Carmina Castellano-Tejedor

Surviving cancer: The psychosocial outcomes of childhood cancer survivors and its correlates

This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.

Training professionals’ communication and motivation skills to improve spinal cord injury patients’ satisfaction and clinical outcomes: Study protocol of the ESPELMA trial

Acute spinal cord injury leaves patients severely impaired and generates high levels of psychological distress among them and their families, which can cause a less active role in rehabilitation, worse functional recovery, and less perceived satisfaction with the results. Additionally, rehabilitation professionals who deal with this psychological distress could ultimately experience higher stress and more risk of burnout. This article presents the study protocol of the ESPELMA project, aimed to train rehabilitation professionals in the clinical management of acute spinal cord injury–associated psychological distress, and to measure the impact of this training on the patients’ perceived satisfaction with treatment.

Type of tumour, gender and time since diagnosis affect differently health‐related quality of life in adolescent survivors

Research findings about health-related quality of life (HRQoL) of childhood cancer survivors are mixed and the features which could modulate these results have not been investigated rigorously. This research aims to improve the knowledge on these topics. Thus, HRQoL between central nervous system (CNST) and non-central nervous system (non-CNST) adolescent cancer survivors was compared. The influence of selected factors (gender and years since diagnosis) on HRQoL was also analysed. In a cross-sectional design, 78 survivors (12-20 years) who were ≥ 1 year free of oncological treatment answered the self-reported version of the KIDSCREEN-52. HRQoL mean scores of CNST survivors were lower in comparison with non-CNST in physical well-being and social support and peers dimensions. Furthermore, female gender was also related to lower HRQoL scores for both types of tumours in physical well-being and autonomy dimensions. Additionally, scores on psychological well-being, social support and peers, parent relations and home life and school environment dimensions decrease with length of time from diagnosis. Therefore, diagnosis of CNST and gender were related to lower HRQoL among survivors in some dimensions, whereas time from diagnosis was related to impaired HRQoL in other features. These results can help to design tailored interventions and psychosocial guidelines to follow-up survivors.Research findings about health-related quality of life (HRQoL) of childhood cancer survivors are mixed and the features which could modulate these results have not been investigated rigorously. This research aims to improve the knowledge on these topics. Thus, HRQoL between central nervous system (CNST) and non-central nervous system (non-CNST) adolescent cancer survivors was compared. The influence of selected factors (gender and years since diagnosis) on HRQoL was also analysed. In a cross-sectional design, 78 survivors (12–20 years) who were ≥1 year free of oncological treatment answered the self-reported version of the KIDSCREEN-52. HRQoL mean scores of CNST survivors were lower in comparison with non-CNST in physical well-being and social support and peers dimensions. Furthermore, female gender was also related to lower HRQoL scores for both types of tumours in physical well-being and autonomy dimensions. Additionally, scores on psychological well-being, social support and peers, parent relations and home life and school environment dimensions decrease with length of time from diagnosis. Therefore, diagnosis of CNST and gender were related to lower HRQoL among survivors in some dimensions, whereas time from diagnosis was related to impaired HRQoL in other features. These results can help to design tailored interventions and psychosocial guidelines to follow-up survivors.

Perceived positive and negative consequences after surviving cancer and their relation to quality of life

Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health-related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer-related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty-one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN-52 self-reported version. Data were analysed using mixed methods approach. Overall, 87.8% of the studied sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer-related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well-being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well-being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.

Predictors of Suicide Behavior Relapse in Pediatric Population

Identifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R 2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room.

Acute spinal cord injury patients’ satisfaction with care: Results from an intervention study in a specialized rehabilitation unit:

To assess satisfaction with care in acute spinal cord injury patients admitted to a specialized rehabilitation unit prior and after a tailored training in communication skills for the staff, the Picker Patient Experience-33 ((1) Content of the information, (2) Quality of the information, and (3) Quality of the relationship), the Spinal Cord Independence Measure-III, and the Hospital Anxiety and Depression Scale were administered. The more troublesome dimension regarding patients’ satisfaction was content of the information, with 88.37 and 91.43 percent (pre/post-intervention) reporting problems with information provided concerning their rights, and 51.15 and 58.72 percent (pre/post-intervention) with the information received at discharge. Overall, functionality (Spinal Cord Independence Measure-III) improved at discharge, but Hospital Anxiety and Depression Scale pre/post-scores revealed to be high.

A study of burden of care and its correlates among family members supporting relatives and loved ones with traumatic spinal cord injuries

Objective: To understand and describe in a sample of caregivers of persons with spinal cord injury, their burden of care, resilience and life satisfaction and to explore the relationship between these variables. Design: Cross-sectional design. Setting: One Spinal Cord Injury Acute Inpatient Unit from a general hospital. Subjects: Seventy-five relatives of persons with spinal cord injuries (84% women) with a mean age of 48.55 (SD = 12.55) years. Interventions: None. Measures: Demographics (neurological loss and severity according to the American Spinal Injury Association criteria), the Zarit Burden Interview, the Resilience Scale and the Life Satisfaction Checklist. Results: All caregivers experienced feelings of different intensities of burden (52% mild-to-moderate, 43% moderate-to-severe and 5% severe), and none of them expressed little or no burden at the assessment moment. Caregivers’ main worries were “dependence” and “the future of the injured.” Resilience was medium-to-high (mean = 141.93, SD = 23.44) for the whole sample with just a minority of them revealing low (15%) or very low resilience (7%). The highest scores were obtained in relation to “caregivers’ independence” and “meaning of their lives.” Life satisfaction scores were medium-to-high (mean = 36.6, SD = 6). These scores were not related to demographics or the severity of the injury. Zarit Burden Interview scores were negatively correlated to Resilience Scale (r = −.370, P = .001) and Life Satisfaction Checklist scores (r = −.412, P < .001). Conclusion: More resilient and satisfied caregivers experienced lower burden. Burden is moderate-to-high and mainly related to uncertainty about the future, caregivers’ insecurity with caregiving and dependence of the injured.

In The Aftermath of Cancer: The Psychological Status of AdolescentCancer Survivors and its Correlates

Objective: To assess the psychological status of adolescent cancer survivors and examined its associations with selected personal (coping, cancer-related distress) and familial factors (parents’ general stress, cancer-related distress). Method: Using a cross-sectional design, forty-one survivors (12-19 years) answered standardized measures to assess psychological well-being, mood and emotions and self-perception (KIDSCREEN-52), coping (ACS) and cancer-related distress (two numeric scales). Similarly, forty-one parents were assessed for general stress (PSS-14) and cancer-related distress (two numeric scales). Results: Mean scores for all KIDSCREEN psychological dimensions assessed were within normative values (50 ± 10). Regression analyses revealed two models with a range of explained variance between 17.3-31.1% for psychological well-being (F(2,37) = 5.070; p = 0.011) and mood and emotions (F(3,36) = 6.877; p = 0.001) respectively. Conclusion: This study provides tentative evidence that survivors’ psychological status is related to diverse personal and familial factors, especially those concerning adolescent mobilization of coping resources during hospitalization, and parental general stress in survivorship. Although psychological outcomes in survivorship appeared satisfactory compared to normative values; this study revealed that to facilitate positive psychological adaptation in the aftermath of cancer, psychosocial interventions aimed to enhance personal and family strengths to cope with the illness are needed throughout the process.