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    Childhood cancer survivors : technical reading Childhood cancer survivors : technical reading Document Transcript

    • Childhood cancer survivors : technical reading http://www.patientcenters.com/survivors/news/reading.html Oeffinger, K.C., et al. "Programs for adult survivors of childhood cancer." Journal of Clinical Oncology 16, no. 8 (1998): 2864-7. Gray, R.E. "Psychologic adaptation of survivors of childhood cancer." Cancer 70, no. 11 (Dec 1992): 2713-21 Hollen, P.J., and W.L. Hobbie. "Risk taking and decision making of adolescent long-term survivors of cancer." Oncology Nursing Forum 17 (1994): 137-48. Kazak, A.E., et al. "Young adult cancer survivors and their parents: adjustment, learning problems, and gender." Journal of Family Psychology 8, no. 1 (1994): 74-84. Mulhern, R.K., et al. "Social competence and behavioral adjustment of children who are long-term survivors of cancer." Pediatrics 83 (1989): 18-25. Zeltzer, L.K., et al. "Comparison of psychologic outcomes in adult survivors of childhood acute lymphoblastic leukemia versus sibling controls: A cooperative Children's Cancer Group and National Institutes of Health study." Journal of Clinical Oncology 15 (1997): 547-56. Chang, P.N. "Psychosocial needs of long-term childhood cancer survivors: a review of literature." Pediatrician 18, no. 1 (1991): 20-4. Kokkonen, J., et al. "Physical and psychosocial outcome for young adults with treated malignancy." Pediatric Hematology/Oncology 14, no. 3 (May-Jun 1997): 223-32. Pendley, J.S., et al. "Body image and psychosocial adjustment in adolescent cancer survivors." Journal of Pediatric Psychology 22, no. 1 (Feb 1997): 29-43. Puukko, L.R., et al. "Impaired body image of young female survivors of childhood leukemia." Psychosomatics 38, no. 1 (Jan-Feb 1997): 54-62 Bolinger, C. "Smoking prevention in childhood cancer survivors." Journal of Pediatric Oncology Nursing 11, no. 4 (Oct 1994): 167-71. Bradley, K.A., et al. "Medical risks for women who drink alcohol." Journal of General Internal Medicine 13, no. 9 (Sept. 1998): 627-39. Haupt, R., et al. "Smoking habits in survivors of childhood and adolescent cancer." Medical Pediatric Oncology 20, no. 4 (1992): 301-6. Mulhern, R.K., et al. "Health-related behaviors of survivors of childhood cancer." Medical Pediatric Oncology 25, no. 3 (Sept 1995): 159-165. Robison, L.L. "Issues in the consideration of intervention strategies in long-term survivors of childhood cancer." Cancer 71, no. 10 Suppl (15 May 1993): 3406-10. Tyc, V.L., et al. "Tobacco use among pediatric cancer patients: recommendations for developing clinical smoking interventions." Journal of Clinical Oncology 15, no. 6 (Jun 1997): 2194-204. World College Health Adult Survivors of Childhood and Adolescent Cancer: Successes and Challenges http://www.worldcollegehealth.org/032399.htm Ohio State University : MARRIAGE RATES DIFFER ONLY SLIGHTLY IN CHILDHOOD CANCER SURVIVORS : http://www.osu.edu/units/research/archive/childca.htm Health Issues & Concerns : life beyond childhood cancer http://www.outlook-life.org/healthissues/ This is a web site designed for adolescent cancer survivors. Following are some of the internal links. Teen Smoking : http://www.outlook-life.org/healthissues/smoke.html 12 Tips to Healthy Living for Teens : http://www.outlook-life.org/healthissues/tips.html Sun Exposure : http://www.outlook-life.org/healthissues/sun.html Importance of self-image : http://www.outlook-life.org/healthissues/image.html Stress-Management for Survivors of Childhood Cancer : http://www.outlook-life.org/healthissues/ managingstress.html Books : http://www.outlook-life.org/resources/resourcebook.html 1/34
    • US organizations: http://www.outlook-life.org/resources/resourceorgs.html Pediatric cancer survivors : assessment of late effects (including psychosocial) http://www.springnet.com/ce/j012a.htm Eiser, C. (1998) Practitioner review : long-term consquences of childhood caner. J Child Psychol Psychiatry. 39(5) : 621-33. The Phoenix, a newsletter for Adult Survivors of Childhood Cancer, published by the Candlelighters Childhood Cancer Foundation. Facing Forward: A Guide for Cancer Survivors, published by The National Institute of Health Record 1 AUTHOR: Tyc VL, Hadley W, Crockett G TITLE: Prediction of health behaviors in pediatric cancer survivors. SOURCE: Med Pediatr Oncol; 37(1):42-6 2001 UI: 21359804 ABSTRACT: BACKGROUND: It is important to understand the factors that motivate survivors of childhood cancer to engage in healthy behaviors. This is because of their susceptibility to adverse late effects from their malignancy and its treatment. We specifically examined sociodemographic and health perception variables as predictors of health- protective behaviors in pediatric cancer survivors. PROCEDURE: Forty- six patients, ages 10--18 years, who were previously treated for cancer and were 1--4 years off-therapy, were assessed using a battery of testing instruments. RESULTS: Preadolescent and adolescent cancer survivors reported moderately frequent practice of a variety of health-protective behaviors. The prevalence of risky health behaviors, as indicated by alcohol and tobacco use, was low. Regression analyses indicated that the practice of health-protective behaviors was best predicted by patient's age and socioeconomic status (SES); younger adolescents and patients from higher SES more frequently engaged in healthy behaviors. Health perception variables were not significantly related to health-protective behaviors. This was true despite findings that survivors perceived themselves to be vulnerable to health problems, identified a need to protect their health, and perceived their health outcomes to be largely determined by their own behaviors. CONCLUSIONS: Sociodemographic factors should be kept in mind when designing interventions to promote continuing good health for young cancer survivors. Also to be included is the assessment of specific health risks secondary to the cancer therapies given. Risk counseling that recognizes and builds on these variables will be most effective in helping this patient population observe sound health habits. Copyright 2001 Wiley-Liss, Inc. MESH TERMS: Adolescence Adult Alcohol Drinking Automobile Driving Child Exercise Female Food Habits 2/34
    • Health Behavior* Human Life Style* Male Neoplasms*/Therapy Predictive Value of Tests Regression Analysis Sleep Smoking Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Survivors/*Statistics and Numerical Data LANGUAGE: ENG PUBLICATION TYPE: JOURNAL ARTICLE TITLE ABBREVIATION: Med Pediatr Oncol YEAR: 2001 ADDRESS: Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. vida.tyc@stjude.org ENTRY MONTH: 200107 ID: CA 21765CANCI Record 2 AUTHOR: Tyc VL, Hadley W, Crockett G TITLE: Predictors of intentions to use tobacco among adolescent survivors of cancer. SOURCE: J Pediatr Psychol; 26(2):117-21 2001 UI: 21104339 ABSTRACT: OBJECTIVE: To examine the relationship between knowledge of tobacco-related health risks, perceptions of vulnerability to these health risks, and future intentions to use tobacco in a sample of adolescent survivors of cancer. METHODS: Written self-report questionnaires were administered to 46 survivors, 10-18 years of age (61% males, 93.5% Caucasian). RESULTS: Overall, survivors were generally knowledgeable about tobacco-related health risks, perceived themselves to be vulnerable to these health risks, and reported low future intentions to use tobacco. Regression analyses indicated that demographic factors, treatment-related variables, knowledge, and perceived vulnerability explained 28% of the variance in intentions scores, F:(6, 39) = 2.52, p <.05. Age and knowledge were significant predictors, indicating that older adolescent survivors and those with lower knowledge scores reported greater intentions to use tobacco. CONCLUSIONS: Young survivors will benefit from risk counseling interventions that educate them about their susceptibility to specific tobacco-related health risks secondary to their cancer treatment. Intensive tobacco prevention programs that target older adolescents should be developed. MESH TERMS: Adolescence Attitude to Health* Child 3/34
