학술논문

Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer.
Document Type
Article
Source
Cancers. May2024, Vol. 16 Issue 9, p1661. 13p.
Subject
*CROSS-sectional method
*CANCER treatment
*PARENTS
*SOCIAL determinants of health
*TUMORS in children
*RESEARCH funding
*FAMILY conflict
*ECOLOGY
*CANCER
*FATIGUE (Physiology)
*QUESTIONNAIRES
*HEALTH
*ANXIETY
*POVERTY areas
*FAMILIES
*LONGITUDINAL method
*PSYCHOLOGICAL stress
*QUALITY of life
*HEALTH outcome assessment
*CANCER patient psychology
*PSYCHOLOGY of caregivers
*AFFECT (Psychology)
*SLEEP quality
*SPECIALTY hospitals
*MENTAL depression
*SLEEP disorders
*SOCIAL classes
*REGRESSION analysis
*NEIGHBORHOOD characteristics
*EVALUATION
*ADOLESCENCE
*CHILDREN
Language
ISSN
2072-6694
Abstract
Simple Summary: This cross-sectional study analyzed how multilevel social factors affect patient-reported outcomes in children under 18 who survived cancer. Study participants include 293 pairs of these survivors who received survivorship care at a U.S.-based comprehensive cancer center between 2017 and 2018 and their primary caregivers. Findings indicate that higher caregiver anxiety is linked to worse depression, stress, fatigue, sleep problems, and lower positive affect in survivors of pediatric cancer. The study also found that family conflicts are associated with sleep issues in childhood cancer survivors. Furthermore, survivors living in socioeconomically deprived areas experience poorer sleep quality, and those residing in environments with high physical deprivation experience more psychological stress and fatigue, alongside reduced positivity and mobility. These results highlight the significant impact of parental, familial, and neighborhood factors on a range of patient-reported outcomes among young cancer survivors, suggesting these social factors as crucial targets for intervention. In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children's Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors' and caregivers' PROs. General linear regression tested associations of social determinants with survivors' PROs. We found that caregivers' higher anxiety was significantly associated with survivors' poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers' sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors' sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors' poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors' higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors' quality of life and well-being and represent new intervention targets. [ABSTRACT FROM AUTHOR]