Teses / dissertações: "Survivors of childhood cancers"

1

Vangile, Kirsten M. "Childhood Cancer Survivors: Patient Characteristics". Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/iph_theses/51.

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Survivors of childhood cancer are a relatively new phenomenon in the medical world. The introduction of treatment protocols in the 1970s started a trend in curing children of cancer that historically had been a death sentence. Under these treatment protocols children were given different treatment regimens based on past research that helped remove cancerous cells from their bodies, but were later found to be the cause of treatment related morbidities years into the future; for most survivors roughly ten to 20 years post treatment. These morbidities, commonly called late-effects, are the prime reason that survivors of childhood cancer need to participate in survivorship care. Survivors of childhood cancer are particularly vulnerable to late-effects because the majority of them receive their treatment at a time when their bodies are still growing and developing. Survivorship care services vary by site, but all maintain the common goals of providing long-term follow up for the survivor and education about the ways in which treatments may affect a survivors’ health as they age. Similar to many other facets of healthcare and medicine, there are many populations who do not participate in survivorship care. The purpose of this research is to identify possible barriers to care, assess the level of impact these barriers have upon the survivor’s potential for participation and provide suggestions as to how these barriers can be mitigated. Additionally, this research highlights areas that need further research and analysis.

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Janson, Christopher M. "Marriage and Divorce in Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study". Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08092007-145913/.

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In this report from the Childhood Cancer Survivor Study (CCSS), we described marriage and divorce rates in survivors of childhood cancer, as compared to a sibling control group and the general U.S. population. We also sought to identify patient and treatment characteristics that were associated with survivor marital status. This study included 8,930 five-year survivors of childhood malignancy and 2,855 sibling controls participating in the CCSS. Data on marital status, sociodemographic factors, and current health status were obtained from questionnaires; detailed disease and treatment histories were available from medical records. Marital status of the U.S. population was obtained from the 2002 Current Population Survey of the U.S. Census. We found that survivors were more likely to have never married than both sibling (odds ratio [OR] = 1.79; 95 % CI = 1.65-1.94; p < 0.0001) and population controls (OR = 2.29; 95 % CI = 2.19-2.38; p < 0.0001), with persistence of trends across age and gender strata. Once married, survivors divorced at rates equivalent to controls. In adjusted analysis, we found that several survivor characteristics predicted never-married status, including treatment involving cranial radiation (OR = 2.41; p < 0.0001), CNS tumor diagnosis (OR = 2.05; p < 0.0001), history of growth hormone deficiency (OR = 2.02; p < 0.0001), and unemployment secondary to disability (OR = 1.78; p = 0.0001). Survivor characteristics predictive of divorce included unemployment (OR = 1.91; p < 0.0001, for unemployed or disabled), lower educational achievement (OR = 1.74; p < 0.0001, for non-college graduates), and psychological distress (OR = 1.60; p < 0.0001). This study confirms prior reports of lower marriage rates in survivors of childhood cancer, providing further evidence that this population struggles with psychosocial adjustment to adult life.

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Thomson, Angela B. "Male fertility in survivors of childhood cancer". Thesis, University of Edinburgh, 2003. http://hdl.handle.net/1842/27532.

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The successful treatment of childhood cancer with chemotherapy and radiotherapy may be associated with testicular damage resulting in impaired spermatogenesis and temporary or permanent infertility in adulthood. In this study testicular function and semen quality was investigated in 33 survivors of childhood cancer. Treatment of childhood cancer was associated with a significant risk of impaired spermatogenesis, with 30.3% of this population being azoospermic and 18.2% being oligozoospermic. Moreover, in those men who do have surviving spermatogenesis after treatment, it is commonly compromised, with reductions being observed in ejaculate volume, sperm concentration, sperm motility and the proportion of morphologically normal sperm. Only 33.3% of this group of 33 male childhood cancer survivors had completely normal semen quality by conventional criteria. However, the sperm produced do not appear to carry a greater burden of damaged DNA compared with the healthy population, suggesting that assisted conception treatment is a safe option for these men. Detection of gonadal damage in the prepubertal male is hampered by lack of a sensitive marker. The role of inhibin B as a marker of early gonadotoxic effects of chemotherapy in prepubertal children treated for cancer was investigated. In prepubertal boys, chemotherapy had little immediate effect on Sertoli cell production of inhibin B during and immediately after treatment stopped, although one boy showed a delayed deleterious effect. Inhibin B changed earlier and appeared to be a more sensitive marker of gonadal damage than FSH or LH. Prospective studies are underway combining inhibin B with FSH, LH and sex hormone measurements, to assess the impact of cancer therapy on gonadal function in children, particularly as they approach and progress through puberty. For prepubertal boys fertility preservation through semen cryopreservation is not an option and consequently, attention is focusing on the development of techniques that might preserve or restore fertility potential in boys being subjected to gonadotoxic cancer therapy. In rats, it has been shown that some germ cells survive cytotoxic therapy and that the resulting azoospermia is a consequence of the inability of those spermatogonia that are present to proliferate and differentiate. Suppression of the hypothalamic-pituitary-gonadal (H-P-G) axis facilitates recovery of spermatogenesis following such cytotoxic treatment. Investigation of whether suppression of the H-PG axis in men rendered azoospermic by treatment for childhood cancer might restore spermatogenesis was undertaken, using both semen analysis and testicular biopsy as end points. In men treated with sterilising radiotherapy and chemotherapy for childhood cancer, effective gonadotrophin suppression with medroxyprogesterone acetate for at least 3 months did not result in restoration of spermatogenesis. The absence of histological evidence of spermatogonial stem cells in testicular biopsies from these men before and after suppression suggests complete ablation of the germinal epithelium and irreversible infertility. Understanding the vulnerability of the prepubertal human testis to cytotoxic damage is compounded by the dearth of data describing normal testicular development in the prepubertal human. Based on immunohistochemical studies in marmosets, a primate that exhibits a similar developmental profile to the human male, it has been shown that significant testicular development occurs during childhood long before the clinical onset of puberty. If we can establish that cell activity does occur in the 'quiescent' testis in boys and is comparable to changes shown in the marmoset, it will validate use of the marmoset as a model for the human in this instance and give encouragement to the possibility of using this primate model to develop a method of protecting spermatogenesis in boys undergoing cancer therapy prior to puberty. Preliminary studies to investigate the development of the prepubertal human testis confirmed testicular cell activity in the foetal and neonatal periods and infancy comparable to that shown in the marmoset. However, to date development during mid childhood and early puberty has proved to be somewhat discordant with the marmoset studies. It is too premature to definitively conclude that marmoset and human testicular development are dissimilar, as a number of explanations have been proffered to explain the discrepancies, including suboptimal tissue fixation and antigen preservation in the human tissues.

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Absolom, Kate L. "Follow-up for survivors of childhood cancer". Thesis, University of Sheffield, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425627.

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Russell, Claire C. "LONGITUDINAL PREDICTORS OF QUALITY OF LIFE IN ADOLESCENT SURVIVORS OF CHILDHOOD CANCER: A REPORT FROM THE CHILDHOOD CANCER SURVIVOR STUDY". VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/3160.

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Objective: The impact of childhood cancer on future quality of life (QoL) in survivors is unclear. Current studies focus on comparing outcomes to healthy peers and identifying related treatment and demographic variables, but a shift in our approach is necessary. This study is guided by the Wilson and Cleary Model (WMC) and seeks to identify longitudinal predictors of QoL in adolescent survivors of cancer that explain variance in QoL beyond the impact of treatment and demographic variables. Methods: The Childhood Cancer Survivor Study (CCSS) is a multi-institutional longitudinal study following a cohort of childhood cancer survivors. This study focuses on the CCSS cohort (N = 305) who completed the baseline survey in 1994 and the Teen survey in 2001. The baseline survey assessed parent-report of child’s psychological and physical symptoms, functional status, and health perceptions. The Teen survey utilized the Child Health and Illness Profile – Adolescent Edition (CHIP-AE), a self-report measure assessing QoL in six domains: achievement, resilience, satisfaction, discomfort, disorders, and risk. The primary hypothesis was that psychological and physical symptoms, functional status impairment, and health perceptions as rated by parents at baseline would predict variance in quality of life as rated by adolescents at follow-up after adjusting for demographic and treatment-related variables. Six separate hierarchical regressions were analyzed for each of the QoL domains. Results: The main hypothesis was supported. For each QoL outcome, a significant amount of variance was predicted: achievement, F (6, 259) = 8.90, p < .001, adjusted R2 = .152, resilience, F (12, 209) = 3.47, p < .001, adjusted R2 = .118, satisfaction, F (6, 265) = 8.73, p < .001, adjusted R2 = .146, discomfort, F (7, 273) = 6.75, p < .001, adjusted R2 = .126, disorders, F (9, 212) = 6.47, p < .0001, adjusted R2 = .182, and risk, F (7, 238) = 4.81, p < .001, adjusted R2 = .098. Furthermore, for all outcomes, psychological and physical symptoms, functional status impairment, and health perceptions predicted variance above and beyond the impact of demographic and treatment variables. These factors accounted for an additional 9.5% of the variance in the achievement domain, 6.2% for resilience, 10.8% for satisfaction, 6.5% for discomfort, 12.4% for disorders, and 6.1% for risk. Conclusions: Results suggest that psychological and physical symptoms, functional status and health perceptions should be assessed and targeted in interventions for childhood cancer survivors to promote future positive QoL. Future studies need to continue identifying factors related to positive long-term functioning in diverse samples of childhood cancer survivors.

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6

McMillan, Amy. "Educational late effects among survivors of childhood cancer". Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/31601.

