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Los supervivientes de tumores del sistema nervioso central (TSNC) presentan peor calidad de vida en relación a la salud (CVRS) que los supervivientes de otras neoplasias y la población normativa. El tipo y gravedad de las secuelas no parecen tener un impacto claro en la CVRS, pero la afectación del cociente intelectual (CI) sí podría modular la CVRS. Además, las estrategias de afrontamiento del paciente y de los progenitores y el malestar emocional parental podrían también actuar sobre la CVRS. Objetivo: Determinar si las estrategias de afrontamiento del adolescente y su CI, y las estrategias de afrontamiento, el estrés general y el malestar emocional parental, modulan las dimensiones psicosociales de la CVRS del superviviente. Método: Estudio transversal descriptivo-correlacional. Se reclutaron 37 adolescentes (12-19 años) que llevaban ≥1 año fuera de tratamiento oncológico y 44 progenitores. Resultados: En la CVRS valorada por los adolescentes, las dimensiones Relación con los Padres y Vida Familiar, Amigos y Apoyo Social, y Entorno Escolar dependen de la estrategia de afrontamiento de resolución del problema usada por el adolescente. La dimensión Aceptación Social depende del estilo de afrontamiento improductivo del adolescente y del estilo de búsqueda de ayuda social de los padres. La CVRS valorada por los padres depende de las secuelas, el CI del adolescente y, el tipo de tratamiento oncológico recibido. Discusión y conclusiones: Las estrategias de afrontamiento centradas en la resolución del problema, deben ser consideradas para valorar e intervenir en la mejora de la CVRS de los supervivientes TSNC. Central Nervous System Tumor (CNST) survivors tend to show worse HRQoLthan survivors of other types of cancer and general population. There are still many doubts about whatvariables and to what extend these are related to their HRQoL. Type and severity of late effects havenot a clear impact on HRQoL. However, Intelligence Quotient (IQ) changes as a specific late effectof this sample population, could modulate their HRQL. Furthermore, coping from both patients andparents, as well as parental distress could play a significant role modulating HRQoL in these survivors.Aim: To study whether survivors' coping strategies and IQ, as well as coping, general stress and cancerrelateddistress of parents could modulate some psychosocial dimensions of their children HRQoL.Methodology: Correlational descriptive cross-sectional study. Thirty-seven teenagers (12-19 years old,both included) ≥1 year free of disease and 44 parents were recruited for the study. Results: When HRQoLis assessed by adolescents, the dimensions Parent Relations and Home Life, Social Support and Peer,and School Environment are related with the use of coping with problem style by adolescents. SocialAcceptance/Bullying dimension is related with nonproductive coping by the adolescent and helpseekingcoping style by parents. HRQoL assessed by parents is related with late effects, adolescents' IQ, andtype of oncological treatment received. Discussion/Conclusion: Coping strategies, and specificallyproblem-solving strategies must be taken into account to assess and to intervene in the improvement ofHRQoL of this sample population.

This study was twofold: 1) to assess parental reactions to childhood cancer throughout the oncological experience and 2) to explore associations between parents’ reactions during treatment and cancer-related distress at survival. A cross-sectional descriptive study collecting data (at survival) from retrospective (perceived social support, optimism, distress, coping in the worst situation) and current variables (general stress, distress regarding cancer, benefit finding) was carried out. Forty-one parents of childhood cancer survivors were assessed. High levels of distress (M= 9.5,SD= 1.32, range 4-10) and self-reported efforts to overcome difficulties occurring during the hospitalization (M= 7.48,SD= 3.01, range 0-10) were found. However, parents received high social support from very different sources. This could explain the satisfactory levels of optimism found (43.9% of the sample,M≥ 16, range 9 – 24). Most parents reported to use engagement (M= 2.57,SD= 0.41, range 1-4) and help-seeking (M= 2.52,SD= 0.53, range 1-4) coping strategies to overcome difficulties. Some parents recognized to use psychological defenses when coping with the distress of cancer. However, this disengagement style was less preferred (M= 1.62,SD= 0.37, range 1-4). Finally, 22% of parents reported positive consequences and 60% reported positive and negative consequences too. When exploring how treatment experiences can influence cancer-related distress in survivorship, we observed that those who received less social support used more disengagement coping and referred higher efforts to overcome difficulties during treatment, displayed persistent distress at survival. These same parents showed higher scores on general stress. Besides, these results were not influenced by child’s sequelae at survival. These findings support the hypothesis that “the end of treatment is not the end”. Consequently, special attention should be placed in screening parents experiences throughout different milestones of cancer to design tailored interventions aimed at reducing persistent distress at survival.

