Kvalita života dětí po léčbě onkologického onemocnění: handicapy i benefity
Psychosociální problémy po prodělané léčbě dětské malignity jsou vedle zdravotních problémů nejzávažnějšími následky protinádorové terapie. V předkládané studii jsou prezentována data z projektu „qolop“, prospektivní longitudinální studie kvality života dětí po léčbě náVýzkumné studie nádorového onemocnění (Quality of Life Longitudinal Study of Pediatric Oncology Patients). Jsou analyzována data od 91 bývalých onkologických pacientů (44 chlapců a 47 dívek) ve věku 9 – 19 let, která byla porovnána se skupinou dětí ze základních a středních škol v Jihomoravském kraji. Analýzy byly provedeny zvlášť pro mladší (9 – 12 let) a starší (13 – 19 let) věkovou skupinu. Autoři se zaměřili na co nejširší spektrum oblastí kvality života. Bývalým pacientům byl administrován dotazník MMQL (Minnesota-Minneapolis Quality of Life Instrument) a další metody, pomocí nichž autoři zjišťovali zapojení do běžných denních aktivit, vztahy mezi dětmi a rodiči a emoční pohodu vyjádřenou mírou depresivních symptomů. Děti po onkologické léčbě uváděly menší míru zapojení do sociálních aktivit (obě věkové skupiny) a zhoršený fyzický výkon (mladší děti), na druhou stranu lepší vztahy s rodiči (obě věkové skupiny) a dále nižší míru depresivity, lepší kognitivní výkon a vyšší míru celkové životní spokojenosti (starší děti). and Objectives. The study deals with psychosocial problems of patients who underwent childhood malignancy treatment.
Subjects and setting. In this study, data from the “qolop” project (Quality of Life Longitudinal Study of Pediatric Oncology Patients) are presented. Data from 91 cancer survivors (44 boys and 47 girls) aged 9-19 which were compared to a control group of healthy children attending elementary and secondary schools in the South Moravian region were analyzed.
Hypothesis. The quality of life of children in short-term remission will not be significantly affected, as many late effects occur only after a longer period of time.
Statistical analysis. Multivariate analysis of variance (MANOVA) and univariate tests of between-subjects effects were used to compare individual characteristics of children and adolescents with oncologic disease to their healthy peers.
Results. The analyses were done separately for younger (9-12 years) and older (13-19 years) age groups. As many areas of quality of life as possible were targeted. Cancer survivors were asked to complete the Minnesota-Minneapolis Quality of Life Instrument (MMQL) and other methods measuring involvement in everyday life activities, parent-child interactions, and emotional well-being, expressed by the degree of depressive symptoms. Children cancer survivors expressed less social involvement (both age groups) and worse physical functioning (younger group). On the other hand, cancer survivors had better parent-child interactions (both age groups), a lower level of depressiveness, better cognitive functioning and a higher level of general life satisfaction (older group).
Study limitation. The research has the usual limitations arising from the fact that a range of selfreport methods were used. This applies particularly to the results of the questionnaire measuring depressiveness (CDI) which should be verified using projective testing and an interview.
This study reviews existing research devoted to the topic of social support in childhood cancer survivors, the structure of their social network and its influence to selected characteristics of childhood cancer patients and survivors according to the source of support. Parents, siblings, friends, medical staff, classmates and teachers are analyzed as support sources. Positive as well as negative social support outcomes are reported. Among the positive outcomes, lower levels of anxiety, loneliness and pain, quality of life improvements and strenghtening of coping strategies can be named. Negative outcomes can be represented for example by excessive paren tal care, lack of privacy and feeling of being left out after the end of treatment. The limits of existing research are discussed, too., Tereza Blažková, Veronika Koutná., and Obsahuje seznam literatury