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Increased survival rates of childhood cancer have meant a growing population of survivors within the education system. Although research suggests that survivors face educational difficulties, methodological shortcomings and lack of consensus have contributed to difficulties interpreting this literature. Moreover, there exists a paucity of literature objectively measuring survivors' educational outcomes, particularly achievement. In this population-based research, 782 survivors of childhood cancer from the BC cancer registry, and BC school system from 1995-2004, were age and gender-matched with a randomly selected control group of 8386 BC schoolchildren. Objective educational measures including Foundation Skills Assessments (FSAs), Provincial examinations, and special education designations from the BC Ministry of Education were compared between the survivor and control cohorts; potential disease-related risks among survivors were assessed. Survivors were significantly more likely than controls to have special education or physical disability designations and performed significantly more poorly on several FSAs. Notably, once survivors of central nervous system (CNS) tumours and leukemia were excluded from the analysis, there were no significant achievement differences. Survivors younger at diagnosis (<2 years) had higher educational achievement, despite having more hearing and visual impairments than survivors older at diagnosis ([Greater Than or Equal to] 5 years). Childhood cancer survivors appear at increased risk for special education utilization. In particular, survivors of leukemia and CNS tumours may be at increased risk for poor educational achievement and special education designations. It is important that potential adverse educational outcomes and associated risk factors be identified such that surveillance and appropriate interventions be provided to ensure survivors a successful educational experience.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate

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7

Behera, Malabika. "Long term endocrine sequelae of childhood cancer survivors". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206611.

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Background: Newer multimodality therapeutic interventions have resulted in dramatic survival rates in childhood cancers. However diverse treatment related morbidities affect the long term survivors. An Endocrine complication comprises 20-40% of these morbidities and affects the hypothalamic pituitary axis, growth, pubertal progression, fertility, bone health and glucose homeostasis. Objectives: The aim of our study was to enumerate and evaluate the frequency of endocrine complications arising as a late effect of treatment in childhood cancer survivors. Risk factors likely to be associated with these complications were also evaluated. Methodology: Retrospective analysis of medical records from the Long Term Endocrine Follow up clinic in the Department of Paediatrics and Adolescent Medicine of Queen Mary Hospital was done. Patients with a primary diagnosis of Cancer and Langerhans cell histiocytosis with endocrine sequelae arising from various treatment modalities who have survived 5 years after diagnosis were included in the study. Those who had endocrine complications arising from various treatment modalities for Thalassemia’s, Immunodeficiency’s were excluded from the study Results: 135 cases were included in the study and 27 were excluded. Leukemia and Brain tumor survivors were the majority accounting for 40% and 26.67% respectively. ALL formed majority of leukemia survivors, Medulloblastoma survivors accounted for 50% of brain tumor survivors. Most common endocrine problem was Hypogonadism in 51.1% of cases, followed by growth disturbances in 40%, Thyroid dysfunction in 23% and Hyperlipidemias in 18.5%. Pubertal problems, Central Diabetes Insipidus, Adrenal insufficiency, Obesity, Altered glucose homeostasis were rest of the problems in small frequencies. PHGN (Primary Hypogonadism) was present in 91.3% and mostly in prepubertal males. PHGN was statistically associated with Leukemia survivors with OR-2.06 (1.02- 4.15), p value 0.04. The risk factors associated were exposure to alkylating agents, radiotherapy, TBI prior to transplant. SHGN (Secondary HGN) was statistically associated with Brain tumor survivor OR - 15.8 (1.7-140.5), p value 0.013. Cranial irradiation was the major risk for SHGN. PGV (Poor growth velocity) was the major growth problem.GHD (Growth Hormone Deficiency) had a highly significant association with Brain tumors (p value ˂ 0.0001), and significantly associated when all 3 modalities of treatment given together (p value 0.01). Risk factors for GHD were cranial radiotherapy, exposure to cyclophosphamide and TBI. PH (Primary Hypothyroidism) had highly significant association with craniospinal radiotherapy (p value ˂ 0.0001), and significantly associated with brain tumors. Similar results were observed in patients of CH (Central Hypothyroidism). Hyperlipidemias were present in 18% with no statistical correlation with the type of cancer. Brain tumor survivors had a significant association of GHD, PH, CH, SHGN and CDI. Leukemia survivors had significant association with GHD and PHGN. Conclusions: Endocrine problems are frequent manifestations of late effects of cancer related treatments. Early detection and intervention of these potentially treatable problems could be done through structured long term surveillance. Increasing awareness among health care professionals to anticipate problems in suspected patients and education of patients would optimize health care and quality of life.
published_or_final_version
Paediatrics and Adolescent Medicine
Master
Master of Medical Sciences

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Reulen, Raoul. "Adverse health outcomes in survivors of childhood cancer". Thesis, University of Birmingham, 2009. http://etheses.bham.ac.uk//id/eprint/265/.

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This thesis concerns investigations into adverse health outcomes among survivors of childhood cancer using the British Childhood Cancer Survivor Study (BCCSS). The BCCSS is a large-scale population-based cohort of 17,981 survivors of childhood cancer who were diagnosed with childhood cancer (age 0-14 years) between 1940 and 1991, in Britain, and had survived for at least five years. The specific aims were to investigate, within the BCCSS cohort; (1) the psychometric properties of the SF-36 health-status questionnaire, (2) the self-reported health-status by using the SF-36, (3) the effect of therapeutic radiation on the offspring sex ratio, (4) the risks of adverse pregnancy outcomes, and (5) the risks of second primary breast cancer. This thesis demonstrates that the SF-36 questionnaire exhibits good validity and reliability when used in long-term survivors of childhood cancer. Survivors rate their physical and mental health similarly to those in the general population, apart from bone and central nervous system tumour survivors who rate their physical health below population norms. Therapeutic irradiation does not alter the sex ratio of offspring. Female survivors exposed to abdominal irradiation are at a three-fold risk of delivering premature and two-fold risk of producing low birth-weight offspring. Lastly, the risk of breast cancer among female survivors is two-fold that of the general population, but is not sustained into ages at which the risk of breast cancer in the general population becomes substantial.

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WIERMAA, JACQUELYN DAWN. "HEALTH BEHAVIORS IN ADULT SURVIVORS OF CHILDHOOD CANCER". University of Cincinnati / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1021032822.

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10

Kamonchaiwanich, Jinda. "Dental late effects in survivors of childhood cancer". Thesis, Faculty of Dentistry, 1994. http://hdl.handle.net/2123/4580.

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11

Prouty, Diana Frances Ward-Smith Peggy. "The lived experience of adult survivors of childhood cancer". Diss., UMK access, 2005.

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Thesis (Ph. D.)--School of Nursing. University of Missouri--Kansas City, 2005.
"A dissertation in nursing." Advisor: Peggy Ward-Smith. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed June 26, 2006. Includes bibliographical references (leaves 142-147). Online version of the print edition.

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Larcombe, Isobel. "Lifestyle behaviours of young adult survivors of childhood cancer". Thesis, University of Bristol, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364928.

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13

Charrier, Thibaud. "Study of the occurrence of multiple iatrogenic events in long-term survivors of childhood cancer". Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASR030.

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Le taux de survie à 5 ans des cancers de l'enfant atteint aujourd'hui 80 %. Les survivants à 5 ans de cancer pédiatrique (CCS) ont cependant un risque accru d'occurrence de nombreux évènements. Beaucoup d'études ont été réalisé pour comprendre les liens entre ces évènements iatrogènes et les traitements pédiatriques, et un taux élevé d'évènements iatrogènes multiples a été observé. Cependant, ce taux d'évènements iatrogènes multiples est méconnu. Ce projet de thèse avait pour objectif d'étudier les causes et conséquences de ce taux élevé.La recherche présentée dans cette thèse est basée sur les données de la French Childhood Cancer Survivors Study, une cohorte rétrospective à suivi prospectif de 7670 CCS diagnostiqués avant l'âge de 21 ans entre 1945 et 2000 en France. La cohorte contient des données détaillées sur les traitements des cancers pédiatriques, et un important travail de validation des évènements iatrogènes a été réalisé.Nous avons utilisé la méthode de landmark combiné avec des pseudo-observations, afin de pouvoir étudier les effets des seconds cancers sur l'incidence cumulée d'évènement cardiaque et les années de vie perdues des patients.Nous avons constanté une augmentation de risque instantanné (csHR: 2.1, 95% CI: 1,5-2,9) et de l'incidence cumulée d'évènement cardiaque (CD) (+3,8%, 95% CI: 0,5-7,1) après un second cancer. Nous avons aussi constaté un impact de la radiothérapie, des seconds cancers, et des CD sur l'espérance de vie des patients, avec respectivement 6, 10,5 et 7,7 années de vie perdues à 16 ans. Nous avons trouvé un effet nul de l'interaction entre second cancer et CD, mais notre analyse de simulation a montré que ce résultat est biaisé par la corrélation entre seconds cancers et CD.En conclusion, dans cette thèse nous avons démontré que le risque accru de multi-morbidité chez les CCS est partiellement attribuable à l'occurrence d'un premier évènements iatrogène. Nous avons aussi montré un fort impact des seconds cancers et évènements cardiaques sur l'espérance de vie des patients. Ces résultats nous ammènent à recommander une forte surveillance des patients dévelopant l'une de ces maladies, et de poursuivre la recherche sur la multi-morbidité chez les CCS qui apapraît complexe et forte de conséquences pour les patients
5-years survival of childhood cancer exceeds 80% today. Nonetheless, 5-year childhood cancer survivors (CCS) are at increased risk of health-related late effects. Many studies have been conducted to investigate the link between those late effects and childhood cancer treatments. Furthermore, an elevated number of patients experiencing multiple iatrogenic event was observed. However, little is known about the causes of this multi-morbidity. This thesis aimed to study the causes et consequences of this elevated multi-morbidity.Research presented in this thesis is based on the French Childhood Cancer Survivors Study, a retrospective cohort with prospective follow-up, following 7,670 CCS diagnosed in France before 21 years old between 1945 and 2000. This cohort contains detailed data regarding childhood cancer treatments, and the iatrogenic event observed were validated by trained professionals.We used the landmark method combined with pseudo-observations to study the consequences of subsequent malignant neoplasm on the cumulative incidence of cardiac disease, and the life years lost by CCS.We found a subsequent malignant neoplasm (SMN) to cause a two-fold increase in the cause-specific hazard of cardiac disease (CD) and a 3.8% increase of its cumulative incidence. We found the use of radiotherapy to treat childhood cancer, the occurrence of SMN, and of CD to impact the life expectancy of CCS, with respectively 6, 10.5, and 7.7 life years lost at 16 years old. We found a nul effect of the interaction of SMN and CD on the life expectancy, although our simulation study suggested this was biased by the correlation between SMN and CD.In conclusion, we demonstrated that the increased risk of multi-morbidity among CCS is partially attributable to the occurrence of a first iatrogenic event. We also showed that subsequent malignant neoplasm and cardiac disease have a strong impact on the life expectancy of CCS. Therefore, we recommend to keep following in details the CCS developing either disease, and to pursue further research on the multi-morbidity among CCS which appears to be complex and consequentful for patients

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Leary, Alison. "Emotion regulation in childhood cancer survivors : the coping after cancer study /". Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/9159.

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Martinez, Mariel, e Mariel Martinez. "Assessing Nurse Practitioner Preparedness When Caring for Childhood Cancer Survivors". Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/622904.

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Background: The rate of childhood cancer survivors has grown to nearly 80% in the past few decades. Current evidence reveals that primary care providers report feeling unprepared with inadequate knowledge about the variable types of late effects and diagnostic screenings recommended for childhood cancer survivors (Dulko et al., 2013; Potosky et al., 2011). However, the current evidence reflects data mainly from physicians. None of the current literature addresses the specific preparedness of primary care nurse practitioners. Such data would be helpful in better understanding how education and current resources affect nurse practitioner preparedness for such a narrow, but growingly prevalent, patient population.Purpose: To assess primary care nurse practitioner preparedness when caring for childhood cancer survivors.Methods: This descriptive study obtained data using a survey disseminated to primary care nurse practitioner members of the Puget Sound Nurse Practitioner Association in Seattle, WA. Analysis was conducted by calculating the means and modes for each survey item. Results: This sample (n=5) revealed that 50% of nurse practitioners identify as feeling adequately trained to care for childhood cancer survivors. Time and insurance coverage were not found to be barriers to care. Less than 50% of nurse practitioners utilized guidelines from the Children’s Oncology Group. The most wanted resources included the Children’s Oncology Group guidelines, survivor care plans, and electronic health record prompts. Discussion: According to the results of this study imply that nurse practitioners in the Seattle area feel adequately prepared to care for childhood cancer survivors. In addition, nurse practitioners identify that clinical practice guidelines may be beneficial in guiding their care. However, certain limitations, including small sample size, may affect the trustworthiness of the results. Thus, more research is warranted to gather more comprehensive knowledge and understanding regarding nurse practitioner preparedness when caring for childhood cancer survivors in the primary care setting.

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Lopez, Alana Delores. "Transition Experiences of Adolescent Survivors of Childhood Cancer: A Qualitative Investigation". Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3213.

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Adolescent survivors of childhood cancer are a growing population with unique needs as they face a combination of challenges associated with normal development and returning to life after treatment completion (Wakefield et al., 2010). One specific need identified in the research literature includes the effective delivery of transitional care and planning (Hewitt, Greenfield, & Stovall, 2005). It has been suggested that the provision of transition care and planning can help facilitate the shift from one phase of care to another and promote positive transition experiences (National Cancer Institute, 2008). The shift from off-treatment to post-treatment and school reintegration have been identified in the literature as significant transitions for adolescent survivors of childhood cancer (Cabat & Shafer, 2002; MacLean, Foley, Ruccione, & Sklar, 1996). However, limited research has been conducted to explore these transitions from the perspectives of adolescent survivors of childhood cancer. An exploratory, qualitative study was conducted with eight adolescent survivors of childhood cancer between the ages of 14 and 17. A multiple case study research design was used to explore adolescent cancer survivors' perceptions of these transition processes, challenges associated with these transitions, and their beliefs about what supports/services were or would be beneficial during these transitions. Data collected for analysis included questionnaires, transcribed interviews and follow-up meetings, direct observation, documents, and parent feedback. These data were analyzed using a combination of a template organizing style, immersion/crystallization (I/C) approach, and multiple case study strategies (Borkan, 1999; Crabtree & Miller, 1999, Stake, 2005; Yin, 2008). Results indicated that adolescents perceived that change was occurring on some level during the shift from off-treatment to post-treatment and school reintegration but did not necessarily define this time as a "transition." They defined these times in personalized terms that reflected more subtle changes in their lives. The focus was placed on returning to a sense of "normalcy" and capitalizing on opportunities to regain some control over one's life. The improvement and/or absence of treatment residuals along with re-engagement in activities and roles served as signs, or indicators, that life was returning back to "normal" and provided feedback to the adolescent on their transition progress. Conversely, the presence of these signs continued to impact their lives as they restricted participation in desired activities and served as reminders that the effects of cancer and treatment extended beyond treatment completion. In addition to the presence of treatment residuals, fear of relapse also was a concern associated with the transition from off to post-treatment. However, adolescents tended not to let this be the focus of their lives. School reintegration challenges included disruption of school life and routines as well as academic and social concerns. Academic challenges included falling behind/catching up with work, maintaining motivation to do work, and readjusting to school demands and routines. Social challenges included answering peer questions, adjusting to peer awkwardness/discomfort, and managing peer reactions to their physical side effects. These challenges were not perceived by adolescents as sources of significant distress and, often times, they adapted and employed coping strategies to address these concerns in the school setting. Adolescents also varied in their perceived need for transitional care and support during these transitions. Support received during the shift from off-treatment to post-treatment included advice from health care team members as well as relationships with peer cancer survivors across school, community, hospital, and camp settings. They received a variety of academic and social support during school reintegration. Teachers, family members, and peers provided academic support across home, hospital, and school settings. Teachers were a particularly important source of academic assistance. Accommodations and modifications also were provided to these adolescents at school. Peers, teachers, and other school staff provided social support. Based on the findings of the study, suggestions for future research and practical implications are offered.

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Guha, Joyeeta. "Risks of adverse health and social outcomes among childhood cancer survivors". Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6612/.

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As a result of improvement in survival after childhood cancer, there are now increasing numbers of long-term survivors of childhood cancer living in the United Kingdom and across Europe. Specific groups of these childhood cancer survivors experience substantial excess risks of adverse health and social outcomes. Using the population-based British Childhood Cancer Survivor Study (BCCSS) the following areas were investigated: (I) The proportion of survivors on regular long-term hospital follow-up using risk stratification levels of care developed by the BCCSS in partnership with the National Cancer Survivorship Initiative. (2) The risks of adverse health and social outcomes using record-linkage and a self-reported questionnaire to assess which survivors of central nervous system tumours were at excess risk compared to the general population. (3) The risk of hospitalisation due to cerebrovascular conditions among childhood cancer survivors by electronic record linkage with Hospital Episode Statistics. Using the European PanCareSurFup cohort, the excess risks of genitourinary subsequent primary neoplasms were investigated among five-year survivors of childhood cancer. This thesis quantifies the risks experienced by childhood cancer survivors in four areas and provides an evidence-base for risk stratification by healthcare professionals caring for survivors.

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Parkinson, Caprice S. "Camp for Childhood Cancer Survivors and Their Families: A Program Conceptualization". Wright State University Professional Psychology Program / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=wsupsych1342017721.

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19

Curwen, Gillian B. "G₂ chromosomal radiosensitivity in childhood and adolescent cancer survivors and their offspring". Thesis, St Andrews, 2008. http://hdl.handle.net/10023/425.

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20

Hawkins, Michael Magnus. "Effects of childhood cancer and its treatment upon survivors and their offspring". Thesis, University of Oxford, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305992.

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Wilson, Carmen Louise Children's Cancer Institute Australia for Medical Research UNSW. "The late effects of therapy in an Australian cohort of childhood cancer survivors". Awarded By:University of New South Wales. Children's Cancer Institute Australia for Medical Research, 2008. http://handle.unsw.edu.au/1959.4/43794.

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In Australia, up to 80% of individuals diagnosed with childhood cancer are now expected to survive for more than five years after their initial diagnosis. However, survivors of childhood cancer are at risk of developing late sequelae as a consequence of therapies received during childhood. The aim of this study was to determine the incidence of selected late sequelae in a cohort of Australian childhood cancer survivors and identify treatment and genetic factors that may modify the risk of late sequelae in survivors. Our study included 1150 individuals treated for childhood cancer at the Sydney Children??s Hospital between 1962 and 1999, who had remained in remission >3 years and were confirmed to be alive. Rates of mortality and second cancers among survivors were compared against population rates to determine standardised mortality and incidence ratios. Survivors completed a questionnaire on the incidence of adverse health conditions and provided a buccal specimen. Real time PCR was used to detect polymorphisms in genes involved in drug detoxification and transport. Rates of mortality and secondary cancers were found to be 7.5-fold (95%CI 5.4-10.1) and 4.9-fold (95%CI 2.9-8.0) higher among survivors of childhood cancer relative to the general population, respectively, with the highest risks observed for those survivors previously treated for Hodgkin??s disease. Over 60% of survivors reported at least one cardiopulmonary, endocrine or sensory-motor condition following diagnosis of childhood cancer; the most frequently observed conditions included growth hormone deficiency, hypothyroidism, and hypertension. Late sequelae were most frequently reported by females and survivors of brain tumours. Genetic investigations showed that an increased risk of growth hormone deficiency was associated with homozygosity for the GSTM1 null polymorphism, while no gene associations were observed to influence the risk of second cancers among survivors. Our study demonstrates that survivors of childhood cancer are at risk of developing a variety of health conditions as a result of anti-cancer therapies received during childhood. Determining risk factors for late sequelae based on therapy type, lifestyle and genetic predisposition will enable the optimisation of treatment protocols and promote the future well-being of childhood cancer survivors.

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Hauser, Jennifer E. M. S. "Genetic Epidemiology of Radiation Sensitivity and Basal Cell Carcinoma in Childhood Cancer Survivors". University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1447689192.

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Schulga, John. "Salivary steroid profiles in the assessment of adrenocortical function in childhood cancer survivors". Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/25165.

