Ernest R. Katz

Adjustment of children with newly diagnosed cancer : Cross-informant variance

In recent years, more and more intensive treatment protocols have been initiated with the goal of improving long-term survival of pediatric cancer patients. Empirical evaluation of the psychological and social adjustment of the cohort of children with newly diagnosed cancer being treated with these modem regimens is essential to enhance quality of life. Inconsistencies in the literature on the average adjustment of children with cancer can be attributed to a number of methodological differences across studies. Assessment of physically healthy childrens adjustment based on independently derived information from the children, parents, and teachers has consistently shown a lack of congruence among these three sources. This discordance or lack of agreement among reports of child adjustment was termed cross-informant variance for the purposes of the present investigation. Cross-informant variance among child, parent, and teacher report measures has not been systematically investigated for pediatric cancer...

Perceived physical appearance and adjustment of children with newly diagnosed cancer : a path analytic model

More intensive medical treatment protocols have been initiated with the goal of improving survival of pediatric cancer patients. Evaluation of the adjustment of this cohort of children with newly diagnosed cancer being treated with these modern regimens is essential in order to enhance quality of life. Children with cancer who experience disease and treatment-related changes in physical appearance are hypothesized to be at greater risk for psychological and social adjustment problems given societys attitudes toward visible physical differences. Within a risk and resistance theoretical framework, perceived physical appearance was investigated as a predictor of depressive symptoms, social anxiety, and general self-esteem in newly diagnosed pediatric cancer patients. In support of the a priori conceptual model, path analysis findings indicate that perceived physical appearance has direct and indirect effects on depressive symptoms and social anxiety with the indirect effects mediated by general self-esteem. Exploratory analysis suggests that the effect of perceived.

Perceived Stress and Adjustment of Long-Term Survivors of Childhood Cancer

With the increased probability of long-term survival from childhood cancer, quality of life has assumed an increasingly prominent role. The objective of the present study was to predict statistically the observed variability in adaptation of long-term survivors of childhood cancer. Perceived stress was selected for investigation as a potentially modifiable predictor variable, given its hypothesized role in patient functioning. Higher perceived stress statistically predicted increased psychological distress and lower general self-esteem after controlling for relevant demographic and medical variables. The implications of these findings suggest that stress management interventions may enhance the quality of life of long-term survivors of childhood cancer.

Psychological aspects of cancer in children, adolescents, and their families

Abstract With improving medical management and survival of children and adolescents with cancer, increasing attention is being focused on the quality of life for the patient and family. This review will discuss the psychological aspects of various phases in the illness process and highlight major issues in intervention. It is concluded that the psychological care of children and adolescents with cancer can serve as a model for comprehensive care in other pediatric disorders as well.

Social support and social cognitive problem-solving in children with newly diagnosed cancer.

Children newly diagnosed with cancer have been documented to be at increased risk for difficulties in their return to school and ongoing positive social experiences. This article reviews the critical role of social support in helping children adjust to their illness and treatment. Social skills training for newly diagnosed children is presented as an important intervention strategy for increasing positive social interactions and overall psychosocial adjustment. A randomized, clinical research trial currently in progress that will evaluate the impact of social skills training on newly diagnosed children 5–13 years of age is delineated. The potentially positive impact of social skills training on the prevention of emotional problems and increased biologic survival are discussed.

Guest column A cognitive-behavioral approach to pain associated with pediatric chronic diseases

In marked contrast to the rather extensive clinical literature on adult chronic pain, the systematic investigation of pediatric pain represents a relatively recent area of scientific inquiry.’ Advances have been particularly notable in the cognitive-behavioral assessment and management of pediatric pain. To illustrate these advances, this brief review describes the cognitive-behavioral treatment of chronic, recurrent, and acute pain associated with hemophilia, juvenile rheumatoid arthritis, and sickle cell disease. More extensive presentations are also available.2J

Cancer in children and adolescents.

Advances in biomedical science and technology have resulted in dramatic changes in the prognosis of children and adolescents diagnosed with cancer. While in the past survival was measured in terms of months, today many children are surviving 5 years and longer, with an ever-increasing number who are completely cured (Sposto & Hammond, 1985). Childhood cancer has gradually evolved from an inevitably fatal illness to a life-threatening chronic condition. With the increased probability of long-term survival, psychological factors have assumed a more salient role in overall child and family coping (Katz & Jay, 1984; Varni & Katz, 1987).

Principles of psychosocial programming for children and cancer

The working group on psychosocial issues believes that we need a protocol or checklist, along with tested examples, to guide local practice, research, and assessment of institutional psychosocial services and support for children, teenagers, and families affected by cancer. Such a protocol should be standardized, but it should be designed to accommodate the individual needs of both the patient and family and of the caregivers and their institutions. It also should have as its objective the normalization and empowerment of the child and the family. The protocol must be comprehensive, and it must take a longitudinal approach to care. Above all, it should be accessible and feasible. Such a protocol, once developed, should lend itself to funding support from a variety of community and national organizations. Development of such a protocol is beyond the scope of this working group in this limited time frame. As noted at the conclusion of this report, we recommend establishment of a special Psychosocial Task Force to take the next steps and develop such a protocol. However, we have identified here the key principles on which this protocol can be constructed, at the same time enumerating potential impediments to implementation of each principle. These follow. 1. Psychosocial care is, and should be seen as, essential to improving the chances for disease-free and life-enhancing futures for everyone affected by childhood cancer. It is fundamental to the promotion of physical and mental health and social productivity. Impediments: