Risk and Protective Factors of Psychosocial Functioning in Survivors of Childhood Cancer: Results of the DCCSS-LATER Study

Anne Maas; Heleen Maurice-Stam; DCCSS-LATER Study Group; E. A.M. Feijen; Jop C. Teepen; Alied M. van der Aa-van Delden; Nina Streefkerk; Eline van Dulmen-den Broeder; Wim J.E. Tissing; Jacqueline J. Loonen; Helena J.H. van der Pal; Andrica C.H. de Vries; Marry M. van den Heuvel-Eibrink; Cécile Ronckers; Sebastian Neggers; Dorine Bresters; Marloes Louwerens; Birgitta A.B. Versluys; Margriet van der Heiden-van der Loo; Leontien C.M. Kremer; Martha Grootenhuis

doi:10.1002/pon.9313

Risk and Protective Factors of Psychosocial Functioning in Survivors of Childhood Cancer: Results of the DCCSS-LATER Study

Anne Maas^*, Heleen Maurice-Stam, DCCSS-LATER Study Group, E. A.M. Feijen, Jop C. Teepen, Alied M. van der Aa-van Delden, Nina Streefkerk, Eline van Dulmen-den Broeder, Wim J.E. Tissing, Jacqueline J. Loonen, Helena J.H. van der Pal, Andrica C.H. de Vries, Marry M. van den Heuvel-Eibrink, Cécile Ronckers, Sebastian Neggers, Dorine Bresters, Marloes Louwerens, Birgitta A.B. Versluys, Margriet van der Heiden-van der Loo, Leontien C.M. KremerMartha Grootenhuis

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Objective:

This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS).

Methods:

CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self-Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self-Rating Scale for Post-Traumatic Stress Disorder, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and Short Form-36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p < 0.004).

Results:

A total of 1382 CCS participated, all diagnosed ≥ 15 years ago. The mean age of participating CCS was 36 years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self-esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self-esteem (10×), and perceived burden (9×). Self-esteem (all β ≤ 0.47) and perceived burden (all β ≤ 0.38) demonstrated strongest associations of medium/large size.

Conclusions:

Perceptions of childhood cancer, illness cognitions, self-esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio-demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self-esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.

Original language	English
Article number	e9313
Journal	Psycho-Oncology
Volume	33
Issue number	10
DOIs	https://doi.org/10.1002/pon.9313
Publication status	Published - Oct 2024

Bibliographical note

Publisher Copyright:
© 2024 The Author(s). Psycho-Oncology published by John Wiley & Sons Ltd.

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Maas, A., Maurice-Stam, H., DCCSS-LATER Study Group, Feijen, E. A. M., Teepen, J. C., van der Aa-van Delden, A. M., Streefkerk, N., van Dulmen-den Broeder, E., Tissing, W. J. E., Loonen, J. J., van der Pal, H. J. H., de Vries, A. C. H., van den Heuvel-Eibrink, M. M., Ronckers, C., Neggers, S., Bresters, D., Louwerens, M., Versluys, B. A. B., van der Heiden-van der Loo, M., ... Grootenhuis, M. (2024). Risk and Protective Factors of Psychosocial Functioning in Survivors of Childhood Cancer: Results of the DCCSS-LATER Study. Psycho-Oncology, 33(10), Article e9313. https://doi.org/10.1002/pon.9313

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title = "Risk and Protective Factors of Psychosocial Functioning in Survivors of Childhood Cancer: Results of the DCCSS-LATER Study",

abstract = "Objective: This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS). Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self-Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self-Rating Scale for Post-Traumatic Stress Disorder, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and Short Form-36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p < 0.004). Results: A total of 1382 CCS participated, all diagnosed ≥ 15 years ago. The mean age of participating CCS was 36 years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self-esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self-esteem (10×), and perceived burden (9×). Self-esteem (all β ≤ 0.47) and perceived burden (all β ≤ 0.38) demonstrated strongest associations of medium/large size. Conclusions: Perceptions of childhood cancer, illness cognitions, self-esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio-demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self-esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.",