Research findings about health-related quality of life (HRQoL) of childhood cancer survivors are mixed and the features which could modulate these results have not been investigated rigorously. This research aims to improve the knowledge on these topics. Thus, HRQoL between central nervous system (CNST) and non-central nervous system (non-CNST) adolescent cancer survivors was compared. The influence of selected factors (gender and years since diagnosis) on HRQoL was also analysed. In a cross-sectional design, 78 survivors (12-20 years) who were ≥ 1 year free of oncological treatment answered the self-reported version of the KIDSCREEN-52. HRQoL mean scores of CNST survivors were lower in comparison with non-CNST in physical well-being and social support and peers dimensions. Furthermore, female gender was also related to lower HRQoL scores for both types of tumours in physical well-being and autonomy dimensions. Additionally, scores on psychological well-being, social support and peers, parent relations and home life and school environment dimensions decrease with length of time from diagnosis. Therefore, diagnosis of CNST and gender were related to lower HRQoL among survivors in some dimensions, whereas time from diagnosis was related to impaired HRQoL in other features. These results can help to design tailored interventions and psychosocial guidelines to follow-up survivors.

Resumen Fundamento y objetivo Evaluar la calidad de vida en relacion con la salud de un grupo de adolescentes oncologicos en remision en comparacion con adolescentes de la poblacion general sin historia previa de cancer. Pacientes y metodo Se evaluo a un total de 372 adolescentes con edades comprendidas entre los 14 y los 19 anos, de los cuales 34 formaban parte del grupo de supervivientes oncologicos y 338 del grupo normativo. A todos ellos se les administro el cuestionario de salud SF-12v 2 en una unica sesion de evaluacion. Resultados Los adolescentes oncologicos en remision presentaron puntuaciones medias estadisticamente superiores en comparacion con el grupo control en el componente mental (MCS) de calidad de vida del SF-12v 2 (52,60 frente a 47,85; p=0,004; intervalo de confianza del 95%: −7,9 a −1,6). No se encontraron diferencias estadisticamente significativas entre ambas muestras en el componente fisico (PCS), pese a que los supervivientes presentaron puntuaciones medias superiores (54,03 frente a 52,72). Conclusiones Los adolescentes supervivientes de cancer manifiestan una calidad de vida satisfactoria (valores en torno a la media poblacional) y, en concreto, presentan mayor percepcion de bienestar psicologico que el grupo control sin historia previa de cancer.

Objective: To assess the psychological status of adolescent cancer survivors and examined its associations with selected personal (coping, cancer-related distress) and familial factors (parents’ general stress, cancer-related distress). Method: Using a cross-sectional design, forty-one survivors (12-19 years) answered standardized measures to assess psychological well-being, mood and emotions and self-perception (KIDSCREEN-52), coping (ACS) and cancer-related distress (two numeric scales). Similarly, forty-one parents were assessed for general stress (PSS-14) and cancer-related distress (two numeric scales). Results: Mean scores for all KIDSCREEN psychological dimensions assessed were within normative values (50 ± 10). Regression analyses revealed two models with a range of explained variance between 17.3-31.1% for psychological well-being (F(2,37) = 5.070; p = 0.011) and mood and emotions (F(3,36) = 6.877; p = 0.001) respectively. Conclusion: This study provides tentative evidence that survivors’ psychological status is related to diverse personal and familial factors, especially those concerning adolescent mobilization of coping resources during hospitalization, and parental general stress in survivorship. Although psychological outcomes in survivorship appeared satisfactory compared to normative values; this study revealed that to facilitate positive psychological adaptation in the aftermath of cancer, psychosocial interventions aimed to enhance personal and family strengths to cope with the illness are needed throughout the process.

This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.

This article is intended to review the concept of resilience from the scope of paediatric psycho-oncology. The origin, its different defini- tions and its suitability of application in the field of serious physical illness - such as cancer - will be analyzed. Furthermore, the differences between resilience and other concepts commonly associated or confused with it, such as post-traumatic growth or benefit finding, will be discussed. Finally, a proposal for a comprehensive model of resilience in paediatric cancer will be put forward.

This article is intended to review the concept of resilience from the scope of paediatric psycho-oncology. The origin, its different definitions and its suitability of application in the field of serious physical illness - such as cancer - will be analyzed. Furthermore, the differences between resilience and other concepts commonly associated or confused with it, such as post-traumatic growth or benefit finding, will be discussed. Finally, a proposal for a comprehensive model of resilience in paediatric cancer will be put forward.