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Endocrine deficits can occur as a result of target organ damage to the thyroid, gonad or adrenal gland by both radiotherapy and chemotherapy, as well as damage to the hypothalamo-pituitary (HP) axis. While most endocrine deficit can be pre-empted by regular surveillance, the detection of secondary adrenocortical insufficiency (SAI) poses a particular problem. The symptoms of SAI (tiredness, lethargy, etc.) are non-specific, and are very similar to those experienced from anti-cancer therapy. Moreover, existing tests of adrenal function are difficult to interpret, and may not be diagnostic in children with mild to moderate degrees of SAI. It is in the child’s interest for SAI to be promptly diagnosed and steroid replacement instigated. Correct diagnosis is essential as steroid therapy can have an adverse effect on growth and may cause weight gain. This study attempts to address the challenge of diagnosing SAI in long-term survivors of childhood cancer. Sensitive assays of steroids in saliva (cortisol, 17-hydroxyprogesterone, and adrostenedione) have been developed using radioimmunoassays with microencapsulated antibody. A reference range of these steroids in saliva has been derived from a control population of 147 schoolchildren (77 girls, 70 boys), aged 5 to 15 years, enabling salivary steroid profiles to be used in the assessment and monitoring of adrenocortical function in survivors of childhood cancer. These results have been compared with standard tests of adrenocortical function. The study group included 43 patients of whom 36 patients (15 girls, 21 boys) provided salivary profiles. Their average age was 12.9 years (range 7.0 to 19.8 years). These patients had received either radiotherapy for brain tumours, total body irradiation as part of conditioning treatment for bone marrow transplantation, or were patients with leukaemia who had relapsed and had received cranial irradiation in addition to the standard radiotherapy for prophylactic treatment. This thesis has shown that the use of salivary steroid profiles can be useful in both the diagnosis and in screening of SAI. We have also shown that SAI is not as prevalent as has been reported in previous studies.

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Brown, Morven C. "Investigating the psychosocial outcomes of young adult survivors of childhood and adolescent cancer". Thesis, Queen Margaret University, 2016. https://eresearch.qmu.ac.uk/handle/20.500.12289/7733.

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While several studies report survivors of childhood and adolescent cancer to have affected outcomes in areas such as health-related quality of life, psychological health, education, employment and relationships, other studies report positive findings. Inconsistencies in the measures and methods used across studies hinder our ability to draw conclusions from the research and there is also a lack of measures which are designed specifically to capture the concerns of these survivors. In addition, survivors’ subjective perceptions have been identified as potentially crucial risk factors for poorer psychosocial outcomes, but receive less attention than traditional risk factors involving disease and demographics. The research for this thesis employed a mixed methods design, in the form of an exploratory sequential design, with the purpose of providing a comprehensive investigation of the psychosocial outcomes of young adult survivors of childhood and adolescent cancer. The first study aimed to qualitatively explore survivors’ own perceptions of the impact of cancer and the influence it has had on their lives. The second study aimed to quantitatively investigate the outcomes and concepts identified in the qualitative study, and in a review of the literature, in a larger sample of survivors. In both studies, the survivors own views, experiences and concerns were of central importance. Overall, survivors reported high levels of achievement and functioning. However, it was evident that a minority of survivors may benefit from further support and information with regards to fertility, education, employment, concerns about the impact of cancer and future health. Results of the questionnaire study indicate that survivors’ views, as assessed by the Impact of Cancer for Childhood Cancer Survivors scale, may be associated with health-related quality of life and distress outcomes. Results suggest that overall the mixed methods study enabled a comprehensive investigation of psychosocial outcomes. The research indicates that health professionals should monitor the psychosocial health of even long-term survivors of childhood and adolescent cancer.

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Miller, Tamara Porter. "Psychosocial functioning in childhood cancer survivors, measured by parent, teacher & child surveys". [New Haven, Conn. : s.n.], 2008. http://ymtdl.med.yale.edu/theses/available/etd-12092008-144355/.

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Merriman, Bridgette. "The Impact of Childhood Cancer on Young Adult Survivors: A Life Course Perspective". Thesis, Boston College, 2020. http://hdl.handle.net/2345/bc-ir:108790.

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Thesis advisor: Wen Fan
This thesis investigated the impact that cancer has on young adult survivors of childhood malignancies. Existing studies explore varying physical, psychosocial, and psychological, late effects experienced by survivors of childhood cancer. However, there exists a gap in survivorship literature; young adults, and young adult survivors of childhood cancer in particular, are understudied compared to adult and pediatric survivors. Moreover, most studies address objective, clinical, aspects of cancer survivorship. They rarely focus on survivors’ subjective experiences. Yet, previous research suggests that positive cognitive appraisals of adverse life events such as cancer mitigate detrimental psychosocial and psychological symptomologies later in life. This study adopted the life course perspective to investigate the subjective experiences of young adult survivors of childhood cancer. It examined how events such as cancer diagnoses and transitions back to school are interconnected throughout one’s entire life history, rather than analyzing these specific occurrences as isolated events. Participants were invited to fill out two existing quality of life surveys and take part in an interview to explore areas of survivorship previously identified as being specific to young adult survivors. An analysis of interview transcripts and survey data revealed three major events that occur after being diagnosed with a pediatric malignancy. Furthermore, each participant not only recalled positive subjective experiences over the course of these checkpoints, but ultimately found positive meaning from their cancer experience. This thesis suggests that positive subjective experiences soon after a cancer diagnosis are critical in ensuring that patients have favorable conceptions of their journeys and their aftermath
Thesis (BA) — Boston College, 2020
Submitted to: Boston College. College of Arts and Sciences
Discipline: Departmental Honors
Discipline: Sociology

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Gallagher, Sandra Marie 1964. "Intimacy, marital adjustment, and well-being in long-term survivors of childhood cancer". Diss., The University of Arizona, 1999. http://hdl.handle.net/10150/284891.

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The present study examined well-being and the contribution of intimacy and marital satisfaction to well-being in long-term survivors of childhood cancer (LTSCC). In addition, self-esteem, warmth and gregariousness were included to test for mediating effects. 207 adult LTSCC were assessed using the Rand Well-Being measure, Miller's Social Intimacy Scale, the Dyadic Adjustment Survey, Rosenberg Self-Esteem Scale, the NEO-PI Warmth and Gregariousness subscales, and the Marlowe-Crowne Social Desirability Scale (M-C) each of these is a well established and well validated self-report measure. Survivors scores on each of these measures were contrasted with those of a control group of adults who did not have a cancer history (N = 169). Each of the variables, as well as several sociodemographic and medical variables, were utilized in regression and path analyses to determine their ability to predict well-being. LTSCC reported significantly less overall well-being (F = 78.9, p < .000), significantly more anxiety (F = 194.2, p < .000) and depression (F = 1262.3, p < .000), and significantly less positive well-being (F = 18.6, p < .000), health (F = 137.0, p < .000), and self-control (F = 88.3, p < .000) than controls. Survivors reported significantly more intimacy (F = 5.1, p < .01), marital adjustment (F = 5.3, p < .01), self-esteem (F = 216.8, p < .001), warmth (F = 65.2, p < .001) and gregariousness (F = 113.3, p < .001) than controls. LTSCC also had higher scores on the M-C (F = 26.7, p < .001). An omnibus stepwise multiple regression analysis accounting for 27% of the variance, revealed that self-esteem and the interaction of warmth and intimacy were the best predictors of well-being. Group membership was a nonsignificant predictor of well-being. Finally, path analysis was employed and different models "fit" the LTSCC and the controls. The best path model (NET = .94) for the LTSCC indicates that well-being predicts intimacy. The best path model (NET = .98) for the controls, on the other hand, indicates that intimacy predicts well-being. These results are discussed in terms of developmental and social support theories. Interpretations of these results, strengths and weaknesses of the study, and implications for theory, application, and future research are discussed.

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Hedden, Lindsay Kathleen. "Health services utilization and provider continuity of care among survivors of childhood cancer : a cohort analysis". Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/2490.

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Purpose: A majority of childhood and adolescent cancer survivors face life-long cancer- and treatment-related sequelae. Long-term follow-up is necessary to facilitate timely diagnosis and management of these health conditions. As part of strategic long-term follow-up, provider continuity of care (PCOC) may improve outcomes through appropriate use of surveillance, screening, and coordination of services. The purpose of this thesis was to assess physician services utilization and PCOC among survivors of childhood cancer compared with general population subjects, and to examine factors associated with survivors' use of physician services and PCOC scores. Methods: Physician services utilization and PCOC were assessed in a population-based cohort of 1322 five-year cancer survivors diagnosed between 1981 and 1995 under age 20 in British Columbia, and a group of 13,220 age- and gender-frequency matched, randomly selected population-based subjects, whose records were linked to individual-level administrative healthcare datasets. Effects of clinical and sociodemographic modifiers on utilization and PCOC were examined using generalized linear modeling. Changes in utilization and PCOC by age were estimated using a longitudinal, repeated measures modeling approach. Results: Survivors incurred an average of 8.94 medical visits per year: 4.82 to primary care physicians, 2.69 to specialists, and 1.43 to non-physician providers. Survivors had more visits than comparators in all visit categories (p<0.0001 for all). As they age, survivors' use of primary care services increases significantly, while their use of specialist services declines, trends that are not mirrored by the comparison population. The average PCOC score for survivors was 0.54 ± 0.22, indicating survivors saw the same primary care provider for only 50% of their primary care visits. Mean score did not differ between survivors and comparators; however, in the population sample scores improved with age (p=0.02), while among survivors, scores worsened (p=0.05). Conclusions: The dramatic age-related increase in primary care visits observed in the survivor group suggests that primary care physicians play a key role in ensuring quality long-term follow-up care. Survivors are at heightened risk for poor PCOC as they age and transition into adult-oriented community care, raising concerns about whether they are receiving the appropriate follow-up care encompassing screening, surveillance and psychosocial support.

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Khng, Nee-wey Joan, e 康雅惠. "Perceived parental support in the resilience of childhood cancer survivors in Singapore: an exploratorystudy". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B41897079.

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Khng, Nee-wey Joan. "Perceived parental support in the resilience of childhood cancer survivors in Singapore an exploratory study /". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B41897079.

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Bright, Chloe Jayne. "Adverse health outcomes among long-term survivors of childhood, teenage and young adult cancer". Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7455/.

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Survivors of childhood, teenage and young adult cancer are at increased risk of developing adverse health outcomes. This thesis aims to address the gaps in knowledge regarding the most severe adverse health outcomes. The Teenage and Young Adult Cancer Survivor Study (TYACSS) provides 200,945 survivors of cancer diagnosed aged 15-39 years. The PanCare Childhood and Adolescent Cancer Survivor Care and Follow-Up Studies (PanCareSurFup) provides 69,460 survivors of cancer diagnosed aged < 20 years. Within the TYACSS cohort 1) cancer survivors had increased risk of developing subsequent primary neoplasms, particularly in previously irradiated sites; 2) cancer survivors who likely received cranial irradiation had increased risk of a cerebrovascular event; and 3) central nervous system tumour survivors experienced premature mortality due to neoplastic and nonneoplastic causes. Within the PanCareSurFup cohort 1) the excess number of subsequent softtissue sarcoma was low, except leiomyosarcoma after retinoblastoma; and 2) the excess number of subsequent breast cancers remained elevated beyond 40 years of age among survivors of Hodgkin lymphoma, Wilms tumour and sarcoma. This thesis focuses on the most severe adverse health outcomes among childhood, teenage and young adult cancer survivors and provides evidence for developing clinical follow-up guidelines aimed at reducing such adverse health outcomes.

