ABSTRACT
OBJECTIVES: To evaluate the quality of life and related demographic factors in long-term survivors of childhood non-Hodgkin's lymphoma (NHL). METHODS: A retrospective analysis was performed on the medical and demographic data of the NHL patients who received treatment in the Sun Yat-sen University Cancer Center and achieved long-term survival at follow-up, with an age of <18 years at initial diagnosis and a present age of ≥18 years. A questionnaire survey was performed using 36-Item Short-Form Health Survey (SF-36) and the symptom subscale of the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30). The health status of long-term survivors of NHL was evaluated by comparing the scores of various dimensions of the SF-36 scale of general adult population in the United States (American norm) and those of the SF-36 scale of general adult population in Hong Kong, China (Hong Kong norm). The correlation between the score of each dimension of the scale and demographic characteristics was evaluated. The symptoms of long-term NHL survivors were evaluated according to the score of QLQ-C30 scale. RESULTS: A total of 23 patients with NHL with complete follow-up data were enrolled. The pathological types included diffuse large B-cell lymphoma in 10 patients, Burkitt lymphoma in 4 patients, T-cell lymphoblastoma in 5 patients, B-cell lymphoblastoma in 3 patients, and natural killer/T cell lymphoma in 1 patient. All patients received the chemotherapy regimen containing anthracyclines and alkylating agents. The median present age was 26.2 years (range: 16.9-55.8 years), and the median age at initial diagnosis was 10.4 years (range: 2.4-17.6 years). Among the 23 patients, 6 were married and had children and 2 had chronic diseases. There was no significant difference between the long-term survivors and the US norm in role physical, general health, role-emotional, and mental health (P>0.05), while the long-term survivors had significantly better scores of the other dimensions than the US norm (P<0.05). Similar results were obtained for the comparison between the long-term survivors and the China Hong Kong norm. Age at initial diagnosis was negatively correlated with the scores of social functioning, role physical, and general health in the SF-36 scale (P<0.05), and the present age of patients was positively correlated with the score of physical functioning and was negatively correlated with the score of general health (P<0.05). The urban and rural distribution of patients was related to the general health status (P<0.05). In addition, the long-term survivors of childhood NHL had relatively low scores of the symptom domain of QLQ-C30, and few moderate or severe symptoms were found. CONCLUSIONS: Long-term survivors of childhood NHL tend to have a good overall health status, with no significant differences compared with the general population. Age at initial diagnosis is the main demographic factor that affects patients' quality of life. Citation.
Subject(s)
Lymphoma, Non-Hodgkin , Lymphoma , Adolescent , Adult , Humans , Lymphoma, Non-Hodgkin/drug therapy , Middle Aged , Quality of Life , Retrospective Studies , Survivors , Young AdultABSTRACT
BACKGROUND: Resilience is commonly used to refer to the capacity to resist negative psychological reactions when encountering aversive circumstances. However, clinicians generally define resilience as a lack of psychological distress or an adoption of positive attitude in response to a potentially traumatic event. Although resilience was initially considered to be a psychological variable, it has gradually become seen as a psychosocial indicator now used in clinical settings in the Western world but is still a relatively new topic in most Eastern countries. In this study, we aimed to extend our understandings of the psychological responses of a group of mainland Chinese parents upon being informed that their children were diagnosed with cancer, using resilience as a major indicator. OBJECTIVE: The aim of this study was to evaluate the level of resilience among mainland Chinese parents in response to knowing that their children were diagnosed with cancer and to examine the relationships between resilience and other psychosocial outcomes. METHODS: A descriptive and a cross-sectional survey design was used and involved a sample of 125 parents who visited a specialist cancer hospital in southeast China between September 2013 and February 2014. RESULTS: The participants reported lower level of resilience as compared with a control population in the Chinese community (P < .01). Resilience was negatively correlated with uncertainty in illness (P < .01) and depression (P < .01) and was positively correlated with social support (P < .01) and all other positive coping strategies subscales (P < .01). Parents from the high- resilience group reported better psychosocial functions than did those from the low-resilience group (P < .01). In addition, 6 influencing factors were identified and entered into the multiple linear regression equation of psychological resilience, which predicts 38.3% (adjusted R) of total variation in psychological resilience. CONCLUSION: A high level of resilience in parents of children diagnosed with cancer is associated with better psychosocial function in response to the traumatic event. IMPLICATIONS FOR CLINICAL PRACTICE: Additional attention should be given to those Mainland Chinese parents who demonstrated a low level of resilience in response to their child's diagnosis. This is particularly important because of the long and stressful process for cancer treatment. Clinicians should also provide targeted interventions to those parents to promote their psychological resilience.