    • Disease-Free Survival Female Health Behavior Health Promotion Human Male Neoplasms/*Therapy Prospective Studies Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Tobacco Use Disorder/*Epidemiology/Prevention and Control LANGUAGE: ENG PUBLICATION TYPE: JOURNAL ARTICLE TITLE ABBREVIATION: J Pediatr Psychol YEAR: 2001 ADDRESS: Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphi, Tennessee 38105-2794, USA. vida.tyc@stjude.org ENTRY MONTH: 200106 ID: CA21765CANCI CA23099CANCI Record 4 AUTHOR: Hollen PJ, Hobbie WL, Finley SM TITLE: Testing the effects of a decision-making and risk-reduction program for cancer-surviving adolescents. SOURCE: Oncol Nurs Forum; 26(9):1475-86 1999 UI: 20518492 ABSTRACT: PURPOSE/OBJECTIVES: To test the effects of a decision-making and risk-reduction program for cancer-surviving adolescents. DESIGN: Prospective clinical trial using a quasi-experimental pretest/post-test design with repeated measures. SETTING: Two survivor follow-up clinics and a camp for children and adolescents with cancer located in upstate New York. SAMPLE: A convenience sample of 64 survivors (13-21 years of age). The intervention group consisted of 21 survivors who attended a workshop, and the comparison group consisted of 43 survivors who did not attend the workshop. METHODS: Intervention- integrated information specific to survivorship, decision-making skills, risk behaviors, and social support from peers and healthcare professionals. The educational component of the program lasted one day (five one-hour units), and the social component lasted overnight. A single, semistructured interview at the time of the previous yearly evaluation visit was used for baseline data. Testing was conducted during home visits at 1, 6, and 12 months. MAIN RESEARCH VARIABLES: Decision making, risk motivation, and risk behaviors (i.e., smoking, alcohol use, and illicit drug use). FINDINGS: The effect of the intervention for improving decision making was significant at 1-month postintervention, marginally significant at 6-months postintervention, and highly significant at 12-months postintervention. The effect of the intervention for motivation toward alcohol use was significant at 1-month 4/34
    • postintervention and marginally significant at 6-months postintervention; however, the intervention had no effect on smoking motivation at any of the three time intervals. The effect of the intervention for improving smoking behavior was marginally significant at 6-months postintervention and was marginally significant at 12-months postintervention for alcohol use. CONCLUSIONS: The intervention had a dampening effect on the upward trajectory of substance use, a path that is well-known to increase with age for both genders in the general population. This short, five-hour program for improving decision making and affecting substance use of teen survivors shows promise; however, a larger sample is needed to enhance findings. IMPLICATIONS FOR NURSING PRACTICE: Besides tailoring risk-behavior information based on actual or potential late effects of treatment to each teen survivor during follow-up visits, oncology professionals need to provide booster programs to refine decision-making skills within meaningful decision context for teen survivors as a means of reducing risk behaviors. MESH TERMS: Adolescence Adolescent Psychology* Decision Making* Female Health Promotion/*Organization and Admin Human Male Neoplasms/*Psychology Patient Education/*Organization and Admin Program Evaluation Prospective Studies Questionnaires Risk-Taking* Social Support* Substance-Related Disorders/*Prevention and Control Support, U.S. Gov't, P.H.S. Survivors/*Psychology LANGUAGE: ENG PUBLICATION TYPE: CLINICAL TRIAL CONTROLLED CLINICAL TRIAL JOURNAL ARTICLE TITLE ABBREVIATION: Oncol Nurs Forum YEAR: 1999 ADDRESS: School of Nursing, Northeastern University, Boston, MA, USA. phollen@lynx.neu.edu ENTRY MONTH: 200012 ID: 1 R29 CA55202CANCI Record 5 AUTHOR: Hollen PJ 5/34
    • TITLE: A clinical profile to predict decision making, risk behaviors, clinical status, and health-related quality of life for cancer-surviving adolescents: part 2. SOURCE: Cancer Nurs; 23(5):337-43 2000 UI: 20489653 ABSTRACT: This is the second part of a two-part article describing a multifactorial model of clinical factors predicting decision-making quality, risk behaviors, clinical status, and health-related quality of life for cancer- surviving adolescents. To support the conceptualization of the model, findings from the literature and from the research program of the current author are presented. In part 1, support for the antecedent predictors, both primary and secondary factors, was presented. In part 2, the mediator of decision making, the moderator of risk motivation, and the expected outcomes related to risk behaviors, clinical status, and health-related quality of life are addressed. Besides a description supporting the second part of the clinical profile and its empirical underpinnings in part 2, methodologic challenges in future research and implications for clinical trials and clinical use specific to cancer-surviving adolescents also are discussed. MESH TERMS: Adolescence Child Decision Making* Female Human Male Models, Psychological Neoplasms/Nursing/*Rehabilitation Nursing Assessment/*Methods Risk-Taking* Support, U.S. Gov't, P.H.S. Survivors/*Psychology LANGUAGE: ENG PUBLICATION TYPE: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL TITLE ABBREVIATION: Cancer Nurs YEAR: 2000 ADDRESS: Northeastern University, School of Nursing, Boston, Massachusetts 02115, USA. ENTRY MONTH: 200012 ID: 1 R29 CA55202CANCI 2S07-RR0505952-07RRNCRR Record 6 AUTHOR: Hollen PJ TITLE: A clinical profile to predict decision making, risk behaviors, clinical status, and health-related quality of life for cancer-surviving adolescents. Part 1. 6/34
    • SOURCE: Cancer Nurs; 23(4):247-57 2000 UI: 20395085 ABSTRACT: The purpose of this two-part series is to describe a multifactorial model of clinical factors predicting decision-making quality, risk behaviors, clinical status, and health-related quality of life for cancer-surviving adolescents. This model was developed as a clinical profile to help health professionals in better identifying cancer-surviving adolescents at highest risk for substance use. Findings in the literature and results from the program of research by the author are presented to support the conceptualization of the model. In part 1, support for the antecedent predictors, both primary and secondary factors, is presented. Part 2 addresses decision making as a mediator, risk motivation as a moderator, and the expected outcomes related to risk behaviors, clinical status, and quality of life. In addition to describing the first part of the clinical profile in part 1, the background, theoretical basis of the model, and definitions of the model constructs also are provided. MESH TERMS: Adolescence Adolescent Behavior Cognition Decision Making* Human Models, Theoretical Neoplasms/*Nursing/*Psychology Oncologic Nursing Quality of Life* Risk-Taking* Sickness Impact Profile* Support, U.S. Gov't, P.H.S. Survivors/*Psychology LANGUAGE: ENG PUBLICATION TYPE: JOURNAL ARTICLE TITLE ABBREVIATION: Cancer Nurs YEAR: 2000 ADDRESS: Northeastern University, School of Nursing, Boston, Massachusetts 02115-5096, USA. ENTRY MONTH: 200009 ID: 1 R29 CA55202CANCI 2S07-RR0505952-07RRNCRR Record 7 AUTHOR: Madan-Swain A, Brown RT, Foster MA, Vega R, Byars K, Rodenberger W, Bell B, Lambert R TITLE: Identity in adolescent survivors of childhood cancer. SOURCE: J Pediatr Psychol; 25(2):105-15 2000 UI: 20280583 ABSTRACT: OBJECTIVE: To investigate identify formation among adolescent survivors of childhood cancer. Family functioning, perceived emotional support from family and peers, life stress, and anxiety produced by the cancer experience also were examined as they influenced identity 7/34