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Harila, M. (Marika). "Health-related quality of life in survivors of childhood acute lymphoblastic leukaemia". Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514294631.

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Abstract Leukemia treatment has been implicated to be responsible for a diversity of long-term adverse effects (Pui 2008), which can occur even years after diagnosis and can seriously impair survivors’ performance status and quality of life (Campbell et al. 2007, Zeltzer et al. 2008). The aim of the present work was to assess health-related quality of life in long-term survivors of acute lymphoblastic leukemia (ALL), and to find out whether vocational rehabilitation can promote the coping at work of young people who take part in a training intervention or help them find employment. Neuropsychological testing was performed on 64 survivors. Cranial irradiation had been administered to 44 of the survivors, while 20 survivors had been treated solely with chemotherapy. A control group consisted of 45 healthy young adults. We found that young adult survivors of childhood ALL treated with cranial irradiation had clear progressive deficits in their neurocognitive functioning at a mean of 20 years after diagnosis compared with healthy controls. Non-irradiated ALL survivors performed significantly better, but even they had statistically significant impairments in some of the neuropsychological test scores compared with the controls. Rand-36-Item health Survey (RAND-36) was used to assess subjective HRQoL, depressive symptoms were assessed with Beck Depression Inventory (BDI-21), and mental distress with General Health Questionnaire (GHQ-12) in 74 survivors of ALL. The control group consisted of 146 healthy young adults selected from local population registry. ALL survivors showed good HRQoL scores in comparison to the control group. Patients who had been treated for an ALL relapse and had received the most intensive chemo- and radiotherapy had significantly higher scores on mental health and vitality than the controls. Survivors of ALL report fewer depressive symptoms and equal mental well-being compared to healthy controls. Nine out of 63 survivors were selected for rehabilitation based on their occupation and psychosocial difficulties. The occupational rehabilitation course improved physical fitness and decreased overweight in long-term survivors of ALL, but impaired their HRQoL. Our findings support the idea that ALL survivors’ subjective experience of well-being is possibly affected by a repressive adaptive style
Tiivistelmä Leukemiahoidoilla on todettu olevan pitkäaikaisvaikutuksia (Pui 2008), jotka voivat ilmetä jopa vuosia diagnoosin jälkeen heikentäen sairaudesta selvinneiden toimintakykyä ja elämänlaatua (Campbell et al. 2007, Zeltzer et al. 2008). Tämän tutkimuksen tavoitteena oli arvioida akuutista lymfaattisesta (ALL) leukemiasta selvinneiden terveyteen liittyvää elämänlaatua pitkällä aikavälillä sekä selvittää, voidaanko ammatillisen kuntoutuksen avulla edistää interventioon osallistuneiden työssä selviytymistä tai työllistymistä. Neuropsykologiseen tutkimukseen osallistui 64 ALL pitkäaikaisselviytyjää. Heistä 44 oli saanut pään alueen sädehoitoa ja 20 pelkästään solunsalpaajahoitoa. Verrokkiryhmässä oli 45 tervettä nuorta aikuista. Havaitsimme, että lapsuudessa pään alueen sädehoitoa saaneilla ALL-selviytyjillä oli verrokkeihin verrattuna selkeitä progressiivisia muutoksia neurokognitiivisessa toimintakyvyssä keskimäärin 20 vuotta diagnoosista. Ne, jotka eivät olleet saaneet sädehoitoa suoriutuivat huomattavasti paremmin, mutta heilläkin havaittiin tilastollisesti merkittäviä puutoksia joillakin neuropsykologisten testien osa-alueilla verrokkeihin verrattuna. 74 entisen ALL-potilaan terveyteen liittyvää elämänlaatua (HRQoL) mitattiin Rand-36 -mittarilla, masennusoireita Beckin masennustestillä (BDI-21) ja henkistä hyvinvointia General Health Questionnaire -mittarilla (GHQ-12). Verrokkiryhmäksi valittiin väestörekisteristä 146 tervettä nuorta aikuista. ALL-ryhmässä tutkittavien terveyteen liittyvää elämänlaatua mittaavat pisteet olivat hyvät verrokkiryhmään verrattuna. Ne potilaat, joita oli hoidettu leukemian uusiutumisen takia ja jotka olivat saaneet intensiivisintä solunsalpaaja- ja sädehoitoa saivat huomattavasti paremmat pisteet psyykkisen hyvinvoinnin ja vitaalisuuden osa-alueilla kuin verrokit. ALL -selviytyjät raportoivat vähemmän masennusoireita, ja he arvioivat psyykkinen hyvinvointinsa yhtä hyväksi kuin verrokit. Yhdeksän ALL pitkäaikaisselviytyjää osallistui heille suunnattuun ammatilliseen kuntoutusinterventioon. Ammatillinen kuntoutuskurssi paransi ALL -selviytyjien fyysistä suorituskykyä ja vähensi ylipainoa, mutta heikensi terveyteen liittyvää elämänlaatua. Tutkimustulokset tukevat ajatusta, että repressiivinen adaptaatio voi vaikuttaa lapsuusiän leukemiasta selvinneiden subjektiiviseen hyvinvoinnin kokemukseen

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Newton, Kelly. "Facing the unknown : exploring the impact of possible infertility on young adult childhood cancer survivors". Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/64155.

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Background: Approximately 83% of children diagnosed with cancer survive into adulthood. Yet, adult survivors of childhood cancer (ACCS) are at high risks for late effects, conditions that develop 5 or more years following cancer treatment. Cancer treatments during childhood can cause infertility, a late effect associated with psychological distress and poor quality of life. However, not all ACCS at risk for infertility have a definitive diagnosis and the experience of facing an unknown fertility status, and specific support needs of survivors remain poorly understood. Purpose: The primary purpose of this research was to describe the challenges young ACCS experience when facing an unknown fertility status. This study also examined the ways in which men and women differed in their perceptions and experiences of unknown fertility. Methods: This interpretive descriptive qualitative study included 10 ACCS, 5 men and 5 women, who participated in semi-structured interviews. Interview data were analyzed using an exploratory approach, allowing for content-driven inductive analysis, which involved open coding and constant comparative techniques to identify themes that captured the main similarities and differences in ACCS experiences. Results: Six central themes emerged. First, living in the unknown is emotionally challenging for ACCS, in that the related fear, sadness and anxiety complicates the lives of the participants. Second, possible infertility influences romantic relationships by impeding emotional connections and contributing to the worry of disappointing one’s partner. Third, determining when to seek fertility testing is difficult, with readiness to have children and complications associated with fertility testing important considerations. Fourth, discussing fertility with health care providers, friends and family is awkward. Fifth, ACCS receive limited fertility-related education across the cancer trajectory because of their young age at time of treatment and health care provider insufficient infertility-related knowledge. Lastly, ACCS perceive that fertility testing and confirmed infertility is detrimental to women but not men, which they attribute to both biological and gender differences. Conclusion: This study provides beginning insights into the experiences of young ACCS as they navigate an unknown fertility status, and highlights existing gaps in fertility-related healthcare services.
Applied Science, Faculty of
Medicine, Faculty of
Nursing, School of
Population and Public Health (SPPH), School of
Graduate

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Khong, Pek-Lan. "Diffusion tensor MR imaging in the evaluation of treatment-induced white matter injury in childhood cancer survivors". Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B38320666.

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Boeving, Charmayne Alexandra. "Coping and Adjustment in Child Cancer Survivors: An Investigation into Spirituality as a Predictor of Psychosocial Outcomes". Diss., Virginia Tech, 2003. http://hdl.handle.net/10919/27558.

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The state of the literature on the psychosocial adjustment of children and adolescents with cancer is primed for novel contributions to the promotion of quality of life and depletion of negative psychosocial outcomes. Many recent studies indicate that this population may be at increased risk for depressed and anxious symptomatology; however, there is a large degree of individual variation. Coping responses have been demonstrated as significant predictors of adjustment outcomes with these patients. Research focusing upon coping with childhood chronic illness is progressing toward levels of greater specificity of construct and application; therefore, it is timely to target specific coping mechanisms in response to specified stressors. Health psychology has examined the role of spirituality as promoting positive health outcomes in adult populations. However, the pediatric literature has not empirically addressed this potential coping mechanism for child populations. The current study sought to: (a) develop a preliminary child measure of spiritual coping, and (b) to employ this assessment tool in an empirical investigation of the relationship between spiritual coping and psychosocial adjustment in the childhood cancer population. This investigation included 55 child participants recruited from three hospital settings across the southeastern, Midwestern, and western United States. During the measure development phase, 22 children were interviewed regarding their use of coping strategies (specifically spirituality) to target illness-related stress. The spiritual coping measure was based upon the response set obtained during this phase, and incorporated items into two subscales: existential and religious coping. The rest of the sample (N=33) participated in an individual interview that assessed coping (approach, avoidant, and spiritual) as well as depression, anxiety, and quality of life. A pilot factor analysis was employed to examine the structure of the new spiritual coping measure. Additionally, hierarchical regression analyses were employed to examine the contributions of each coping variable to the prediction of child adjustment outcomes. The results indicated that depression is significantly predicted by the full coping model; however, the analyses for anxiety and quality of life were not significant. Furthermore, spiritual coping was not demonstrated to add significantly to the prediction of child adjustment in the full coping model. Post-hoc analyses revealed a mediation effect for social functioning upon the relationship of existential coping and depression. Additionally, religious coping was found to mediate the effect of emergency room utilization upon perceived efficacy of avoidant coping. The factor analysis for the measure, while preliminary in nature, reflected a two-factor solution with strong loadings that closely approximated the theoretical delineation of the subscales.
Ph. D.

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Khong, Pek-Lan, e 孔碧蘭. "Diffusion tensor MR imaging in the evaluation of treatment-induced white matter injury in childhood cancer survivors". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B38320666.

