Psychosocial Factors and Health-Related Quality of Life in Pediatric Cancer

Abstract

Children with cancer are at risk for poorer health-related quality of life (HRQOL). Prior work indicates that HRQOL may change throughout cancer treatment, and some evidence indicates that psychosocial factors affect overall HRQOL. Additional research is needed to examine the trajectory of domain-specific HRQOL over the first year of pediatric cancer treatment as well as the psychosocial predictors of those trajectories. The current study addresses gaps in the literature by describing the trajectories of domains of HRQOL, examining psychosocial predictors of those trajectories, and examining changes in the association between HRQOL and psychosocial factors over time. Primary caregivers of children newly diagnosed with cancer completed self-report measures of depression, anxiety, PTSS, parent-child conflict, emotion coaching and their child’s psychological adjustment and HRQOL at 1-, 6- and 12-months post-diagnosis. Data were analyzed using multi-level models. Child HRQOL increased over the first year of treatment. Child internalizing symptoms at the time of diagnosis were associated with level of general (β = -6.82), physical (β = -7.80), social (β = -6.32), and school (β = -6.86) HRQOL during the first year of pediatric cancer treatment. Parent-child conflict was associated with level of social HRQOL (β = -2.67). Changes in psychological adjustment over time were not associated with changes in HRQOL. On average, children’s HRQOL improves over the first year of cancer treatment; however, children with more internalizing problems and more conflict with caregivers at baseline may be at risk for poorer HRQOL over time.