Objetivo y métodos: La práctica regular de ejercicio físico (EF), es una de las principales conductas relacionadas con un estilo de vida saludable que ha demostrado reportar beneficios tanto físicos como psicológicos sobre la calidad de vida en relación a la salud (CVRS) de las personas. Sin embargo, en España son escasos los trabajos que exploren dicha asociación en población infanto-juvenil superviviente a un cáncer. Por ello, el presente estudio descriptivo mediante encuesta analiza la relación entre el patrón de realización de EF y la CVRS en una muestra de adolescentes oncológicos en remisión (GS), en comparación con un grupo normativo de referencia (GN). Todos los participantes cumplimentaron el cuestionario de salud SF-12v2 y el Autoinforme del Estadio de Cambio para el Ejercicio Físico (AECEF). Resultados: En ambos grupos había un porcentaje significativamente mayor de varones activos para EF que, además, presentaban puntuaciones significativamente superiores en MCS. No obstante, la CVRS entre ambos grupos era similar e incluso significativamente superior para el GS en MCS. El EF sólo explicó un 12% de la varianza de MCS en el GN, en conjunción con el género y la edad del superviviente. Conclusiones:A partir de los resultados,creemos necesario seguir explorando otros factores no contemplados en el presente trabajo, tales como la intensidad o el tipo de actividad física llevada a cabo, que puedan mediar la asociación entre EF y CVRS en supervivientes. También se discute la necesidad de utilizar ins-trumentos específicos de CVRS para población adolescente superviviente a un cancer. Purpose and methods: The regular practice of physical exercise (PE) is one of the main behaviours related with a healthy lifestyle that has demonstrated to yield benefits both on physical and psychological health- related quality of life' domains (HRQoL). However, in Spain, studies exploring such association in pediatric survivors of childhood cancer are scarce. For that reason, this descriptive study examines the relationship between the pattern of PE performance and self-rated HRQoL in a sample of adolescent survivors of childhood cancer (ASCC), compared to a normative group from the general population (NG). All participants filled in the SF-12v2 questionnaire and the AECEF. Results: In both groups, a significantly higher percentage of male active survivors was found and they also showed significantly higher mean scores in MCS. However, HRQoL between groups was equivalent and even higher in the case of MCS for the GS. Only 12% of explained variance for MCS was accounted in the NG, considering PE, gender and age at the assessment. Conclusions: Considering these results, we believe it's needed to explore other factors not addressed in the present work, such as PE intensity or type of physical activity performed that might be mediating the association between PE and HRQoL in adolescent cancer survivors. It is also discussed the suitability of using specific tools to assess HRQoL in adolescent survivors of childhood cancer populations.

This research assesses Health-Related Quality of Life (HRQoL) in a Spanish sample of adolescent cancer survivors, and analyzes the relationship between HRQoL, coping styles and physical exercise. Forty-two survivors (12–19 years), who were ≥ 1 year of remission, completed standardized measures of HRQoL (CHIP-AE), coping strategies (ACS) and physical exercise (AECEF). Mean scores in all HRQoL domains were within normative values. Multiple regression analysis revealed that physical exercise and productive coping were related to higher HRQoL, whereas non-productive coping was related to lower HRQoL. This sample of survivors reported good levels of HRQoL, which are mediated by coping styles and physical exercise.

To assess health-related quality of life of adolescent survivors of childhood cancer, compared to adolescent's health-related quality of life who had no history of cancer.A total of 372 adolescents aged between 14 and 19 years, 34 cancer survivors and a comparison group of 338 peers without a history of cancer, were assessed. All of them filled in the SF-12v(2) in a cross-sectional study.Survivors revealed significantly higher mean values compared to the normative group for the Mental Component Scale (MCS) from the SF-12v(2) (52,60 vs. 47,85; p=0,004; IC 95%, -7,9--1,6). No significant differences between groups were found for the Physical Component Scale (PCS), even though adolescent survivors of childhood cancer showed higher mean scores (54,03 vs. 52,72).Adolescent cancer survivors showed a satisfactory quality of life (mean scores around the normative values), and, specifically, they reported greater perception of psychological wellbeing compared to peers.

Background: Health-related quality of life (HRQoL) in cancer has been related to several protective and risk factors such as perceived social support (PSS) and coping. However, their effects on HRQoL once patients are in survivorship have not been fully described in pediatric samples.Objective: To describe and explore the relationship between HRQoL in survivorship and some factors (PSS, coping) present while active treatment.Methods: Cross-sectional study. Forty-one pediatric cancer survivors answered HRQoL measures referred to survivorship, as well as PSS and coping measures referred to treatment period.Results: The discriminant function obtained succeeds to correctly classify 78% of the sample. Survivors who showed high HRQoL were those who, in the hardest moment while hospitalization, perceived satisfactory emotional support (from nurses) and did not deploy a wide range of active coping resources to cope with stressful events (only social action coping strategy showed a significant relationship with HRQoL).Conclusions and implications: Considering these outcomes, educational and counseling interventions to strengthen patients’ social networks and supportive relationships are recommended, specially, among health providers (nurses). These results highlight the importance of not overlooking opportunities to address the emotional needs of patients while hospitalization, since a positive and endurable effect has been observed at survivorship.