文章：

儿童癌症年轻幸存者患者报告结局的多层次社会决定因素

Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer

原文发布日期：25 April 2024

DOI: 10.3390/cancers16091661

类型: Article

开放获取: 是

英文摘要：

In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children’s Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors’ and caregivers’ PROs. General linear regression tested associations of social determinants with survivors’ PROs. We found that caregivers’ higher anxiety was significantly associated with survivors’ poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p< 0.05); caregivers’ sleep disturbances were significantly associated with lower mobility in survivors (p< 0.05). Family conflicts were associated with survivors’ sleep problems (p< 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors’ poorer sleep quality (p< 0.05), while higher physical environment deprivation was associated with survivors’ higher psychological stress and fatigue and lower positive affect and mobility (p< 0.05). Parental, family, and neighborhood factors are critical influences on young survivors’ quality of life and well-being and represent new intervention targets.

摘要翻译： 

本研究探讨了18岁以下儿童癌症年轻幸存者患者报告结局的社会决定因素。这项横断面研究调查了与儿童癌症年轻幸存者不良患者报告结局相关的社会决定因素。我们纳入了2017年至2018年随访期间在圣裘德儿童研究医院接受治疗、年龄小于18岁的293对幸存者及其主要照顾者。社会决定因素包括家庭因素（照顾者报告的患者结局、家庭动态）和县级资源匮乏程度（通过"县健康排名与路线图"评估社会经济地位和物理环境）。采用PROMIS量表评估幸存者和照顾者的患者报告结局。通过一般线性回归检验社会决定因素与幸存者患者报告结局的关联性。研究发现：照顾者较高焦虑水平与幸存者较严重的抑郁、压力、疲劳、睡眠问题及积极情感减少显著相关（p<0.05）；照顾者睡眠障碍与幸存者较低活动能力显著相关（p<0.05）。家庭冲突与幸存者睡眠问题相关（p<0.05）。居住在社会经济贫困地区与幸存者较差的睡眠质量显著相关（p<0.05），而较高的物理环境匮乏程度则与幸存者较高的心理压力、疲劳程度以及较低的积极情感和活动能力相关（p<0.05）。父母因素、家庭因素和社区环境因素对年轻幸存者的生活质量和健康状况具有重要影响，可作为新的干预目标。

原文链接：

Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer