Abstract：
OBJECTIVE: Investigate the association between presence, number and type of clinically relevant health conditions and a range of psychosocial outcomes (emotional, social, cognitive, physical) in survivors of childhood cancer (CCS).
METHODS: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed between 1963-2001, attained age ≥ 18, diagnosed < 18, ≥ 5 years since diagnosis) completed a questionnaire on health conditions (2013-2014), and questionnaires on psychosocial outcomes (2017-2020): Hospital Anxiety and Depression Scale, Short form 36, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and the Self-Rating Scale for Post-Traumatic Stress Disorder. Associations among health conditions and psychosocial outcomes were assessed with regression analysis, adjusting for attained age, sex, and time since diagnosis, and adjusting for multiple testing (p < 0.004).
RESULTS: A total of 1437 CCS, mean age 36.3 years, 51.1% female, ≥ 15 years since diagnosis, completed questionnaires on health and psychosocial outcomes. CCS with a clinically relevant health condition, and those with more conditions had worse emotional, social, and physical outcomes; regression coefficients were small to moderate. CCS with gastro-intestinal conditions, endocrine, nervous systems, eye, or ear conditions, and especially those with secondary malignant neoplasms, reported worse psychosocial functioning; regression coefficients were small/moderate to large.
CONCLUSIONS: Health care professionals should be aware of the increased risk for psychosocial problems among CCS with health conditions, especially for survivors with secondary malignant neoplasms, gastro-intestinal, endocrine, nervous system, eye, and ear conditions. CCS may benefit from psychological interventions to develop coping strategies to manage health conditions and psychosocial consequences of the cancer trajectory.
METHODS: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed between 1963-2001, attained age ≥ 18, diagnosed < 18, ≥ 5 years since diagnosis) completed a questionnaire on health conditions (2013-2014), and questionnaires on psychosocial outcomes (2017-2020): Hospital Anxiety and Depression Scale, Short form 36, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and the Self-Rating Scale for Post-Traumatic Stress Disorder. Associations among health conditions and psychosocial outcomes were assessed with regression analysis, adjusting for attained age, sex, and time since diagnosis, and adjusting for multiple testing (p < 0.004).
RESULTS: A total of 1437 CCS, mean age 36.3 years, 51.1% female, ≥ 15 years since diagnosis, completed questionnaires on health and psychosocial outcomes. CCS with a clinically relevant health condition, and those with more conditions had worse emotional, social, and physical outcomes; regression coefficients were small to moderate. CCS with gastro-intestinal conditions, endocrine, nervous systems, eye, or ear conditions, and especially those with secondary malignant neoplasms, reported worse psychosocial functioning; regression coefficients were small/moderate to large.
CONCLUSIONS: Health care professionals should be aware of the increased risk for psychosocial problems among CCS with health conditions, especially for survivors with secondary malignant neoplasms, gastro-intestinal, endocrine, nervous system, eye, and ear conditions. CCS may benefit from psychological interventions to develop coping strategies to manage health conditions and psychosocial consequences of the cancer trajectory.
摘要：
目的：调查存在之间的关联，临床相关健康状况的数量和类型以及一系列社会心理结果(情绪，社会,认知，儿童癌症(CCS)幸存者的身体)。
方法：来自荷兰儿童癌症幸存者研究（DCCSS）的CCS-LATER队列（在1963-2001年之间诊断，年龄≥18岁，诊断<18岁，诊断后≥5年）完成了一份关于健康状况的问卷（2013-2014年），和心理社会结果问卷（2017-2020）：医院焦虑和抑郁量表，简表36，成人健康相关生活质量TNO-AZL问卷，和创伤后应激障碍的自评量表。用回归分析评估健康状况和心理社会结果之间的关联，根据年龄调整，性别,和诊断后的时间，并调整多次测试(p<0.004)。
结果：共1437个CCS，平均年龄36.3岁，51.1%女性，诊断后≥15年，完成了关于健康和心理社会结果的问卷。具有临床相关健康状况的CCS，那些条件更多的人情绪更差，社会,和物理结果；回归系数为小到中等。CCS与胃肠道条件，内分泌，神经系统,眼睛,或耳朵状况，尤其是那些患有继发性恶性肿瘤的人，报告的心理社会功能较差；回归系数为小/中至大。
结论：卫生保健专业人员应该意识到有健康状况的CCS中心理社会问题的风险增加，特别是对于患有继发性恶性肿瘤的幸存者，胃肠道,内分泌，神经系统,眼睛,耳朵的条件。CCS可能受益于心理干预，以制定应对策略来管理健康状况和癌症轨迹的心理社会后果。
方法：来自荷兰儿童癌症幸存者研究（DCCSS）的CCS-LATER队列（在1963-2001年之间诊断，年龄≥18岁，诊断<18岁，诊断后≥5年）完成了一份关于健康状况的问卷（2013-2014年），和心理社会结果问卷（2017-2020）：医院焦虑和抑郁量表，简表36，成人健康相关生活质量TNO-AZL问卷，和创伤后应激障碍的自评量表。用回归分析评估健康状况和心理社会结果之间的关联，根据年龄调整，性别,和诊断后的时间，并调整多次测试(p<0.004)。
结果：共1437个CCS，平均年龄36.3岁，51.1%女性，诊断后≥15年，完成了关于健康和心理社会结果的问卷。具有临床相关健康状况的CCS，那些条件更多的人情绪更差，社会,和物理结果；回归系数为小到中等。CCS与胃肠道条件，内分泌，神经系统,眼睛,或耳朵状况，尤其是那些患有继发性恶性肿瘤的人，报告的心理社会功能较差；回归系数为小/中至大。
结论：卫生保健专业人员应该意识到有健康状况的CCS中心理社会问题的风险增加，特别是对于患有继发性恶性肿瘤的幸存者，胃肠道,内分泌，神经系统,眼睛,耳朵的条件。CCS可能受益于心理干预，以制定应对策略来管理健康状况和癌症轨迹的心理社会后果。
