Self-concept in adult survivors of childhood acute lymphoblastic leukemia: A Cooperative Children's Cancer Group and National Institutes of Health Study
| Autor: | Anna T. Meadows, James L. Mills, Dorie A. Glover, Lonnie K. Zeltzer, Leslie L. Robison, H. Stacy Nicholson, Robin L. Seitzman, Julianne Byrne |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Employment Male Pediatrics medicine.medical_specialty Adolescent Risk Factors Acute lymphocytic leukemia Ethnicity medicine Humans Survivors Sibling Child Childhood Acute Lymphoblastic Leukemia Cancer survivor business.industry Data Collection Siblings Case-control study Cancer Hematology Odds ratio Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Combined Modality Therapy Self Concept humanities Oncology El Niño Case-Control Studies Pediatrics Perinatology and Child Health business Follow-Up Studies |
| Zdroj: | Pediatric Blood & Cancer. 42:230-240 |
| ISSN: | 1545-5017 1545-5009 |
| Popis: | Background Self-concept was compared between adult survivors of childhood acute lymphoblastic leukemia (ALL) and sibling controls. Adult survivor subgroups at greatest risk for negative self-concept were identified. Procedure Survivors (n = 578) aged ≥18 years, treated before age 20 years on Children's Cancer Group (CCG) ALL protocols, and 396 sibling controls completed a telephone interview and the Harter Adult Self-Perception Profile (ASPP). Results Survivors global self-worth scores were significantly lower than sibling controls (mean 3.09 vs. 3.18; P = 0.022). Unemployed survivors reported lower global self-worth scores than employed (mean 2.77 vs. 3.12; P = 0.0001), whereas employment status was not associated with self-worth in controls. Among survivors, predictors of negative self-concept included unemployment (odds ratio (OR) = 2.87; 95% CI: 1.50–5.50), and believing that cancer treatment limited employability (OR = 3.17; 95% CI: 1.79–5.62). Unemployment increased the odds for negative self-concept among survivors who received combinations of central nervous system (CNS) irradiation (CRT) and intrathecal methotrexate (IT-MTX), except high CRT with no or low dose IT-MTX. Employed survivors who perceived that treatment limited their employability showed increased odds of negative self-concept for all treatment groups compared to those who did not. Minority ethnic group membership was a borderline significant predictor of negative self-concept (OR = 1.79; 95% CI: 0.94–3.33). Conclusions Global self-worth was significantly lower in ALL survivors than sibling controls, however, 81% of survivors had positive self-concept. Survivor subgroups most vulnerable to negative self-concept were the unemployed survivors, believing that cancer treatment affected employability, and ethnic minority group members. Targeted intervention may have greater clinical relevance for these subgroups. © 2003 Wiley-Liss, Inc. |
| Databáze: | OpenAIRE |
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