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McCann, Lisa. "Transition or transfer? : an experiential perspective on moving from paediatric to adult cancer services". Thesis, University of Dundee, 2012. https://discovery.dundee.ac.uk/en/studentTheses/80ae2c0e-ddce-47ae-a33f-6c680a35364e.

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This thesis explores the experiences of young people who are survivors of childhood cancer, their parents, health care professionals (HCPs), and case note documentation, of the process of transition from paediatric to adult cancer services. A qualitative, collective case study approach (Stake, 1995), informed by a constructivist-interpretive position, allowed exploration of the multiple realities prioritised in this study. Whilst there is a significant body of literature relating to transition for conditions such as rheumatology and cystic fibrosis, there is little research undertaken into transition in a cancer context, specifically so from an experiences perspective. This study aimed to re-address this issue. The experiences of twelve young people were explored in this study. This resulted in the participation of twelve cases, meaning a total of 35 individual, semi-structured interviews were conducted with young people, parents and HCPs. Young people’s case notes (22 sets) were also reviewed. Data were analysed using matrix-based approaches advocated by Miles and Huberman (1994), at both the within- and between-case level. This generated a multi-dimensional and multiple perspective understanding of the experience of the process of transition. The results of this study clearly identified a central orienting theme: The experience of readiness in the context of transition. Three main themes and six sub-themes were also identified within the data, supporting the explanatory power of the orienting theme. The main themes identified were: The experience of childhood cancer; Planning and preparation: Transition or transfer?; and A process of change. The findings demonstrate that understanding the multi-faceted components of readiness is crucial in understanding people’s experiences of readiness. Readiness should embody people’s illness experiences, the numerous and associated losses intertwined with a move from paediatric to adult care and the simultaneous developmental changes occurring in people’s lives. Only by doing so shall a meaningful understanding of the experience of the process of transition for survivors of childhood cancer, their parents and health care professionals be developed. The thesis concludes by making recommendations for future research and clinical practice.

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Trusler, Karen. "Why do a minority of survivors of childhood cancer suffer from health anxiety or health related intrusive thoughts?" Thesis, University of Leeds, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.521535.

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Rocha, Shirley Santos Teles. "Ser adulto sobrevivente de câncer infantil: uma compreensão fenomenológica". Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/59/59137/tde-10032010-190430/.

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O presente estudo tem o objetivo de compreender o que é ser adulto sobrevivente de câncer infantil. O método utilizado foi o fenomenológico-existencial e foi desenvolvido no Ambulatório de Curados do Serviço de Oncologia Pediátrica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo e contou com a colaboração de sete adultos que tiveram câncer na infância. Foi realizada uma entrevista a partir da questão norteadora: Conte-me como está a sua vida. A análise das entrevistas foi construída à luz de algumas idéias de Martin Heidegger em Ser e Tempo (2005). Ser-adulto-sobrevivente-de- câncer-infantil se desvelou como um ser que se lança e que já está lançado e se projetando, resgata o vigor de ter sido, que se atualiza a cada instante. Assim, a vivência do adulto sobrevivente de câncer infantil desvela-se na temporalidade: vigor de ter sido, atualidade e porvir. Dessa forma, ter vivenciado câncer na infância constitui o existir do adulto, ainda que não se queira lembrar, podendo esta vivência ser impulsionadora do existir. Dessa forma, ser-sobrevivente-de-câncer-infantil-no-mundo-com-os-outros é ser projeto, é porvir, é lançar-se, é existir na fluidez da existência, ora na busca de si mesmo, ora buscando ser igual a todo mundo, sendo impessoal, sendo normal, porém a busca pela normalidade dá-se a partir do ser diferente, da busca de si mesmo, pois somos singular e plural ao mesmo tempo. Foi possível perceber que os adultos sobreviventes de câncer infantil necessitam de programas de acompanhamento que atendam às suas demandas e necessidades Porém, esse acompanhamento não deve ficar restrito ao âmbito metafísico, é necessário abertura para estar, co-existir com esse adulto sobrevivente, para que assim possa compreender o seu modo de existir. Assim, o profissional de saúde, em sua atuação, lidará com as diferentes formas de ser no mundo do sobrevivente, além da dimensão biológica do funcionamento do corpo humano. E isso só é possível, quando a equipe de saúde e o paciente constróem relações autênticas. Porém, essa atuação convoca a equipe de saúde a se colocar, a perceber-se co-existente, tendo que cuidar do seu vir a ser, buscando ou se perdendo de si mesma.
The aim of this work is to comprehend what is be an adult survivor of childhood cancer using the method existential-phenomenologic. This work was developed in the Ambulatório de Curados do Serviço de Oncologia Pediátrica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo and it count on the colaboration of seven adults that had childhood cancer. An interview was held from the following guiding question: tell me how your live is. The analysis of the interviews were developed using the ideas of Martin Heidegger in the book Ser e Tempo (2005). Be-adult-survivor-of-childhood-cancer was viewed as a being that throws oneself and that is already thrown and that, projecting oneself, recovers the strength of have been that renews every instant. Thus, the experience of live of the adult survivor of childhood cancer manifests on the temporality: the strength of have been, the present and the future. Then, to have experienced cancer during the childhood is part of the existence of the adult, even if he does not want to remember and this experience can even stimulate his existence. Thus, be-adult-survivor-of-childhood-cancer-in-the-world-with-the-other is be project, is future, is to throw oneself, is to exist in the flow of the existence, once looking for oneself, once trying to be equal to the other, being impersonal, being normal. However, the search of the normality happens from the I am different looking for himself/herself, because we are singular and plural at the same time. It was noted that the adult survivors of childhood cancer need accompaniment programs that attend your necessities. Nevertheless, this accompaniment cannot be restricted to the metaphysic field. It is necessary to be open to be with and to coexist with this adult survivor in order to understand your way of existence. Then, in your actuation, the health professional will deal with the different ways of the be in the world of the survivor, besides the biological dimension of the work of the human body. This is only possible when the health team and the patient build an authentic relation. Although, this actuation requires that the health team to perceive coexistent taking care of your own will be, searching or loosing itself.

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Almeida, Milena Dorea de. "Sobreviventes de câncer infanto-juvenil: contribuições da psicanálise e novos dispositivos clínicos". Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-25042017-091726/.

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Esta tese tem como objetivo geral investigar os significados que os adultos, sobreviventes de tumor de Sistema Nervoso Central (SNC) na infância, atribuem às suas experiências de vida durante o adoecimento e após o término do tratamento oncológico, a fim de oferecer subsídios para a formulação de novos dispositivos clínicos para o atendimento destes casos. Considera-se como adultos sobreviventes de câncer infanto-juvenil os pacientes, de 20 a 59 anos, que tenham concluído o tratamento oncológico há pelo menos cinco anos e estejam sem evidência da doença. A concepção de investigação que embasa esta tese é o modelo de pesquisa qualitativa em psicanálise que permite compreender os fenômenos em profundidade. Consta de uma pesquisa bibliográfica - uma revisão sobre a história da oncologia e da oncologia pediátrica no Brasil e sobre os textos psicanalíticos ligados ao tema aqui proposto - e de uma pesquisa de campo, através de entrevistas abertas que buscam o testemunho das experiências vivenciadas pelo sujeito a partir do diagnóstico. As entrevistas com onze adultos, pacientes do Hospital São Rafael / Unidade ONCO / Salvador, funcionam como material clínico para a discussão sobre alguns temas à luz da psicanálise Freud-lacaniana. Os temas estão divididos em cinco categorias: reações ao diagnóstico; sentidos e significados do adoecimento; lembranças do tratamento; vivências pós-tratamento; e percepção dos efeitos tardios. Os conceitos e as noções psicanalíticos norteadores para a discussão abarcam o trauma, o luto, o estádio do espelho, o narcisismo e o complexo de Édipo. Também são discutidos os desafios do psicanalista diante do inenarrável das vivências com o adoecimento e diante das condições que reproduzem, nas instituições de saúde, as situações socioculturais de preconceitos em relação a parcelas da população e que são decorrentes do contexto histórico brasileiro. Além disso, coloca-se em evidência a importância da presença do psicanalista nas equipes multidisciplinares que assistem os sobreviventes de câncer infanto-juvenil do SNC. E se discute as possibilidades de diferentes dispositivos clínicos, que preservem a ética e a escuta psicanalítica, poderem ser oferecidos pelo psicanalista, que deve levar em conta, também, as vicissitudes do trabalho nas instituições públicas de saúde
This thesis aims to investigate the meanings that adults, survivors of Central Nervous System (CNS) tumor in childhood, attribute to their life experiences during illness and after the end of the oncological treatment, to offer subsidies for the formulation of new clinical apparatus to treat these cases. The patients aged 20 to 59 years who have completed cancer treatment for at least five years and are without evidence of the disease are considered to be adult survivors of childhood cancer. The research conception that underlies this thesis is the qualitative model in psychoanalysis that allows understanding the phenomena in depth. It consists of a bibliographical research - a review on the history of pediatric oncology and oncology in Brazil and on the psychoanalytic texts related to the theme proposed in this thesis - and a field research, through open interviews that seek the testimony of experiences lived by the subjects since the diagnosis. Interviews with eleven adults, patients from São Rafael Hospital / ONCO / Salvador, serve as clinical material for the discussion of some themes in the light of Freud-Lacanian psychoanalysis. The themes are divided into five categories: reactions to diagnosis; meanings of illness; treatment recollection; post-treatment experiences; and perception of late effects. The psychoanalytic concepts and notions guiding the discussion include Trauma, Grief, the Mirror Stage, Narcissism, and the Oedipus Complex. Also discussed are the challenges of the psychoanalyst in view of the unspeakable experiences from the illness and the conditions that they reproduce, in healthcare institutions, the socio-cultural situations of prejudices in relation to portions of the population and that are derived from the Brazilian historical context. In the final considerations, it is highlighted the importance of the presence of the psychoanalyst in multidisciplinary teams that assist survivors of childhood CNS cancer. And it is discussed about the possibilities of different clinical apparatus, that preserve ethics and psychoanalytic listening, that could be offered by the psychoanalyst, who must also take into account the vicissitudes of work in public healthcare institutions

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Ducos, Claire. "Cancers secondaires chez les patients ayant survécu à un cancer durant l’enfance et Identification de variants rares associés". Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASR013.

