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Social‐ecological predictors of school functioning in Hispanic children treated for cancer with central nervous system–directed therapies
Author(s) -
Patel Sunita K.,
Johansen Christopher,
Gold Abigail Onderwyzer,
Delgado Nicole,
Xu Sandra,
Dennis Jessica
Publication year - 2020
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.28320
Subject(s) - medicine , psychological intervention , cancer , survivorship curve , quality of life (healthcare) , pediatric cancer , multivariate analysis , gerontology , clinical psychology , psychiatry , nursing
Background Children with brain tumor or acute leukemia are at risk for neurotoxic side effects associated with their cancer therapies. These long‐term deficits include poor health‐related quality of life (HRQOL) in school and lower educational achievement. Although social‐ecological factors may impact these outcomes, it is not known which factors play a role. Our objective was to evaluate the factors affecting school HRQOL in Hispanic childhood cancer survivors, an important at‐risk group. Procedure Multivariable regression analyses examined whether selected social‐ecological factors contribute toward suboptimal school HRQOL in 73 Hispanic children treated with central nervous system (CNS)–directed cancer therapies after accounting for effects associated with established cancer‐related risk factors. Results Consistent with expectations from prior research, in our multivariate analysis, the cancer‐related factors of having a brain tumor diagnosis and being younger at cancer diagnosis were significant predictors of reduced parent‐reported school HRQOL ( F (2,65) = 5.46 , P < .01) and accounted for 14% of the variance. Adding the social‐ecological variables of parent education, child motivation, and parental knowledge accounted for an additional 25% of the variance in school HRQOL, where higher levels were associated with better child school HRQOL. Parenting knowledge was a contributor even after controlling for effects associated with the other variables in the model ( F (1,62) = 4.88, P < .05). Conclusions Cancer survivorship care should incorporate parent education interventions to enhance the child's school functioning, particularly for Hispanic childhood cancer survivors from predominantly Spanish‐speaking families. Future research should consider other at‐risk groups and incorporate social‐ecological indicators to predict HRQOL outcomes.