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Abstract：
Most of the studies on functional outcomes in pediatric survivors of cancers and bone marrow failure disorders have been conducted in North American, European, and Oceanian populations, with few studies having been performed in China. The objective of this study was to evaluate psychosocial outcomes in a cohort of Chinese pediatric survivors diagnosed with cancer or conditions requiring hematopoietic stem cell transplantation (HSCT), and to identify clinical and behavioral factors associated with adverse psychosocial outcomes.
This was a cross-sectional survey study. We recruited pediatric survivors of cancer or inherited disorder requiring HSCT at ≤18 years old and were ≥6 months post-treatment. Parents completed the St. Jude Children\'s Research Hospital After Completion of Therapy questionnaire to report their child\'s emotional functioning, social functioning, attention/concentration and behavior. Multivariable general linear modeling was used to identify clinical, treatment and behavioral factors associated with psychosocial outcomes, adjusting for sex, age and cancer diagnoses.
Ninety-five pediatric survivors were recruited (62.1% male; mean [standard deviation] age 9.7 [3.4] years; 4.1 [2.6] years post-diagnosis). They were diagnosed with bone marrow failure disorders (23.2%), hematological malignancies (45.3%) or solid tumors (23.2%). Compared with survivors with no current health problems, those with more than one current health problem performed worse in emotional functioning (Estimate = 2.42, SE = 0.88, P = 0.008) and social functioning (Estimate = 2.90, SE = 1.64, P = 0.03). Higher pain interference was significantly associated with worse emotional functioning (Estimate = 0.19, SE = 0.08, P = 0.03) and attention functioning (Estimate = 0.26, SE = 0.11, P = 0.03). Compared with survivors who reported less sleep problems, those who had more sleep problems demonstrated poorer emotional functioning (Estimate = 0.30, SE = 0.08, P = 0.001). Survivors who had a longer duration of screen usage per day reported more impairment on attention and behavior functioning than those who had a shorter duration of screen usage per day (both P<0.5).
Survivors who were diagnosed at a younger age or had unaddressed/untreated health problems may require additional psychological evaluation. The implementation of psychosocial assessments during routine long-term follow-up care may help to identify high-risk patients during the early phase of survivorship. Rehabilitation interventions should address modifiable behavioral factors (e.g. sleep habits, screen time and chronic pain).
This was a cross-sectional survey study. We recruited pediatric survivors of cancer or inherited disorder requiring HSCT at ≤18 years old and were ≥6 months post-treatment. Parents completed the St. Jude Children\'s Research Hospital After Completion of Therapy questionnaire to report their child\'s emotional functioning, social functioning, attention/concentration and behavior. Multivariable general linear modeling was used to identify clinical, treatment and behavioral factors associated with psychosocial outcomes, adjusting for sex, age and cancer diagnoses.
Ninety-five pediatric survivors were recruited (62.1% male; mean [standard deviation] age 9.7 [3.4] years; 4.1 [2.6] years post-diagnosis). They were diagnosed with bone marrow failure disorders (23.2%), hematological malignancies (45.3%) or solid tumors (23.2%). Compared with survivors with no current health problems, those with more than one current health problem performed worse in emotional functioning (Estimate = 2.42, SE = 0.88, P = 0.008) and social functioning (Estimate = 2.90, SE = 1.64, P = 0.03). Higher pain interference was significantly associated with worse emotional functioning (Estimate = 0.19, SE = 0.08, P = 0.03) and attention functioning (Estimate = 0.26, SE = 0.11, P = 0.03). Compared with survivors who reported less sleep problems, those who had more sleep problems demonstrated poorer emotional functioning (Estimate = 0.30, SE = 0.08, P = 0.001). Survivors who had a longer duration of screen usage per day reported more impairment on attention and behavior functioning than those who had a shorter duration of screen usage per day (both P<0.5).
Survivors who were diagnosed at a younger age or had unaddressed/untreated health problems may require additional psychological evaluation. The implementation of psychosocial assessments during routine long-term follow-up care may help to identify high-risk patients during the early phase of survivorship. Rehabilitation interventions should address modifiable behavioral factors (e.g. sleep habits, screen time and chronic pain).
摘要：
目的：大多数关于癌症和骨髓衰竭疾病的儿科幸存者的功能结局的研究都是在北美进行的，欧洲,和大洋洲人口，在中国进行的研究很少。这项研究的目的是评估中国儿科幸存者的心理社会结果诊断为癌症或需要造血干细胞移植（HSCT），并确定与不良心理社会结果相关的临床和行为因素。
方法：这是一项横断面调查研究。我们招募了≤18岁且治疗后≥6个月的需要HSCT的癌症或遗传性疾病的儿科幸存者。父母在完成治疗问卷后完成了圣裘德儿童研究医院报告他们孩子的情绪功能，社会功能,注意力/注意力和行为。多变量一般线性模型用于识别临床，与心理社会结果相关的治疗和行为因素，适应性，年龄和癌症诊断。
结果：招募了95名儿科幸存者（62.1%为男性；平均[标准差]年龄9.7[3.4]岁；诊断后4.1[2.6]岁）。他们被诊断为骨髓衰竭障碍（23.2％），血液恶性肿瘤（45.3%）或实体瘤（23.2%）。与目前没有健康问题的幸存者相比，当前有多个健康问题的患者在情绪功能(估计值=2.42,SE=0.88,P=0.008)和社会功能(估计值=2.90,SE=1.64,P=0.03)方面表现较差.较高的疼痛干扰与较差的情绪功能（估计值=0.19，SE=0.08，P=0.03）和注意力功能（估计值=0.26，SE=0.11，P=0.03）显着相关。与报告睡眠问题较少的幸存者相比，睡眠问题较多的患者表现出较差的情绪功能(估计值=0.30,SE=0.08,P=0.001).与每天使用屏幕时间较短的幸存者相比，每天使用屏幕时间较长的幸存者对注意力和行为功能的损害更大（均P<0.5）。
结论：在年轻时被诊断出或有未解决/未治疗的健康问题的幸存者可能需要额外的心理评估。在常规的长期随访护理中实施社会心理评估可能有助于在生存的早期阶段识别高风险患者。康复干预措施应解决可改变的行为因素(如睡眠习惯、屏幕时间和慢性疼痛)。
方法：这是一项横断面调查研究。我们招募了≤18岁且治疗后≥6个月的需要HSCT的癌症或遗传性疾病的儿科幸存者。父母在完成治疗问卷后完成了圣裘德儿童研究医院报告他们孩子的情绪功能，社会功能,注意力/注意力和行为。多变量一般线性模型用于识别临床，与心理社会结果相关的治疗和行为因素，适应性，年龄和癌症诊断。
结果：招募了95名儿科幸存者（62.1%为男性；平均[标准差]年龄9.7[3.4]岁；诊断后4.1[2.6]岁）。他们被诊断为骨髓衰竭障碍（23.2％），血液恶性肿瘤（45.3%）或实体瘤（23.2%）。与目前没有健康问题的幸存者相比，当前有多个健康问题的患者在情绪功能(估计值=2.42,SE=0.88,P=0.008)和社会功能(估计值=2.90,SE=1.64,P=0.03)方面表现较差.较高的疼痛干扰与较差的情绪功能（估计值=0.19，SE=0.08，P=0.03）和注意力功能（估计值=0.26，SE=0.11，P=0.03）显着相关。与报告睡眠问题较少的幸存者相比，睡眠问题较多的患者表现出较差的情绪功能(估计值=0.30,SE=0.08,P=0.001).与每天使用屏幕时间较短的幸存者相比，每天使用屏幕时间较长的幸存者对注意力和行为功能的损害更大（均P<0.5）。
结论：在年轻时被诊断出或有未解决/未治疗的健康问题的幸存者可能需要额外的心理评估。在常规的长期随访护理中实施社会心理评估可能有助于在生存的早期阶段识别高风险患者。康复干预措施应解决可改变的行为因素(如睡眠习惯、屏幕时间和慢性疼痛)。