    • development. METHOD: Participants were 52 adolescent survivors and their mothers recruited from a medical center and 42 healthy adolescent counterparts and their mothers recruited from the community. RESULTS: A greater frequency of survivors than their healthy peers was found within the foreclosed identity status. Factors associated with the foreclosed identity status included the cancer diagnosis, symptoms of posttraumatic stress disorder (PTSD), and family functioning characterized by greater levels of conflict. CONCLUSIONS: Data were interpreted to suggest that the foreclosed identity status may serve a protective function in assisting survivors to cope with the stressors of the cancer experience. MESH TERMS: Adolescence Adolescent Behavior/*Psychology Adolescent Psychology Adult Child Female Follow-Up Studies Human Male Neoplasms/*Psychology Social Desirability Social Identification* Support, Non-U.S. Gov't Survivors/*Psychology LANGUAGE: ENG PUBLICATION TYPE: JOURNAL ARTICLE TITLE ABBREVIATION: J Pediatr Psychol YEAR: 2000 ADDRESS: Children's Hospital of Alabama, Birmingham, USA. ENTRY MONTH: 200007 Record 9 AUTHOR: Levin Newby W, Brown RT, Pawletko TM, Gold SH, Whitt JK TITLE: Social skills and psychological adjustment of child and adolescent cancer survivors. SOURCE: Psychooncology; 9(2):113-26 2000 UI: 20232116 ABSTRACT: Social skills and psychological adjustment for survivors of childhood cancer were investigated. Cancer survivors included 42 children and adolescents ranging in age at evaluation from 6 to 18 years with a mean age of 13.1 years. Measures included teacher and parent ratings of social skills and adjustment and parent ratings of family functioning. The findings showed that social skills and psychological adjustment as rated by both parents and teachers were primarily associated with academic functioning. In addition, family cohesiveness was found to account for nearly one third of the variance in survivors' adjustment when rated by teachers, and length of time off treatment accounted for a significant 8/34
    • percentage of the variance in children's adjustment when rated by parents. The findings underscore the importance of a multi-informant approach to the assessment of psychological adjustment of pediatric cancer survivors and demonstrate the role of learning difficulties and family functioning in influencing social skills and adjustment for these children and adolescents. Copyright 2000 John Wiley & Sons, Ltd. MESH TERMS: Adaptation, Psychological* Adolescence Child Family/Psychology Female Human Learning Disorders/Psychology Leukemia/*Psychology Male Neoplasms/*Psychology Personality Assessment Sick Role Social Behavior* Survivors/*Psychology LANGUAGE: ENG PUBLICATION TYPE: JOURNAL ARTICLE TITLE ABBREVIATION: Psychooncology YEAR: 2000 ADDRESS: North Carolina State University at Raleigh, USA. ENTRY MONTH: 200006 Record 10 AUTHOR: Woolverton K, Ostroff JS TITLE: Psychosexual adjustment in adolescent cancer survivors. SOURCE: Cancer Invest; 18(1):51-8 2000 UI: 20166285 MESH TERMS: Adolescence Adolescent Psychology* Child Female Human Interpersonal Relations Male Neoplasms/Physiopathology/*Psychology/Rehabilitation Psychosexual Development* Puberty Social Adjustment* Support, Non-U.S. Gov't 9/34
    • Survivors/*Psychology LANGUAGE: ENG PUBLICATION TYPE: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL TITLE ABBREVIATION: Cancer Invest YEAR: 2000 ADDRESS: Department of Psychiatry and Behavioral Sciences, Memorial Sloan- Kettering Cancer Center, New York, New York, USA. ENTRY MONTH: 200003 12 Cognitive late effect factors related to decision making and risk behaviors of cancer-surviving adolescents. Hollen PJ, Hobbie WL, Finley SM Cancer Nurs; 20(5):305-14 1997 UI: 98055847 13 Psychological functioning of adolescent and young adult survivors of pediatric malignancy. Elkin TD, Phipps S, Mulhern RK, Fairclough D Med Pediatr Oncol; 29(6):582-8 1997 UI: 97464529 14 Tobacco use among pediatric cancer patients: recommendations for developing clinical smoking interventions. Tyc VL, Hudson MM, Hinds P, Elliott V, Kibby MY J Clin Oncol; 15(6):2194-204 1997 UI: 97339532 16 Decision making and risk behaviors of cancer-surviving adolescents and their peers. Hollen PJ, Hobbie WL J Pediatr Oncol Nurs; 13(3):121-33; discussion 135-7 1996 UI: 96349484 Title: Adolescent cancer survivors: psychosocial and familial adaptation Authors: Mada-Swain, Avi; Brown, RT; Sexson, SB; Baldwin, K; Pais, R; Ragab, A. Resource: Psychosomatics; Sept-Oct 1994; 35 (5): 453-9 This study compared measures of adaptation, coping, body image, sexual adjustment, psychopathology, and family functioning among adolescent cancer survivors and healthy adolescents. The key question addressed was what effect did surviving cancer have on these qualities. The requirements for the sample of patients were: (1) they had to be survivors of cancer, (2) they had to be between the ages of 12-18, (3) they had to have been off treatment and free of disease for at least 5 years. The cohort consisted of 25 cancer survivors, 18 of which had ALL. Thecontrol group consisted of nondiseased persons who were matched for age, gender, and race. Subjects from both groups were assessed by themselves, their parents, and teachers during an 8 month period through a variety of scales, inventories, and profiles. The assessments studied specific competencies and emotional adjustments such as global self-worth and perceived competence, sexual adjustment and body image, perceived social desirability, and internalizing and externalizing symptoms of psychopathology and social competence. Coping thoughts and behaviors due to a stressor were 10/34
    • assessed (stressor in the cohort group was cancer, stressor in the control group was adolescence). Communication and cohesiveness among the family was also analyzed. The results of this study showed minimal psychiatric disturbances among cancer survivors with the exception of body image disturbances and adjustment difficulties. Cancer survivors had a strong desire to present themselves favorably and did not display as much self-criticism as the control group. Families of survivors appeared to be somewhat inflexible. In order to avoid conflict, survivors were overly compliant in social and interpersonal situations in order to avoid conflict. This study indicates how important it is for physicians to be aware of these types of psychosocial adjustments in survivors and their families. The strength of this study is that it used multiple sources to assess multiple factors. The weakness in this study is that only 1/3 of the eligible families responded , thus this may be a biased group because it is possible that those who did not respond may not have done so because they suffered more than the cohort and had a harder time adjusting. Their responses could be completely different due to these unknown factors. Questions raised by this study are what exactly causes the body image disturbances (effects of treatment, effects of illness, perceptions of cancer patients, etc.) and what effect do these disturbances have on the survivorÕs ability or desire to develop long-term intimate relationships. It would be interesting to see if the disturbances persist through adulthood. http://jama.ama-assn.org/issues/v285n4/ffull/jqu10000-4.html Cancer Stress Continues Rebecca Voelker Even though many child and adolescent cancer survivors remain well-adjusted during their younger years, a new study reports that about one fifth will experience posttraumatic stress as they become young adults. "Young adulthood is normally a time of increased vulnerability to stress, but especially so with cancer survivors, who are negotiating interpersonal relationships, their ability to have children, and the need to focus on a career," said Wendy Hobbie, CRNP, of Children's Hospital in Philadelphia. In their study, Hobbie and colleagues completed psychiatric assessments of 78 childhood cancer survivors who ranged in age from 18 to 40. At some point since their cancer treatment ended, 20.5% reported having symptoms that meet the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders criteria for posttraumatic stress disorder. Anxiety, intrusive thoughts, and avoidance behavior were some of the most common symptoms the survivors reported. "Many of these young adults worry that their lives remain in danger," Hobbie said, noting that certain smells or driving to a hospital remained potent reminders for some survivors a decade after their treatment had ended. As a result, some may avoid medical care later in life. "It's important for health care providers to recognize such increased stress," she said. The study appeared in the December 15, 2000, issue of the Journal of Clinical Oncology. From CINAHL Stewart JL. 11/34
    • Title Commentary on Future life expectations and self-esteem of the adolescent survivor of childhood cancer [original article by Overbaugh KA et al appears in J PEDIATR ONCOL NURS 1992;9(1):8-16]. Source ONS Nursing Scan in Oncology, 1(2):7, 1992 Jul-Aug. Abbreviated Source ONS NURS SCAN ONCOL. 1(2):7, 1992 Jul-Aug. Cinahl Subject Headings Adolescence *Adolescent Psychology Adult *Attitude to Health *Cancer Patients/pf [Psychosocial Factors] *Cancer Survivors/pf [Psychosocial Factors] Child *Childhood Neoplasms/pf [Psychosocial Factors] Convenience Sample Female Interviews Male *Parent-Child Relations Pearson's Correlation Coefficient Pediatric Oncology Nursing *Quality of Life Questionnaires Research Instruments *Self Concept Abstract SYNOPSIS: Adolescent survivors of childhood cancer are likely to have unique characteristics and concerns about their futures. Researchers used an interview and questionnaire format to study the variables of self-esteem and future life expectations on the part of adolescents and their parents, and the relationship between these variables, in 10 adolescents aged 12 to 18 who were at least 5 years from diagnosis and 1 year posttherapy for a childhood malignancy. Subjects did not differ significantly from a normative population of healthy adolescents on measures of self-esteem or future life expectations, except on a questionnaire item related to reproduction. The study did establish a positive relationship between adolescent self-esteem and parental future life expectations in adolescent cancer survivors. [Original article accession number: 1992138604 (research, tables/charts)] Authors Overbaugh KA. Sawin K. Institution Wayzata Childrens Clinic, 250 N Central Ave Suite 101, Wayzata, MN 55391. Title Future life expectations and self-esteem of the adolescent survivor of childhood cancer. Source Journal of Pediatric Oncology Nursing, 9(1):8-16, 1992 Jan. (35 ref) Abbreviated Source J PEDIATR ONCOL NURS. 9(1):8-16, 1992 Jan. (35 ref) Local Messages Held by a hospital library. Enquire for availability Cinahl Subject Headings Adolescence *Adolescent Psychology 12/34
    • Adult *Attitude to Health *Cancer Patients/pf [Psychosocial Factors] *Cancer Survivors/pf [Psychosocial Factors] Child *Childhood Neoplasms/pf [Psychosocial Factors] Convenience Sample Female Interviews Male *Parent-Child Relations Pearson's Correlation Coefficient Pediatric Oncology Nursing *Quality of Life Questionnaires Research Instruments *Self Concept Instrumentation Harter's Self-Perception Profile for Adolescents. Sawin and Marshall's Future Orientation Scale. Abstract The number of adolescent cancer survivors has increased dramatically over the past decade as the result of improved treatment and diagnostic techniques. This population brings with them unique characteristics and concerns. The present study consisted of interviews with 10 adolescent survivors of childhood cancer and their parents. It investigated the adolescent's present self-esteem, the future life expectations held by both the teenagers and parents, and the relationship between the variables. Results indicated that the adolescents felt moderately competent in their lives (measures of self-esteem) and the parents felt more certain than their children that the teenagers would accomplish the tasks deemed appropriate for entry into a healthy adulthood. Pearson correlations showed a strong relationship between parents' future life expectations and adolescents' self-esteem (r = .82; P = .002), but not between parents' and adolescents' future life expectations or between the adol! escents' future life expectations and self-esteem. The results are significant in addressing the impact parents can have on their child's self-esteem. (35 ref) Authors Woolverton K. Ostroff JS. Institution Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. Title Psychosexual adjustment in adolescent cancer survivors. [Review] [62 refs] Source Cancer Investigation. 18(1):51-8, 2000. Local Messages Held at Gerstein, U of Toronto MeSH Subject Headings Adolescence *Adolescent Psychology Child Female Human Interpersonal Relations Male Neoplasms/pp [Physiopathology] 13/34
    • *Neoplasms/px [Psychology] Neoplasms/rh [Rehabilitation] *Psychosexual Development Puberty *Social Adjustment Support, Non-U.S. Gov't *Survivors/px [Psychology] Authors Rourke MT. Stuber ML. Hobbie WL. Kazak AE. Institution Division of Oncology, Children's Hospital of Philadelphia, PA 19104-4399, USA. Title Posttraumatic stress disorder: understanding the psychosocial impact of surviving childhood cancer into young adulthood. [see comments]. [Review] [25 refs] Comments Comment in: J Pediatr Oncol Nurs. 1999 Jul;16(3):115-6 Source Journal of Pediatric Oncology Nursing. 16(3):126-35, 1999 Jul. Local Messages Held by a hospital library. Enquire for availability MeSH Subject Headings Adaptation, Psychological Adolescence Adult Child Human Neoplasms/mo [Mortality] *Neoplasms/px [Psychology] Psychology, Social Stress Disorders, Post-Traumatic/di [Diagnosis] *Stress Disorders, Post-Traumatic/px [Psychology] Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. *Survivors/px [Psychology] Abstract Little research has been done to explore how the psychological symptoms of child and adolescent cancer survivors change in the decades following successful treatment. This article examines these changes with a focus on the utility of a posttraumatic stress framework for understanding the long-term coping issues that individuals face as they mature and make transitions to young adulthood. First, the literature supporting the use of a posttraumatic stress framework in child and adolescent survivors is reviewed. Developmental contributions to changes and increases in posttraumatic symptomatology during young adulthood are then discussed and posttraumatic symptoms most often seen in this group are presented. Preliminary research with young adult survivors is also reviewed and discussed as support for a posttraumatic stress framework with this population. Ongoing research efforts aimed at elaborating on this framework are described. Finally, clinical implications for health care ! providers are explored, and guidelines for assessing the impact of posttraumatic stress on young adults' use of health care resources are offered. [References: 25] Authors Bauld C. Anderson V. Arnold J. Institution Royal Children's Hospital, Parkville, Victoria, Australia. Title 14/34
    • Psychosocial aspects of adolescent cancer survival. Source Journal of Paediatrics & Child Health. 