RESUMEN
BACKGROUND: Although pediatric brain tumor survivors are at high risk for a variety of psychosocial and neurocognitive late effects, there are few evidence-based interventions to address their needs. The purpose of this study was to test the efficacy of an online problem-solving intervention on improving the quality of life and executive dysfunction among adolescent and young adult brain tumor survivors. PROCEDURE: A Survivor's Journey was adapted from a similar intervention for survivors of traumatic brain injuries, and involved self-guided web modules providing training in problem-solving as a tool for coping with everyday challenges, as well as weekly teleconferences with a trained therapist. Survivors (n = 19) between the ages of 13 and 25, and their caregivers, completed standardized measures of their emotional and behavioral functioning, executive functioning, and quality of life before and after the 12- to 16-week intervention. RESULTS: Participation in the intervention led to significant improvements in self-reported overall (Mpre = 62.03, SDpre = 17.67, Mpost = 71.97, SDpost = 16.75; d = 0.58, P = 0.01) and physical quality of life (Mpre = 63.13, SDpre = 21.88, Mpost = 75.00, SDpost = 21.33; d = 0.55, P < 0.01) as well as parent-reported emotional quality of life (Mpre = 65.00, SDpre = 28.72, Mpost = 76.15, SDpost = 23.47; d = 0.43, P = 0.03). Greater improvement was noted in those who were diagnosed before the age of seven and those with average or above average estimated IQs. Current age did not moderate outcomes. CONCLUSIONS: Online problem-solving therapy may be efficacious in improving pediatric brain tumor survivors' quality of life; however, further research with a comparison group is needed. Online interventions such as Survivor's Journey may decrease barriers to evidence-based psychosocial care for brain tumor survivors.