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Il est estimé qu’un enfant sur 440 développera un cancer avant sa majorité en France. Depuis quelques décennies, grâce à une amélioration des traitements et de la prise en charge, la survie à 5 ans des patients guéris d’un cancer pédiatrique atteint plus de 80 %. Cependant, la fréquence et la diversité des pathologies iatrogènes tardives ont également augmenté. Les seconds cancers font partie des effets ayant le plus d’impact sur la mortalité et la morbidité de cette population croissante. Bien que le traitement reçu lors du cancer pédiatrique soit un facteur de risque reconnu, ce dernier ne suffit pas à expliquer complètement le risque de cancers secondaires suggérant l’existence d’une composante génétique modulant ce risque. Dans un premier temps, nous avons cherché à mieux comprendre les facteurs de risque de l'un des seconds cancers les plus fréquents, celui de la thyroïde, en étudiant l’impact des radiations reçues par les organes lymphoïdes. Nous avons ainsi mis en évidence une association entre ce risque et l’irradiation de la rate et du thymus, deux organes clés du système immunitaire. Ensuite, afin de mieux comprendre l’impact génétique sur le risque de second cancer, nous avons réalisé une revue systématique de la littérature qui a permis de recenser l’ensemble des variants, gènes et voies biologiques déjà associés au risque des différents types de seconds cancers. Finalement, une étude cas-témoins nichée dans la cohorte French Childhood Cancer Survivors Study (FCCSS) a permis de montrer que différents gènes, porteurs de variants rares, tels que APOBEC3F et RNASEL, étaient associés au risque de seconds cancers. Nous avons également mis en évidence une association entre le risque de second cancer du sein avec le gène FANCM, et de second cancer de la thyroïde avec en particulier, les gènes IFI16 et HINFP. Ainsi, les résultats obtenus au cours de cette thèse fournissent des orientations prometteuses pour contribuer à identifier les patients les plus à risque de développer un second cancer. Nos résultats après validation pourraient être considérés pour adapter le suivi à long terme des survivants mais également le traitement des patients atteints d’un cancer pédiatrique afin de minimiser le risque de survenu d’un second cancer à l’âge adulte
One in 440 children in France is expected to develop cancer before reaching the age of majority. In recent decades, thanks to improvements in treatment and patient care, the 5- year survival rate for children diagnosed with cancer has reached over 80 %. However, the frequency and diversity of late iatrogenic events have also increased. Second cancers are one of the most significant adverse effects on mortality and morbidity in this growing population. Although the treatment received for pediatric cancer is a well-known risk factor, it is not sufficient to fully explain the risk of secondary cancers, suggesting the existence of a genetic component modulating this risk. Initially, we aimed to better understand the risk factors for one of the most frequent second cancers, thyroid cancer, by investigating the impact of radiation received by lymphoid organs. We have identified an association between this risk and irradiation of the spleen and thymus, two key immune system organs. Then, to better understand the genetic impact on the risk of second cancers, we conducted a systematic review of the literature, compiling all the variants, genes and biological pathways already associated with the risk of various types of second cancers. Finally, a case-control study nested in the French Childhood Cancer Survivors Study (FCCSS) cohort showed that various genes carrying rare variants, such as APOBEC3F and RNASEL, were associated with the risk of second cancers. We also demonstrated an association between the risk of second breast cancer with the FANCM gene, and second thyroid cancer with, notably, the IFI16 and HINFP genes. The results obtained in this thesis provide promising directions that could contribute to the identification of patients at the highest risk of second cancers. Once validated, our results could be applied to adapt the long-term follow-up of survivors and the treatment of pediatric cancer patients to minimize the risk of second cancers in adulthood

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Philippe, Kaat. "Eating difficulties and parental feeding strategies during and after childhood cancer treatment: The experiences of parents. : A systematic literature review". Thesis, Högskolan för lärande och kommunikation, Högskolan i Jönköping, HLK, CHILD, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-35834.

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Childhood cancer is a life-threatening disease with a profound impact on the family. Treatment side-effects and accompanied dietary difficulties are for example severe stressors, as appropriate nutrition is important for the treatment success and quality of life. In addition, (unhealthy) dietary patterns established in childhood tend to maintain in survivors. Parents are key players in feeding and establishing these pat-terns, though, systematic research on how parents experience these dietary difficulties is limited. This study aimed at exploring parental experiences of children’s dietary changes and difficulties during cancer treatment and after completion: what feelings do parents experience regarding their child’s dietary changes and difficulties, what feeding strategies to they apply to handle these difficulties, and how did they experience professional support and what are parental support needs. A systematic literature review was conducted and resulted in 21 suitable articles. The children were 0-21 years old, had various types of cancer, and received various types of therapy. Findings showed that parents reported many dietary changes (e.g. increase or decrease in food intake) and associated symptoms (e.g. nausea, changed tastes) during and after the cancer treatment course. Parents reported mainly negative feelings towards these dietary difficulties (e.g. distress and anxiety) and applied a wide range of behavioural feeding strategies, both negative (e.g. pressure to eat) and positive (e.g. provide healthy food) strategies. Parents also used complementary and alternative medicine. A high need for informational support regarding eating and feeding was expressed by parents during treatment, a need for emotional and practical support to a lower extent. These results showed how frequent and profound eating and feeding difficulties are in the childhood cancer and survivor population, and their (negative) impact on parents. Parents consequently need more support: they need oral and written information to set realistic expectations and install appropriate feeding strategies. This is important for the child’s nutritional status and general health both during and after cancer.

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Pasqual, Elisa 1989. "Understanding the health effects of low doses of ionizing radiation from medical procedures : Challenges for epidemiology". Doctoral thesis, Universitat Pompeu Fabra, 2019. http://hdl.handle.net/10803/668123.

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La aplicación de la radiación ionizante (RI) en ámbito médico ha llegado, sin duda, para salvar vidas. Sin embargo, hay una preocupación entre los expertos de salud pública y protección radiológica con relación al incremento de la exposición medica a RI, sobretodo en pacientes pediátricos. Esta tesis tiene como objetivo contribuir a una mejor caracterización del riesgo de radiación en pacientes oncológicos. Con ese fin, se creó un estudio de cohorte de supervivientes de cáncer infantil, como base para el análisis futuro y, anidado a esta cohorte, se implementó un estudio transversal sobre el efecto del neurodesarrollo después de haber recibido radioterapia no-craneal. Aquí se presenta un análisis descriptivo del estado de salud mental de la cohorte en forma de articulo científico. También se ha estimado la asociación entre la dosis acumulada de RI de los procedimientos de diagnóstico médico, como la exposición al radio-diagnostico y el cáncer (linfoma en adultos y tumores cerebrales en niños-adolescentes), en dos grandes estudios internacionales caso-control y dicho trabajo se unió a una estimación de dosimetría que puede ser aprovechada aún más para estudios similares. Este trabajo se presenta en forma de tres articulo científicos. En el marco de esta tesis, también, se sintetizó la evidencia actual de un efecto en el neurodesarrollo de la exposición a RI de dosis baja a moderada, en una revisión sistemática (en forma de artículo científico), concluyendo que la evidencia de este efecto es limitada e inadecuada. La estimación de los efectos de radiación médica requiere grandes esfuerzos y la colaboración entre epidemiólogos y clínicos es un aspecto clave en este tema.
The application of ionising radiation (IR) in the medical sector is undoubtedly lifesaving. There are, however, risks associated with IR and there is growing concern among public health and radiation protection experts, in particular for the increasing medical radiological exposure in children. The aim of this dissertation is to contribute to a better characterisation of the IR risk in patients. A hospital-based cohort study of childhood cancer survivors was developed as a basis for future analysis and, nested within the cohort, a cross-sectional study on neurodevelopmental effect after non-cranial radiotherapy was implemented. A descriptive analysis of the mental health status of the cohort is presented here in the form of a Manuscript. The association between cumulative IR from medical diagnostic procedures and cancer (adult lymphoma and childhood/adolescent brain cancer), in two large international case-control studies, were estimated and a dosimetry estimation was developed. This work has lead to three manuscripts, included in the thesis. Evidence of a neurodevelopmental effect at low-to moderate IR dose was synthesized in a systematic review (presented here in a form of a Manuscript) and was found to be limited to inadequate. The estimated effect at this low dose range requires greater effort from epidemiologists to design more informative studies, and collaboration with clinicians is key for future research in radiation epidemiology.

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Armstrong, Katherine B. "The Genetic Counseling Experience in a Multidisciplinary Childhood Cancer Survivor Center". University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1337101530.

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Waldon, Eric G. "School attendance following cancer diagnosis: A report based on the childhood cancer survivor study". Scholarly Commons, 2007. https://scholarlycommons.pacific.edu/uop_etds/2621.

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Medical advances in the area of pediatric oncology have resulted in significantly increased rates of survivorship among children diagnosed with cancer. Accordingly, there has been increasing emphasis placed on long-term, quality-of-life issues for this population. Many agree that maintaining a typical or normalized lifestyle following diagnosis is important for positive adaptation and functioning during adulthood: many agree that, for children, school attendance is seen as an especially important developmental task. However, little attention has been paid to which variables are related to school absence and attendance following a cancer diagnosis. This study explored the extent to which illness-related and personal/environmental factors affect absence rates among a cohort of long-term survivors of pediatric cancer. Two samples ( n = 3039; n = 307) from the Childhood Cancer Survivor Study, a multi-institutional longitudinal investigation, were subjected to analysis. Findings suggest that: (1) The hypothesized set of illness-related factors do predict membership in either a high or low absence group; (2) Additional medical problems account for a significant proportion of the variance explaining school absence; (3) Several personal/environmental factors predict absence beyond that which is explained by the presence of additional medical problems; and (4) Self-esteem serves as a protective factor in terms of school absence, especially for those children receiving central nervous system treatment. Findings are discussed with regard to future research and recommendations aimed towards supporting school reentry for pediatric cancer patients.

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Tshume, Nobom. "Resilience in childhood sexual abuse survivors". Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50438.

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Thesis (MA) -- Stellenbosch University, 2005.
ENGLISH ABSTRACT: This study will review the literature on resilience in adult female childhood sexual abuse survivors with specific focus on incestuous abuse. Adults with histories of sexual abuse are categorised as either resilient or non-resilient on the basis of current functioning. Characteristics of the family of origin and its perceived contribution to the child sexual abuse are discussed. The developmental psychopathology literature addressing issues of resilience and vulnerability to stresses is addressed. The theoretical concepts of resilience, as they relate to protective mechanisms are discussed.
AFRIKAANSE OPSOMMING: Hierdie navorsingstuk bied 'n oorsig oor die literatuur met betrekking tot die herstelvermoe van volwasse vroulike persone wat as kinders seksueel mishandel is, met besondere klem op bloedskandelike mishandeling. Volwassenes met 'n geskiedenis van seksuele mishandeling word op grond van hulle huidige funksionering beskryf as Of in staat om te herstel of nie daartoe in staat nie. Kenmerke van die gesin van oorsprong en die waargenome bydrae van die gesin tot die seksuele mishandeling van kinders word bespreek. Die literatuur met betrekking tot ontwikkelingsgerigte psigopatologie gee aandag aan vraagstukke met betrekking tot herstelvermoe en kwesbaarheid teen die agtergrond van stres. Die teoretiese konsepte van herstelvermoe, en die verband daarvan met beskermende meganismes, word ook bespreek.

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Zancan, Renata Klein. "Transtorno de estresse pós-traumático e percepção sobre a doença em jovens sobreviventes de câncer infantil". Universidade do Vale do Rio dos Sinos, 2013. http://www.repositorio.jesuita.org.br/handle/UNISINOS/4786.

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O câncer infantil é um conjunto de doenças caracterizadas pela proliferação descontrolada de células anormais. Apesar dos avanços da ciência e da medicina, fazendo com que a taxa de sobrevida chegue em média a 80%, a doença ainda é considerada ameaçadora e os tratamentos são dolorosos e invasivos. Esta experiência pode acarretar consequências psicológicas, dentre elas, o Transtorno de Estresse Pós-traumático (TEPT) ou a presença de sintomatologia do mesmo. Dessa forma, o objetivo dessa dissertação foi investigar a presença de TEPT em jovens sobreviventes de câncer infantil através de dois estudos, um de revisão sistemática e outro empírico. O estudo de revisão sistemática, apresentado na sessão 1, buscou investigar a presença e a prevalência de sintomas de TEPT em sobreviventes de câncer infantil, fatores associados ao transtorno e implicações clínicas. Identificaram-se índices de sintomas de TEPT mais altos nos sobreviventes quando comparados à população em geral. Variáveis como idade, idade no diagnóstico, sintomas de TEPT nos pais e crenças sobre saúde e doença foram associadas ao TEPT. Destacou-se a necessidade de intervenções clínicas específicas para esta população. O estudo empírico, apresentado na sessão 2, foi realizado com 65 adultos e adolescentes, com idade média de 19 anos, que haviam concluído o tratamento há pelo menos um ano em um hospital público de Porto Alegre. O principal objetivo foi investigar a presença de sintomas de estresse pós-traumático e sua relação com a percepção sobre a doença nesses pacientes sobreviventes. Examinou-se também a relação dos sintomas de TEPT com variáveis clínicas e sociodemográficas. Foram aplicados os questionários IPQR-H – Revised Illness Perception Questionaire for Healthy People , para avaliar a percepção sobre a doença, o PCL-C- PTSK Checklist – Civilian Version e SPTSS-Screen for Post -traumatic stress symptoms, para transtorno de estresse pós-traumático e um questionário de dados clínicos e sociodemográficos. Os índices de sintomatologia de TEPT variaram de 9,2% a 18,5% na amostra, não havendo diferenças significativas entre homens e mulheres. Correlações significativas foram encontradas entre sintomas de TEPT e algumas dimensões da percepção sobre a doença. Não foram encontradas associações significativas entre variáveis clínicas e sociodemográficas e sintomas de TEPT. A percepção sobre a doença foi preditora de sintomatologia de TEPT em sobreviventes de câncer infantil. Assim, identificou-se que a percepção sobre a doença deve ser investigada em sobreviventes de câncer infantil para atuar na prevenção e no tratamento de sintomas de TEPT nesses pacientes. Destaca-se a importância do acompanhamento psicológico durante todo o tratamento e após o término do tratamento, durante o período necessário para readaptação desses pacientes a vida social.
Childhood cancer is a group of diseases characterized by uncontrolled proliferation of abnormal cells. Despite advances in science and medicine, making the survival rate reaches 80% on average, the disease is still considered threatening, and the treatments are painful and invasive. This experience can lead to psychological consequences, among them Post Traumatic Stress Disorder (PTSD) or the presence of its symptoms. Thus, the aim of this thesis was to investigate the presence of PTSD symptoms in young survivors of childhood cancer through two studies, one systematic review and one empirical. The systematic review study, presented in session 1, attempted to investigate the presence and prevalence of PTSD symptoms in childhood cancer survivors, factors associated with the disorder and clinical implications. Higher indices of PTSD symptoms were identified when compared to general population. Variables as age, age at diagnosis, PTSD symptoms in parents and beliefs about health and illness were associated with PTSD. We pointed out the need for specific clinical interventions for this population. The empirical study presented in session 2 was conducted with 65 adults and adolescents with the mean age of 19, who had completed the treatment, at least one year before, in a public hospital in Porto Alegre. The main objective was to investigate the presence of PTSD symptoms and its relation to illness perception in these survivor patients. It also examined the relationship between the PTSD symptoms and the clinical and sociodemographic variables. Questionnaires were IPQR-H – Revised Illnes Perception Questionnaire for Healthy People, to assess the perception of the disease, the PCL-C-PTSK checklist – Civilian Version and SPTSS- Screen for Post-Traumatic Stress Symptoms for Posttraumatic Stress Disorder and a questionnaire of clinical and sociodemographic date. The rates of PTSD symptoms ranged 9.2% to 18.5% in the sample, with no significant differences between men and women. Significant correlations were found between PTSD symptoms and some dimensions of illness perception. No significant associations were found between clinical and sociodemographic variables and PTSD symptoms. The illness perception was a predictor of PTSD symptoms in survivors of childhood cancer. Thus, we identified that the illness perception should be investigated in childhood cancer survivors in order to act in the prevention and treatment of PTSD symptoms in these patients. We highlight the importance of psychological counseling throughout the treatment and after the treatment during the period required for rehabilitation of these patients social life.

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Smith, Christa M. "Sexual cognitions of childhood sexual abuse survivors /". View online, 2008. http://repository.eiu.edu/theses/docs/32211131464745.pdf.

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Aba, Naïla. "Étude de la survenue de maladies cardiaques à long terme après le traitement du cancer dans l'enfance : Identification de marqueurs biologiques associés". Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASR012.

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Les progrès en oncologie pédiatrique ont conduit à améliorer le pronostic des patients traités pour un cancer de l’enfant ou de l’adolescent avec une survie à 5 ans supérieure à 80%. Cependant, ces patients présentent un risque accru de complications tardives secondaires au traitement du cancer. Les pathologies cardiaques sont une préoccupation majeure au sein de cette population de survivants ayant été exposés à des traitements cardiotoxiques comme les anthracyclines et/ou les radiations au cœur. La capacité des modèles à prédire les pathologies cardiaques à partir de facteurs cliniques et des traitements reste encore insuffisante. Chez des survivants traités de façon similaire, une variabilité interindividuelle de la susceptibilité à la cardiotoxicité a été observée, suggérant l’existence de facteurs génétiques modulant cette susceptibilité. Dans une première partie, nous avons étudié les risques associés aux traitements cardiotoxiques sur la survenue des pathologies cardiaques tardives chez les enfants traités pour un cancer au sein de la cohorte FCCSS. Nous avons mis en évidence le rôle del’irradiation à de faibles volumes cardiaques et la présence d’interaction entre l'irradiation cardiaque et l’administration d’anthracyclines. Dans une deuxième partie, nous avons rapporté à travers une revue systématique de la littérature des facteurs génétiques associés aux pathologies cardiaques chez les survivants d’un cancer dans l’enfance. Dans une troisième partie, une étude cas- témoins appariée nichée dans la cohorte FCCSS a été conduite pour identifier des biomarqueurs du transcriptome associés aux pathologies cardiaques et à l’insuffisance cardiaque en particulier. Le gène NFE2L2 a été identifié avec une expression élevée associée à une diminution du risque de ces évènements. En conclusion, les travaux de cette thèse contribuent à mieux comprendre les facteurs influençant les risques de complications cardiaques tardives chez les enfants traités pour cancer. Nos résultats pourraient être intégrés après validation dans la pratique clinique courante pour l’adaptation de la prise en charge thérapeutique des enfants atteints de cancer et pour les recommandations de leur suivi à long terme
Advances in pediatric oncology have improved the prognosis of patients treated for childhood or adolescent cancer, with a 5-year survival rate of over 80%. However, these patients are at increased risk of late following cancer treatment. Cardiac diseases are a major concern in this population of survivors who have been exposed to cardiotoxic treatments such as anthracyclines and/or radiation to the heart. The ability of models to predict cardiac diseases from clinical and treatment factors is still insufficient. In similarly treated survivors, interindividual variability in cardiotoxicity susceptibility has been observed, suggesting the existence of genetic factors modulating this susceptibility. In a first part, we studied the risks associated with cardiotoxic treatments on the. occurrence of late cardiac diseases in children treated for cancer within the French Childhood Cancer Study cohort. We highlighted the role of low-volume cardiac irradiation and the interaction between cardiac irradiation and anthracycline administration. In the second part, we report on a systematic of the literature on genetic factors associated with cardiac diseases in survivors of childhood cancer. In the third part, a matched case-control study nested in the FCCSS cohort was conducted to identify transcriptome biomarkers associated with cardiac diseases and heart failure in particular. The NFE2L2 gene was identified, with high expression associated with a reduced risk of these events. In conclusion, the work of this thesis contributes to a better understanding of the factors impacting the risk of late cardiac complications in children treated for cancer. Once validated, our findings could be incorporated into current clinical practice to adapt the therapeutic management of children with cancer, as well as recommendations for their long-term follow-up

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Cousino, Melissa K. "Childhood cancer and brain tumor late effects: The impact on families and associated survivor psychological outcomes". Case Western Reserve University School of Graduate Studies / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=case1406733750.

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