. In problem/emotion focused coping three factors categories must be examined: Illness parameters (type, severity, treatment), personal factors (cognitive resources, age and past experiences, gender, temperament) and social factors (protective or risk factors related to family, peers support, environment support). This chapter has two aims: the first is to show and to discuss models on how a child with cancer cope with the illness; the second is to understand how children’s and parents’ factors impact on their coping with the illness and which can be the best strategy adopted by them.
Method: Eighty-three leukemic children and their families, recruited at the Haematology-Oncologic Clinic of the Department of Child and Woman Health, University of Padua, participated in this study. Children’s mean age was 6.69 years (SD = 3.85, range = 1 year-17 years), 46 males and 37 females. Mostly children had Acute Lymphoblastic Leukemia (ALL) (N =70), while 13 had Acute Myeloid Leukemia (AML). All the parents were Caucasian, with a mean age of 37.95 years (SD = 5.93) and a mean of 11.83 years of schooling (SD=3.75). The parents who participated were mostly mothers (N = 73) and only a few were fathers (N = 10) because the mothers were more proximal to the child during hospitalization while fathers stayed with other siblings or continued to work to maintain the family.
The families were contacted by a clinical psychologist during the first hospitalization of their children. The project aims were explained and informed consent was asked for. Parental perceptions on child’s coping during hospitalization (EFI-C, Tremolada et al., 2013) and child’s coping with pain (PPCI questionnaire, Varni et al., 1996; Italian version by Bonichini & Axia, 2000) were assessed in the first month after the diagnosis.
Results: Problem solving and Cognitive self-instructions were more used with age increasing; Seek for social support was the preferred strategy; Catastrophizing was negatively correlated with child’s coping and adaptability measured at the second week from the diagnosis. Family routine and time reorganization was associated with a major use of Problem solving and Cognitive self-instructions during the first month of therapy.
Discussion: These data give relevant information on coping with pain used by children with leukemia at their first hospitalization. Specific interventions can be applied to children taking into consideration their age and their preferred coping strategy. Other supportive interventions can be studied for parents at more risk for their family routine and time reorganization at the diagnosis so to increase the use of cognitive strategies by all the family during the first hospitalization
Development delays and temperament in children with leukemia after the first year of therapy
No full textBackground: Children with leukemia are often hospitalized for long periods because of their immunosuppressed status and because of the therapies; this might place them at further risk for psychosocial developmental delays. The cognitive impairments related to antitumoral drugs and to the blood stem cell transplantation, the general psycho-social difficulties in schooling tasks and in social relationships impact upon their development.
This chapter has two aims: one is to show the adaptation of the children with leukemia during the first year of therapies; the other is to identify the possible developmental deficits in adaptive behaviors in children with leukemia post 1 year from diagnosis and the possible associations with the fixed factor children’s temperament, showing also some clinical intervention guidelines.
Method: Seventy-three leukemic children and their families recruited at the Haematology-Oncologic Clinic of the Department of Child and Woman Health, University of Padua, participated in the study. Children’s mean age was 5.78 years (SD = 2.45, range = 1 year-11 years), 39 males and 34 females. Mostly children had Acute Lymphoblastic Leukemia (ALL) (N =65), while 8 had Acute Myeloid Leukemia (AML). All parents were Caucasian with a mean age of 36.85 years (SD = 6.29) and a mean of 11.72 years of schooling (SD=3.69). The parents who participated were mostly mothers (N = 61) and only a few were fathers (N = 12) because the mothers were more proximal to the child during hospitalization. while fathers stayed with other siblings. or continued to work to maintain the family.
The families were contacted by a clinical psychologist during the first hospitalization of the children. Project aims were explained and informed consent was asked for. The VABS (Sparrow et al., 1984; Italian edition by Balboni & Pedrabissi, 2003) and QUIT-Questionari Italiani del Temperamento (Axia et al., 2002) were administered post 1 year from the diagnosis.
Results: The results showed child’s developmental delays of almost three months at one year post treatment for leukemia in all the domains measured by the Vineland Scales: the domain mostly affected is Socialization,, followed by Motor and Daily Living Skills. Children with AML, with more days of hospitalization and with higher negative emotionality were more at risk for developmental delays in their motor abilities.
Discussion: These findings can guide specific interventions for parents and for children to fill the potential developmental delay due to therapies and hospitalization. Children with AML and with more days of hospitalization are more at risk for motor delays. At this purpose specific physiotherapy and psycho-motor programmes can be implemented during hospitalization. Also socialization and educational programmes can be proposed both during hospitalization and in occasion of day-hospital follow-ups. Social plays and educative guidelines can be taught to parents to stimulate their child also at home
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