Back to Search
Start Over
Predictors of independent living status in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
- Source :
-
Pediatric blood & cancer [Pediatr Blood Cancer] 2011 Dec 15; Vol. 57 (7), pp. 1197-203. Date of Electronic Publication: 2011 Feb 03. - Publication Year :
- 2011
-
Abstract
- Background: Adult survivors of childhood cancer and their siblings are compared on one of the most salient developmental milestones of adulthood, the ability to live independently.<br />Procedure: Adult survivors of childhood cancers (n = 6,047) and siblings (n = 2,326), all 25 years of age and older, completed a long-term follow-up questionnaire that assessed adaptive, neurocognitive, and psychological functioning, as well as demographic and health status. Multivariable logistic regression analyses and structural equation modeling (SEM) were used to identify predictors of independent living.<br />Results: Compared to siblings (n = 206, 8.7%), survivors (n = 1063; 17.7%) were more than twice as likely to live dependently (OR 2.07; 95% confidence interval [CI] 1.77-2.42). Survivors diagnosed with CNS tumors (OR 0.13, 95% CI 0.10-0.18) or leukemia (OR 0.29, 95% CI 0.23-0.27) were significantly less likely to live independently compared to those diagnosed with Hodgkin lymphoma. Other risk factors for reduced independent living included cranial radiation (≤ 24 Gy OR 0.76, 95% CI 0.62-0.93; >24 Gy OR 0.31, 95% CI 0.24-0.41), use of neuroleptic, anticonvulsant, or psychostimulant medication (OR 0.32, 95% CI 0.24-0.43), attention and processing speed problems (OR 0.58, 95% CI 0.47-0.71), poor physical functioning (OR 0.49, 95% CI 0.38-0.63), depression (OR 0.68, 95% CI 0.53-0.88), and racial/ethnic minority status (OR 0.39, 95% CI 0.30-0.51). SEM demonstrated that neurocognitive functioning had both direct effects on independent living status, and indirect effects through use of neurologically directed medication, depression, and poor mental health.<br />Conclusion: Adult survivors of childhood cancer who experience neurocognitive, psychological, or physical late effects are less likely to live independently as adults.<br /> (Copyright © 2011 Wiley Periodicals, Inc.)
- Subjects :
- Adult
Antineoplastic Agents adverse effects
Cohort Studies
Female
Humans
Male
Neuropsychological Tests
Quality of Life
Radiotherapy adverse effects
Siblings
Surveys and Questionnaires
Survivors psychology
Health Status
Independent Living statistics & numerical data
Neoplasms psychology
Neoplasms therapy
Survivors statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1545-5017
- Volume :
- 57
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Pediatric blood & cancer
- Publication Type :
- Academic Journal
- Accession number :
- 21294244
- Full Text :
- https://doi.org/10.1002/pbc.22982