34(2):120-6, 1998 Apr. Local Messages Held by a hospital library. Enquire for availability MeSH Subject Headings *Adaptation, Psychological Adolescence Analysis of Variance Child Female Human Leukemia, Lymphocytic, Acute, L1/px [Psychology] Male *Neoplasms/px [Psychology] Psychological Tests Regression Analysis *Survivors/px [Psychology] Abstract OBJECTIVE: The purpose of this research was to examine the psychosocial status of adolescent cancer survivors and compare them with healthy peers. It has been suggested in previous research that the majority of survivors display equivalent levels of psychosocial functioning post-treatment as compared with healthy controls. However, despite successful treatment, survivors may have to adjust to living with a chronic illness and its associated late effects interspersed across the lifespan (e.g. infertility, cognitive deficits, heart complications). Whilst young people appear to have similar levels of psychosocial functioning, avoidance strategies such as denial may result in previous research findings being confounded and in underestimating the true psychosocial status of survivors. It is important to understand the psychosocial status of survivors in order to optimise their quality of life. METHODOLOGY: Coping mechanisms, anxiety levels and self-concepts of 32 adolescent cance! r survivors, predominantly Acute Lymphoblastic Leukaemia (ALL) were compared with 34 healthy adolescents (age range 12-17 years), via a mailout. RESULTS: Survivors' self-reports suggest no overt psychological dysfunctioning. Whilst the two groups shared similar coping strategies, survivors were found to be less anxious than peers, with a tendency to employ avoidance strategies to deal with problems faced in adolescence. Age, gender and specific illness variables, such as age at diagnosis and time since treatment, were strong predictors of psychological outcome. CONCLUSIONS: Results can be interpreted as suggesting that whilst cancer survivors have a similar psychosocial profile to healthy peers, they are more likely to utilise avoidance strategies to manage problems. Authors Kasiraj JM. Institution California School of Professional Psychology, Fresno Title Predicting residual trauma symptoms in child and adolescent cancer survivors. Source Dissertation Abstracts International: Section B: the Sciences & Engineering. 54(1), 1993. Abstract The purpose of this study was to evaluate the utility of a trauma model in understanding pediatric cancer. Within this model, the study specifically assessed the presence of dissociative and posttraumatic stress symptoms in 62 child and adolescent cancer survivors. A self-report instrument, the Trauma Symptom Checklist for Children (TSC-C), with two scales (Posttraumatic Stress and Dissociation) and a parent-report (mother and father) measure, The Child Dissociative Checklist (CDC), were used. On the TSC-C the childhood cancer survivors appear 15/34
    • to endorse as many dissociative symptoms as sexually abused children. Additionally, mothers reported significantly more dissociative symptoms in the childhood cancer survivors than were reported for the normative CDC control group and more than the fathers in the study reported. This study's findings suggested dissociative symptoms are endorsed by over 50% of the childhood cancer survivors more than 2 yr after ending treatment. Additio! nally, over 25% of this population endorsed posttraumatic stress symptomology. Thus, the trauma model, including dissociative symptoms, appears useful in understanding the long-term impact of cancer and its treatment on children and adolescents. (Full text available from University Microfilms International, Ann Arbor, MI, as Order No. AAD93-15944) Pediatric Oncology Resource Centre http://www.acor.org/diseases/ped-onc/survivors/index.html Contains links to listserve, etc. Life Program, Children's Hospital - Los Angeles http://www.childrenshospitalla.org/life.cfm University of Minnesota Cancer Center, Long-term Follow-up Study http://www.cancer.umn.edu/page/clinical/p_csurv.html This battle which I must fight : Cancer in Canada's children and teenagers (extensive bibliography containing clinical and psychological, etc. citations - appears to be rather dated) http://hwcweb.hc-sc.gc.ca/hpb/lcdc/bc/children/refer_e.html Sat Oct 20 11:29:50 2001 Cambridge Scientific Abstracts Database: MEDLINE Query: KW=(adolescent cancer survivors) Your Comments: Record 1 of 14 TI: Title Prediction of health behaviors in pediatric cancer survivors. AU: Author Tyc VL; Hadley W; Crockett G 16/34
    • AF: Author Affiliation Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. vida.tyc@stjude.org SO: Source Medical and pediatric oncology., 2001 Jul, 37(1):42-6 IS: ISSN 0098-1532 AB: Abstract BACKGROUND: It is important to understand the factors that motivate survivors of childhood cancer to engage in healthy behaviors. This is because of their susceptibility to adverse late effects from their malignancy and its treatment. We specifically examined sociodemographic and health perception variables as predictors of health-protective behaviors in pediatric cancer survivors. PROCEDURE: Forty-six patients, ages 10--18 years, who were previously treated for cancer and were 1--4 years off-therapy, were assessed using a battery of testing instruments. RESULTS: Preadolescent and adolescent cancer survivors reported moderately frequent practice of a variety of health-protective behaviors. The prevalence of risky health behaviors, as indicated by alcohol and tobacco use, was low. Regression analyses indicated that the practice of health-protective behaviors was best predicted by patient's age and socioeconomic status (SES); younger adolescents and patients from higher SES more frequently engaged in healthy behaviors. Health perception variables were not significantly related to health-protective behaviors. This was true despite findings that survivors perceived themselves to be vulnerable to health problems, identified a need to protect their health, and perceived their health outcomes to be largely determined by their own behaviors. CONCLUSIONS: Sociodemographic factors should be kept in mind when designing interventions to promote continuing good health for young cancer survivors. Also to be included is the assessment of specific health risks secondary to the cancer therapies given. Risk counseling that recognizes and builds on these variables will be most effective in helping this patient population observe sound health habits. Copyright 2001 Wiley-Liss, Inc. LA: Language English PY: Publication Year 2001 17/34
    • PT: Publication Type Journal Article CP: Country of Publication United States DE: Descriptors Adolescence; Adult; Alcohol Drinking; Automobile Driving; Child; Exercise; Female; Food Habits; Health Behavior; Human; Life Style; Male; Neoplasms: therapy; Predictive Value of Tests; Regression Analysis; Sleep; Smoking; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Survivors: statistics & numerical data GI: Grant Grant/Contract ID: CA 21765 CA NCI UD: Update 20010806 SF: Subfile Index Medicus AN: Accession Number 11466722 Record 2 of 14 TI: Title Characteristics of adolescent cancer survivors who pursue postsecondary education. AU: Author Griffith KC; Hart LK AF: Author Affiliation College of Nursing, University of Iowa, Iowa City 52240, USA. SO: Source Cancer Nurs, 2000 Dec, 23(6):468-76 IS: ISSN 0162-220X AB: Abstract This study aimed to identify differences between adolescent cancer survivors who participate in postsecondary education and those who do not, as well as factors that helped these survivors to cope. American College Testing records for 129,824 adolescents were meshed with Iowa's Cancer Registry to identify Iowans who had received a diagnosis of cancer between the ages of 12 and 17 years. The potential subject pool contained 85 persons. A questionnaire was sent to the 28 persons who agreed to participate in the study, and 75% responded. Most of the respondents were girls with normal levels of physical function. Measures of adjustment and mood state indicated low distress levels. Fatigue was their area of highest distress. All the respondents were enrolled in education programs or had graduated. Help from family, friends, and teachers was seen as supportive, but lack of 18/34
    • knowledge about their disease was cited most frequently by this same group as interfering with their coping. The respondents demonstrated more discipline, stamina, and commitment than was expected. However, the accrual protocol and respondents' comments revealed a stigmatization of patients with cancer by professional health workers, indicating a need to confront the value that health professionals place on this stigmatized population and health professionals' contribution to this societal posture. LA: Language English PY: Publication Year 2000 PT: Publication Type Journal Article CP: Country of Publication United States DE: Descriptors Adaptation, Psychological; Adolescence; Adolescent Behavior; Child; Educational Status; Female; Human; Male; Neoplasms: nursing; Neoplasms: psychology; Questionnaires; Severity of Illness Index; Survivors: psychology UD: Update 20010501 SF: Subfile Index Medicus; Nursing AN: Accession Number 11128126 Record 3 of 14 TI: Title Social skills and psychological adjustment of child and adolescent cancer survivors. AU: Author Levin Newby W; Brown RT; Pawletko TM; Gold SH; Whitt JK AF: Author Affiliation North Carolina State University at Raleigh, USA. SO: Source Psychooncology, 2000 Mar-Apr, 9(2):113-26 IS: ISSN 1057-9249 AB: Abstract Social skills and psychological adjustment for survivors of childhood cancer were investigated. Cancer survivors included 42 children and adolescents ranging in age at evaluation from 6 to 18 years with a mean age of 13.1 years. Measures included teacher and parent ratings of social skills and adjustment and parent ratings of family functioning. The findings showed that social skills and 19/34
    • psychological adjustment as rated by both parents and teachers were primarily associated with academic functioning. In addition, family cohesiveness was found to account for nearly one third of the variance in survivors' adjustment when rated by teachers, and length of time off treatment accounted for a significant percentage of the variance in children's adjustment when rated by parents. The findings underscore the importance of a multi-informant approach to the assessment of psychological adjustment of pediatric cancer survivors and demonstrate the role of learning difficulties and family functioning in influencing social skills and adjustment for these children and adolescents. LA: Language English PY: Publication Year 2000 PT: Publication Type Journal Article CP: Country of Publication ENGLAND DE: Descriptors Adaptation, Psychological; Adolescence; Child; Family: psychology; Female; Human; Learning Disorders: psychology; Leukemia: psychology; Male; Neoplasms: psychology; Personality Assessment; Sick Role; Social Behavior; Survivors: psychology LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 10767749 Record 4 of 14 TI: Title Psychosexual adjustment in adolescent cancer survivors. AU: Author Woolverton K; Ostroff JS AF: Author Affiliation Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. SO: Source Cancer Invest, 2000, 18(1):51-8 IS: ISSN 0735-7907 LA: Language English PY: Publication Year 20/34
    • 2000 PT: Publication Type Journal Article; Review; Review, Tutorial CP: Country of Publication UNITED STATES DE: Descriptors Adolescence; Adolescent Psychology; Child; Female; Human; Interpersonal Relations; Male; Neoplasms: physiopathology; Neoplasms: psychology; Neoplasms: rehabilitation; Psychosexual Development; Puberty; Social Adjustment; Support, Non-U.S. Gov't; Survivors: psychology FE: Features 62 references LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 10701367 Record 5 of 14 TI: Title Posttraumatic stress disorder: understanding the psychosocial impact of surviving childhood cancer into young adulthood. AU: Author Rourke MT; Stuber ML; Hobbie WL; Kazak AE AF: Author Affiliation Division of Oncology, Children's Hospital of Philadelphia, PA 19104-4399, USA. SO: Source J Pediatr Oncol Nurs, 1999 Jul, 16(3):126-35 IS: ISSN 1043-4542 NT: Notes Comment in: J Pediatr Oncol Nurs. 1999 Jul;16(3):115-6 AB: Abstract Little research has been done to explore how the psychological symptoms of child and adolescent cancer survivors change in the decades following successful treatment. This article examines these changes with a focus on the utility of a posttraumatic stress framework for understanding the long-term coping issues that individuals face as they mature and make transitions to young adulthood. First, the literature supporting the use of a posttraumatic stress framework in child and adolescent survivors is reviewed. Developmental contributions to changes and increases in posttraumatic symptomatology during young adulthood are then discussed and posttraumatic symptoms most often seen in this group 21/34
    • are presented. Preliminary research with young adult survivors is also reviewed and discussed as support for a posttraumatic stress framework with this population. Ongoing research efforts aimed at elaborating on this framework are described. Finally, clinical implications for health care providers are explored, and guidelines for assessing the impact of posttraumatic stress on young adults' use of health care resources are offered. LA: Language English PY: Publication Year 1999 PT: Publication Type Journal Article; Review; Review, Tutorial CP: Country of Publication UNITED STATES DE: Descriptors Adaptation, Psychological; Adolescence; Adult; Child; Human; Neoplasms: mortality; Neoplasms: psychology; Psychology, Social; Stress Disorders, Post-Traumatic: diagnosis; Stress Disorders, Post-Traumatic: psychology; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Survivors: psychology GI: Grant Grant/Contract ID: 16520 PHS; 401604 PHS FE: Features 25 references LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus; Nursing AN: Accession Number 10444940 Record 6 of 14 TI: Title Psychosocial aspects of adolescent cancer survival. AU: Author Bauld C; Anderson V; Arnold J AF: Author Affiliation Royal Children's Hospital, Parkville, Victoria, Australia. SO: Source J Paediatr Child Health, 1998 Apr, 34(2):120-6 IS: ISSN 1034-4810 AB: Abstract OBJECTIVE: The purpose of this research was to examine the psychosocial status of adolescent cancer survivors and compare them with healthy peers. It has been suggested in previous research that the majority of survivors display equivalent levels 22/34
    • of psychosocial functioning post-treatment as compared with healthy controls. However, despite successful treatment, survivors may have to adjust to living with a chronic illness and its associated late effects interspersed across the lifespan (e.g. infertility, cognitive deficits, heart complications). Whilst young people appear to have similar levels of psychosocial functioning, avoidance strategies such as denial may result in previous research findings being confounded and in underestimating the true psychosocial status of survivors. It is important to understand the psychosocial status of survivors in order to optimise their quality of life. METHODOLOGY: Coping mechanisms, anxiety levels and self-concepts of 32 adolescent cancer survivors, predominantly Acute Lymphoblastic Leukaemia (ALL) were compared with 34 healthy adolescents (age range 12-17 years), via a mailout. RESULTS: Survivors' self-reports suggest no overt psychological dysfunctioning. Whilst the two groups shared similar coping strategies, survivors were found to be less anxious than peers, with a tendency to employ avoidance strategies to deal with problems faced in adolescence. Age, gender and specific illness variables, such as age at diagnosis and time since treatment, were strong predictors of psychological outcome. CONCLUSIONS: Results can be interpreted as suggesting that whilst cancer survivors have a similar psychosocial profile to healthy peers, they are more likely to utilise avoidance strategies to manage problems. LA: Language English PY: Publication Year 1998 PT: Publication Type Journal Article CP: Country of Publication AUSTRALIA DE: Descriptors Adaptation, Psychological; Adolescence; Analysis of Variance; Child; Female; Human; Leukemia, Lymphocytic, Acute, L1: psychology; Male; Neoplasms: psychology; Psychological Tests; Regression Analysis; Survivors: psychology LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 9588632 23/34
