Quality of self-report coping measures for children and adolescents with cancer: A systematic review.

BACKGROUND: Cancer and its treatments cause significant stress in children and adolescents. This stress is associated with risks of emotional and behavioral problem development and interfering with adherence to treatment regimens. Instruments enabling the precise evaluation of the coping behaviors of pediatric patients with cancer in clinical practice are needed. AIMS: The study aimed to identify existing self-report measures of pediatric coping patterns and to evaluate their psychometric properties, to aid the selection of tools for application to pediatric patients with cancer. METHODS: This systematic review was conducted according to the PRISMA statement and registered in PROSPERO (CRD 42021279441). Nine international databases were searched from their inception to September 2021. Studies with the main goal of developing and psychometrically validating pediatric coping measures with populations aged <20 years, not specific to any disease or situation, and published in English, Mandarin, or Indonesian were included. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist was applied. RESULTS: Of 2527 studies initially identified, 12 met the inclusion criteria. Five scales had positive internal consistency ratings and adequate reliability (α > .7). Construct validity ratings were positive for five scales (41.6%), intermediate for three (25%), and poor for three (25%). No information was available for one (8.3%) scale. The Coping Scale for Children and Youth (CSCY) and Pediatric Cancer Coping Scale (PCCS) had the largest numbers of positive ratings. Only the PCCS was developed for pediatric patients with cancer and showed acceptable reliability and validity. LINKING EVIDENCE TO ACTION: The findings of this review highlight the need to increase the validation of existing coping measures in clinical and research settings. Some instruments seem to be specific to adolescent's cancer coping assessment and knowledge of these validity and reliability of the instruments may improve the quality of clinical interventions.

Quality of Life and Its Predictors Among Children and Adolescents With Cancer.

BACKGROUND: Quality of life (QoL) increasingly is being assessed in pediatric patients with cancer. However, only a few studies focused on QoL predictors during and after treatment for pediatric patients with cancer. OBJECTIVE: The aims of this study were to (1) assess differences of QoL, distress behavior, and fatigue among children and adolescents; (2) examine the relationship of distress behaviors, fatigue, and a variety of demographic factors to QoL; and (3) identify QoL predictors. METHODS: A cross-sectional descriptive study involving 150 participants treated between 2012 and 2014 was conducted. All participants were given a diagnosis of cancer, ranged in age from 7 to 18 years, and had no developmental delay or mental illness. Three instruments including Pediatric Quality of Life, Distress Behaviors, and Multidimensional Fatigue Scale were administered. RESULTS: Adolescents aged 16 to 18 years reported lower school functioning and experienced more general and sleep/rest fatigue. Fatigue and distress behaviors were associated with a poorer QoL. Diagnosis at a younger age, greater time since diagnosis, and family structure were associated with a better QoL. General fatigue, relationship distress, family structure, and time since diagnosis were significant predictors of QoL, accounting for 64% of the total variance. CONCLUSIONS: Factors associated with a poorer QoL included fatigue, distress behaviors, and diagnosis at an older age. Less general fatigue and relationship distress, greater time since diagnosis, and living in nuclear family predicted a better QoL. IMPLICATIONS FOR PRACTICE: Routinely evaluating fatigue and school functioning in pediatric patients with cancer is warranted, as well as developing educational programs to enhance the management of fatigue and relationship issues, especially for those who were given a diagnosis recently or for late adolescents.