Psychological, demographic, illness and treatment risk factors for emotional distress amongst paediatric oncology patients prior to reaching 5-year survivorship status

Abstract

Objectives: Studies assessing emotional distress severity of paediatric oncology patients prior to reaching 5-year survivorship status have produced inconsistent findings. This cross-sectional multi-centre study aimed to determine psychological, demographic, illness and treatment risk factors for emotional distress in this population.

Methods: Paediatric oncology patients (n = 74), aged 12-18 years, completed the Paediatric Index of Emotional Distress, Self-Description Questionnaire and Paediatric Quality of Life Inventory. Seventy-two parents provided background information regarding demographics, diagnoses and treatment protocols in addition to appropriate proxy ratings.

Results: Hierarchical multiple regression analyses demonstrated that demographic, illness and treatment factors explained little variance in emotional distress. Global self-concept, global-generic and cancer-specific health-related quality of life (HRQOL) were significant predictors. Provisional multiple regression analyses indicated that pain/hurt, illness-related worries, communication difficulties and negative self-views in relation to math abilities, parent relations and opposite-sex peer relations were risk factors for emotional distress in this sample. Paired-sample t-tests and Pearson's moment-correlation coefficients showed patient and parent reports of patients' self-concepts and HRQOL were highly consistent.

Conclusions: This study empirically identified modifiable psychological risk factors for emotional distress prior to 5-year survivorship status and provided guidance for future interventions. Furthermore, findings suggest that parent reports can provide reliable estimates of patients' self-concepts and HRQOL. Generalizability of the findings was enhanced by the diversity of the sample studied, in terms of diagnosis and treatment exposure, and the multi-centre recruitment strategy employed. Nevertheless, the findings should be corroborated by larger, longitudinal studies.

Keywords: anxiety; cancer; depression; emotional distress; oncology; paediatric.