    • Record 7 of 14 TI: Title Tobacco use among pediatric cancer patients: recommendations for developing clinical smoking interventions. AU: Author Tyc VL; Hudson MM; Hinds P; Elliott V; Kibby MY AF: Author Affiliation Department of Hematology-Oncology, St Jude Children's Research Hospital, The University of Memphis, TN 38105-2794, USA. SO: Source J Clin Oncol, 1997 Jun, 15(6):2194-204 IS: ISSN 0732-183X NT: Notes Comment in: J Clin Oncol. 1997 Jun;15(6):2181-2 AB: Abstract PURPOSE AND METHODS: The current status of tobacco use among young cancer patients and the acute and chronic complications associated with tobacco use in these patients is reviewed. RESULTS AND CONCLUSION: Studies report that adolescent cancer survivors use tobacco as much as their peers who have never been treated for cancer, despite the adverse consequences of engaging in this unhealthy habit. Health care professionals have the opportunity and responsibility to incorporate tobacco counseling as a routine component of medical care delivery. Nurse/physician-delivered smoking interventions have been found to promote smoking cessation in adults, although little effort has been devoted to the development of similarly effective smoking interventions for pediatric cancer patients who smoke. Components of existing smoking prevention/cessation curricula from successful school-based interventions and physician-delivered smoking interventions can be adapted and tailored to pediatric cancer patients in medical settings. Smoking interventions that educate patients about their increased vulnerability to tobacco- related consequences, relative to their healthy peers, may have an enhanced impact. Guidelines for conducting a comprehensive assessment of tobacco use and implementing smoking interventions with pediatric cancer patients is provided. Strategies for modifying the cancer patient's perceived vulnerability to tobacco-related consequences is also discussed. LA: Language English PY: Publication Year 1997 PT: Publication Type 24/34
    • Journal Article; Review; Review, Tutorial CP: Country of Publication UNITED STATES DE: Descriptors Adolescence; Adolescent Behavior; Child; Child Behavior; Health Promotion: methods; Human; Neoplasms: etiology; Neoplasms: psychology; Physician's Role; Prevalence; Smoking: adverse effects; Smoking: epidemiology; Smoking: prevention & control; Smoking: psychology; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S. GI: Grant Grant/Contract ID: CA 21765 CA NCI; CA 23099 CA NCI FE: Features 81 references LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 9196131 Record 8 of 14 TI: Title Body image and psychosocial adjustment in adolescent cancer survivors. AU: Author Pendley JS; Dahlquist LM; Dreyer Z AF: Author Affiliation Baylor College of Medicine, USA. SO: Source J Pediatr Psychol, 1997 Feb, 22(1):29-43 IS: ISSN 0146-8693 AB: Abstract Examined body image and social adjustment in 21 adolescents who had completed cancer treatment and a healthy comparison group. Subjects completed questionnaires assessing body image and social adjustment and were videotaped during an interview. Raters blind to health status independently rated subjects' attractiveness. Cancer survivors reported less than half as many social activities as the healthy controls. No group differences were found on social anxiety, loneliness, or composite body image scores. However, within the cancer group, adolescents who had been off treatment longer reported lower self-worth, more social anxiety, and more negative body image perceptions, but were not rated as less 25/34
    • attractive by observers. Findings suggest body image concerns and social anxiety may not develop until several years after treatment termination. LA: Language English PY: Publication Year 1997 PT: Publication Type Journal Article CP: Country of Publication UNITED STATES DE: Descriptors Adolescence; Adult; Body Image; Case-Control Studies; Child; Female; Human; Male; Multivariate Analysis; Neoplasms: psychology; Social Adjustment; Support, Non-U.S. Gov't; Time Factors LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 9019046 Record 9 of 14 TI: Title Adolescent cancer survivors. Psychosocial and familial adaptation. AU: Author Madan-Swain A; Brown RT; Sexson SB; Baldwin K; Pais R; Ragab A AF: Author Affiliation Department of Pediatrics, Emory University, Atlanta, GA. SO: Source Psychosomatics, 1994 Sep-Oct, 35(5):453-9 IS: ISSN 0033-3182 AB: Abstract Adolescent cancer survivors were compared with nondiseased control subjects on measures of adaptation, coping, body image, sexual adjustment, psychopathology, and family functioning. Cancer survivors reported no major difficulties in social competence, overall coping, and family communication. Although their school teachers reported no symptoms of psychopathology, the cancer survivors did report body image disturbances and adjustment difficulties. Further, the surviving adolescents were eager to present themselves favorably. Compared with nondiseased control families, families of survivors were characterized as somewhat inflexible. Implications for clinical practice include the careful monitoring of youth who have survived cancer as well as 26/34
    • sensitivity to underlying concerns that the survivors and their families may avoid. LA: Language English PY: Publication Year 1994 PT: Publication Type Journal Article CP: Country of Publication UNITED STATES DE: Descriptors Adaptation, Psychological; Adolescence; Body Image; Communication; Family: psychology; Female; Human; Leukemia, Lymphocytic, Acute: psychology; Male; Neoplasms: psychology; Personality Development; Psychosexual Development; Sick Role; Support, Non-U.S. Gov't LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 7972660 Record 10 of 14 TI: Title Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors. AU: Author Rait DS; Ostroff JS; Smith K; Cella DF; Tan C; Lesko LM AF: Author Affiliation Family Therapy Program, Palo Alto Veterans Administration Medical Center/Stanford University School of Medicine, CA. SO: Source Fam Process, 1992 Dec, 31(4):383-97 IS: ISSN 0014-7370 AB: Abstract Childhood cancer patients have a greater likelihood of long- term survival than ever before. This study examined both the perceived family functioning of adolescents who had successfully completed treatment for pediatric cancer and the relationship between family functioning and post-treatment adjustment. Eighty-eight adolescent survivors of hematologic malignancies were assessed regarding their family functioning, mental health, self-esteem, global 27/34
    • competence, and problem behaviors. Contrary to expectations about the influence of cancer on these families, adolescent cancer survivors reported lower levels of family cohesion than the normative sample of healthy adolescents and their families. While current age, gender, age at diagnosis, and time since treatment completion were generally not associated with adolescents' adjustment, perceived family cohesion and adaptability were strongly related to post-treatment psychological adjustment. LA: Language English PY: Publication Year 1992 PT: Publication Type Journal Article; Review; Review, Tutorial CP: Country of Publication UNITED STATES DE: Descriptors Adaptation, Psychological; Adolescence; Adolescent Behavior; Adolescent Psychology; Child; Family; Female; Follow-Up Studies; Hodgkin Disease: psychology; Hodgkin Disease: therapy; Human; Leukemia: psychology; Leukemia: therapy; Lymphoma, Non- Hodgkin: psychology; Lymphoma, Non-Hodgkin: therapy; Male; Neoplasms: psychology; Neoplasms: therapy; Regression Analysis; Social Adjustment; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S. GI: Grant Grant/Contract ID: CA09461 CA NCI FE: Features 63 references LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 1289123 Record 11 of 14 TI: Title Future life expectations and self-esteem of the adolescent survivor of childhood cancer. AU: Author Overbaugh KA; Sawin K SO: Source J Pediatr Oncol Nurs, 1992 Jan, 9(1):8-16 IS: ISSN 1043-4542 AB: Abstract The number of adolescent cancer survivors has increased dramatically over the past decade as the result of improved 28/34
    • treatment and diagnostic techniques. This population brings with them unique characteristics and concerns. The present study consisted of interviews with 10 adolescent survivors of childhood cancer and their parents. It investigated the adolescent's present self-esteem, the future life expectations held by both the teenagers and parents, and the relationship between the variables. Results indicated that the adolescents felt moderately competent in their lives (measures of self-esteem) and the parents felt more certain than their children that the teenagers would accomplish the tasks deemed appropriate for entry into a healthy adulthood. Pearson correlations showed a strong relationship between parents' future life expectations and adolescents' self-esteem (r = . 82; P = .002), but not between parents' and adolescents' future life expectations or between the adolescents' future life expectations and self-esteem. The results are significant in addressing the impact parents can have on their child's self-esteem. LA: Language English PY: Publication Year 1992 PT: Publication Type Journal Article CP: Country of Publication UNITED STATES DE: Descriptors Adolescence; Adolescent Psychology; Child; Clinical Nursing Research; Female; Forecasting; Goals; Human; Interviews; Male; Neoplasms: mortality; Parents: psychology; Self Concept; Set (Psychology); Survival Rate LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Nursing AN: Accession Number 1596388 Record 12 of 14 TI: Title Alterations in self-perceptions among adolescent cancer survivors. AU: Author Smith K; Ostroff J; Tan C; Lesko L AF: Author Affiliation 29/34
    • Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021. SO: Source Cancer Invest, 1991, 9(5):581-8 IS: ISSN 0735-7907 AB: Abstract Psychosocial adjustment in adolescent cancer survivors has been documented to be quite variable. Factors mediating adjustment need to be identified. The current study is an exploration of the impact that cancer diagnosis and treatment has on adolescent's self-perceptions and the role this has in mediating adjustment in this group. Fifty-eight adolescent survivors of hematologic malignancies were interviewed about alterations in self-perceptions related to their cancer experience and completed a cancer-specific social problem-solving task. Initial findings suggest that cancer universally alters the way adolescent survivors view themselves, but that the alteration can be both positive or negative depending on the meaning ascribed to it. LA: Language English PY: Publication Year 1991 PT: Publication Type Journal Article CP: Country of Publication UNITED STATES DE: Descriptors Adaptation, Psychological; Adolescence; Child; Family; Female; Hodgkin Disease: psychology; Human; Leukemia: psychology; Lymphoma, Non-Hodgkin: psychology; Male; Neoplasms: mortality; Neoplasms: psychology; Peer Group; Self Concept; Support, Non-U.S. Gov't; Survival Rate LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 1933490 Record 13 of 14 TI: Title Childhood cancer survivors: attained adult heights. Compared with sibling controls. AU: Author Holmes GE; Holmes FF; Baker AB; Hassanein RS 30/34
    • AF: Author Affiliation Department of Preventive Medicine, University of Kansas Medical Center, Kansas City 66103. SO: Source Clin Pediatr (Phila), 1990 May, 29(5):268-72 IS: ISSN 0009-9228 AB: Abstract As part of a large collaborative study, the authors administered a pretested questionnaire to 62 childhood and adolescent cancer survivors and 62 same-sex sibling controls. The authors requested information regarding attained adult height on the questionnaire. Mean adult height of survivors (172.2 cm) was less than that of controls (174.1 cm), at a borderline significant difference of p = 0.0757. Multivariate analysis examined four potential, independent variables as possible predictors of this difference. The presence of brain tumor (vs. nonbrain tumor) (p less than .0001) and diagnosis at an early age (less than or equal to 8 years vs. 9-15 years) (p = .05) were factors significantly related to the differential; sex of patient and type of therapy were not. Our findings thus identify malignancy site and age at diagnosis as important predictors of adult height in childhood and adolescent cancer survivors. LA: Language English PY: Publication Year 1990 PT: Publication Type Journal Article CP: Country of Publication UNITED STATES DE: Descriptors Adolescence; Adult; Body Height; Child; Comparative Study; Epidemiologic Factors; Female; Growth Disorders: epidemiology; Growth Disorders: etiology; Human; Male; Neoplasms: complications; Neoplasms: epidemiology; Regression Analysis; Sibling Relations; Support, U.S. Gov't, P.H.S.; Time Factors; United States: epidemiology GI: Grant Grant/Contract ID: NCI-CP-01036 CP NCI LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile 31/34
    • Abridged Index Medicus; Index Medicus AN: Accession Number 2340689 Record 14 of 14 TI: Title Surviving hematological malignancies: stress responses and predicting psychological adjustment. AU: Author Lesko LM AF: Author Affiliation Department of Neurology, Memorial Sloan-Kettering Cancer Center. SO: Source Prog Clin Biol Res, 1990, 352:423-37 IS: ISSN 0361-7742 AB: Abstract Within the adolescent survivor sample, the psychosocial response of having been diagnosed and successfully treated for cancer is not universal as evidenced by the variability in psychosocial adjustment. Data from the MHI suggests that adolescent cancer survivors do experience more global psychological distress than a comparison group of healthy adolescents. In addition, the majority of these patients reported persistent, intrusive thoughts about their illness and its treatment. Conversely, the adolescent cancer survivors did not differ from a normative sample on social competence, manifestation of problems behaviors, or school achievement. Thus, our data suggest that adjustment in this population is multi-dimensional with variability. While they are functioning quite adequately at school and in social situation, they continue to experience heightened and persistent distress of both a global and illness-specific quality. A number of factors that are conducive to psychosocial intervention appear to be related to adjustment. Family communication and family cohesion were significantly related to the mental health of the adolescent survivors, suggesting a need to further explore the family context of adolescent adjustment. The present work also represents the first attempt to directly examine the psychosocial functioning of young adult, acute leukemia survivors. When compared with normative samples of nonpatients, these survivors (taken as a 32/34
    • whole group), reported heightened levels on several indicators of psychological distress. While not entirely consistent across different psychological measures, these young people were generally one standard deviation above the mean for psychological distress. But when compared to normative samples of psychiatric outpatients, our survivors reported significantly less psychological distress. For instance, leukemia survivors reported less intrusive and avoidant cognitions associated with the stressor of being diagnosed and treated for cancer than those associated with patients experiencing traumatic stress disorders. In aggregate, these findings again suggest that the psychosocial adjustment of leukemia survivors is quite variable. Finally, while group comparisons shed light on the psychosocial functioning of leukemia survivors, in general, wide variability in psychosocial adjustment may mask identification of a cohort of cancer survivors most at-risk for psychosocial dysfunction. Sociodemographic, disease/treatment and psychological distress variables only partially explain this variability. The findings from our data suggest several clinical recommendations. First, the prevalence of persistent, psychiatric comorbidity is quite low among long- term survivors of hematologic malignancies survivors. Second, if survivors do experience some psychological distress, usually, it is of non-psychopathological proportions.(ABSTRACT TRUNCATED AT 400 WORDS) LA: Language English PY: Publication Year 1990 PT: Publication Type Journal Article CP: Country of Publication UNITED STATES DE: Descriptors Adaptation, Psychological; Adolescence; Adult; Body Image; Bone Marrow Transplantation: psychology; Combined Modality Therapy; Comparative Study; Cross-Sectional Studies; Family; Female; Human; Leukemia: complications; Leukemia: drug therapy; Leukemia: psychology; Leukemia: surgery; Male; Psychological Tests; Quality of Life; Sexual Dysfunctions, Psychological: epidemiology; Sexual 33/34
    • Dysfunctions, Psychological: etiology; Social Adjustment; Stress, Psychological: epidemiology; Stress, Psychological: etiology; Stress, Psychological: psychology; United States: epidemiology LR: Last Revision Date 20001218 UD: Update 20001218 SF: Subfile Index Medicus AN: Accession Number 2402518 34/34