author = "Anne Maas and Heleen Maurice-Stam and {DCCSS-LATER Study Group} and Feijen, {E. A.M.} and Teepen, {Jop C.} and {van der Aa-van Delden}, {Alied M.} and Nina Streefkerk and {van Dulmen-den Broeder}, Eline and Tissing, {Wim J.E.} and Loonen, {Jacqueline J.} and {van der Pal}, {Helena J.H.} and {de Vries}, {Andrica C.H.} and {van den Heuvel-Eibrink}, {Marry M.} and C{\'e}cile Ronckers and Sebastian Neggers and Dorine Bresters and Marloes Louwerens and Versluys, {Birgitta A.B.} and {van der Heiden-van der Loo}, Margriet and Kremer, {Leontien C.M.} and Martha Grootenhuis",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Psycho-Oncology published by John Wiley & Sons Ltd.",

year = "2024",

month = oct,

doi = "10.1002/pon.9313",

language = "English",

volume = "33",

journal = "Psycho-Oncology",

issn = "1057-9249",

publisher = "John Wiley & Sons Ltd.",

number = "10",

}

Maas, A, Maurice-Stam, H, DCCSS-LATER Study Group, Feijen, EAM, Teepen, JC, van der Aa-van Delden, AM, Streefkerk, N, van Dulmen-den Broeder, E, Tissing, WJE, Loonen, JJ, van der Pal, HJH, de Vries, ACH , van den Heuvel-Eibrink, MM, Ronckers, C, Neggers, S, Bresters, D, Louwerens, M, Versluys, BAB, van der Heiden-van der Loo, M, Kremer, LCM & Grootenhuis, M 2024, 'Risk and Protective Factors of Psychosocial Functioning in Survivors of Childhood Cancer: Results of the DCCSS-LATER Study', Psycho-Oncology, vol. 33, no. 10, e9313. https://doi.org/10.1002/pon.9313

TY - JOUR

T1 - Risk and Protective Factors of Psychosocial Functioning in Survivors of Childhood Cancer

T2 - Results of the DCCSS-LATER Study

AU - Maas, Anne

AU - Maurice-Stam, Heleen

AU - DCCSS-LATER Study Group

AU - Feijen, E. A.M.

AU - Teepen, Jop C.

AU - van der Aa-van Delden, Alied M.

AU - Streefkerk, Nina

AU - van Dulmen-den Broeder, Eline

AU - Tissing, Wim J.E.

AU - Loonen, Jacqueline J.

AU - van der Pal, Helena J.H.

AU - de Vries, Andrica C.H.

AU - van den Heuvel-Eibrink, Marry M.

AU - Ronckers, Cécile

AU - Neggers, Sebastian

AU - Bresters, Dorine

AU - Louwerens, Marloes

AU - Versluys, Birgitta A.B.

AU - van der Heiden-van der Loo, Margriet

AU - Kremer, Leontien C.M.

AU - Grootenhuis, Martha

PY - 2024/10

Y1 - 2024/10

N2 - Objective: This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS). Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self-Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self-Rating Scale for Post-Traumatic Stress Disorder, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and Short Form-36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p < 0.004). Results: A total of 1382 CCS participated, all diagnosed ≥ 15 years ago. The mean age of participating CCS was 36 years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self-esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self-esteem (10×), and perceived burden (9×). Self-esteem (all β ≤ 0.47) and perceived burden (all β ≤ 0.38) demonstrated strongest associations of medium/large size. Conclusions: Perceptions of childhood cancer, illness cognitions, self-esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio-demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self-esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.

AB - Objective: This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS). Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self-Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self-Rating Scale for Post-Traumatic Stress Disorder, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and Short Form-36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p < 0.004). Results: A total of 1382 CCS participated, all diagnosed ≥ 15 years ago. The mean age of participating CCS was 36 years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self-esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self-esteem (10×), and perceived burden (9×). Self-esteem (all β ≤ 0.47) and perceived burden (all β ≤ 0.38) demonstrated strongest associations of medium/large size. Conclusions: Perceptions of childhood cancer, illness cognitions, self-esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio-demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self-esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.

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U2 - 10.1002/pon.9313

DO - 10.1002/pon.9313

M3 - Article

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AN - SCOPUS:85205527071

SN - 1057-9249

VL - 33

JO - Psycho-Oncology

JF - Psycho-Oncology

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