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Biomedical subjects

B F Last

Publications and source records attributed to B F Last.

28 records · Page 2Linked to original sources
PubMed1996

Exploration of a self-protective strategy in pediatric oncology staff.

Oncology care is considered a stressful occupation. Little is known about the coping strategies oncology staff members use to deal with the stress of their work. The purpose of this study was to determine whether a self-protective strategy found in parents of children with cancer is also present in pediatric oncology staff. To explore this assumption, staff members' ratings were compared with the parents' ratings on the need for support and with the children's ratings on experienced pain. We also explored the characteristics which staff members attribute to the children and the parents. A total of 76 staff members, 84 children with cancer, and their 163 parents participated in the study. Both gender and number of years working in oncology care were positively associated with increased self-protective reactions in staff members. Male staff members rated medical procedures and the pain children experience in general as less painful than did female staff members. Their judgements about experienced pain in general and the lumbar puncture procedure in particular tended to be lower than the children's ratings. Female staff members attributed more positive characteristics to children with cancer and their parents than did male staff members. Staff members with more years of experience in oncology tended to rate all three medical procedures as less painful than those with less years of experience, and they also attributed more positive characteristics to the children. Staff members should be observant to their perceptions of children and parents, especially if their experience increases.

Adaptation, Psychological↗
PubMed1996

Information about diagnosis and prognosis related to anxiety and depression in children with cancer aged 8-16 years.

The aim of this study was to test the hypothesis that being openly informed about the diagnosis and prognosis benefits the emotional well-being of children with cancer. A stratified sample of 56 children with cancer aged 8-16 years and their parents participated. The parents were interviewed about the information they had given to their child. Self-report questionnaires were administered to the children measuring anxiety and depression. Children who received open information about their diagnosis and prognosis at the initial stage of the disease showed significantly less anxiety and depression. Our findings suggest that parents should be advised to inform their child with cancer openly and soon after the initial diagnosis. Physicians should offer help to the parents in dealing with the difficult task of confronting the child with the diagnosis, prognosis and treatment.

Adolescent↗
PubMed1982

[Intelligence and concentration capacity in children with leukemia and their adaptation to school].

In this study we test the hypothesis that children, suffering from acute lymphatic leukaemia (ALL) have more concentration problems, a lower intellectual capacity and more adjustment problems at school. The study deals only with those children whose ALL had been diagnosed at least three years before. Standardized tests have been given to fourteen children (aged 6-12), being treated or checked by the Children's Oncology Center of Amsterdam. Teachers were given a questionnaire and a written interview. Parents were interviewed orally. Scores on tests and questionnaire were compared with scores from norm groups. The study's most important results are: these children with ALL have a low concentration capacity, some adjustment problems at school (withdrawn behavior), but intellectually they don't function at a lower level.

Achievement↗
PubMedDate not supplied

Supportive groups for siblings of pediatric oncology patients: impact on anxiety.

Childhood cancer can have a substantial emotional impact on the siblings of the sick child. In order to help these siblings adjust to the illness, supportive groups were started in 1994 at our medical center. The program is based on a model of psychosocial support; the aim of the group is to enhance control strategies and, thus, to reduce anxiety. It consists of five sessions and is offered to siblings aged 7-18. The study objective is to evaluate the effect of group participation on sibling anxiety. The State Trait Anxiety Inventory for Children was administered to 24 siblings before and after group participation. Results showed that siblings experience less anxiety after participating in the group. Before group participation, a majority of the siblings were more anxious compared with normal peers. The sibling's age and sex, whether the ill child is in treatment, survival perspective, and time since diagnosis were not related to anxiety reduction. The continuation of the group is supported by its positive impact on siblings. Results must nevertheless be interpreted cautiously, considering the small number of siblings participating in the study, the lack of a control group and the restriction to one outcome measure.

Adaptation, Psychological↗
PubMedDate not supplied

Children with cancer with different survival perspectives: defensiveness, control strategies, and psychological adjustment.

The main objective of the present study was to investigate whether children with cancer with different survival perspectives differ in their psychological adjustment, defensiveness and their use of cognitive control strategies. Furthermore, the study investigated which variables predict emotional adjustment of these children with cancer most adequately. A total of n=84 children (n=43 children in remission and n=41 children not in remission) participated in the study. They answered questionnaires about control strategies, defensiveness, anxiety and depression. No differences were found in any of the questionnaires between children in remission and relapse. Emotional adjustment of the children was predicted by defensiveness and by positive expectations about the course of the illness. The findings demonstrate the importance of having positive expectations for the emotional adjustment of children with cancer. The strength of the study is the inclusion of a substantial group of children with cancer who have a reduced survival perspective.

Adaptation, Psychological↗
PubMedDate not supplied

Educational achievement, employment and living situation in long-term young adult survivors of childhood cancer in the Netherlands.

This paper investigated educational achievement, employment status, living situation, marital status and offspring in 500 Dutch long-term young adults survivors of childhood cancer (age range, 16-49 years, 47% female). The results were compared with a reference group of 1092 persons with no history of cancer (age range, 15-33 years, 55% female). The impact of demographic and medical characteristics on psychosocial adjustment was studied. All participants completed a self-report questionnaire. The results showed that, although many survivors are functioning well and leading normal lives, a subgroup of survivors were less likely to complete high-school, to attain an advanced graduate degree, to follow normal elementary or secondary school and had to be enrolled more often on learning disabled programs. The percentage of employed survivors was lower than the percentage of employed controls in the comparison group, but more survivors were student or homemaker. Survivors had lower rates of marriage and parenthood, and worried more about their fertility and the risk of their children having cancer. Survivors, especially males, lived more often with their parents. Cranial irradiation dose <or=25 Gy was an important independent prognostic factor of lower educational achievement. Survivors with a history of brain/CNS tumours had a higher risk of being single than survivors with a diagnosis of leukaemia/non-Hodgkin lymphoma. These results indicate that important aspects of life are affected in a substantial number of persons who have been diagnosed with cancer during childhood or adolescence.

Achievement↗
PubMedDate not supplied

Sibling self-report, parental proxies, and quality of life: the importance of multiple informants for siblings of a critically ill child.

Assessment of quality of life (QoL) has thus far been a neglected approach in describing psychological adaptation in siblings of seriously ill children. The present results concern differences and correspondences between parent- and child-reported QoL in siblings of pediatric cancer patients, at 1 month and 2 years after the diagnosis in the ill child. A total of 83 Siblings aged 7-18 participated in the study at 1 month after the diagnosis; 57 of these siblings (69%) participated in follow-up assessment 24 months later. The parent and child form of the TNO-AZL Children's Quality of Life questionnaire (TACQoL) and the Child Behaviour Check List (CBCL) and Youth Self-Report (YSR) were used to assess QoL and behavioral problems in siblings. The General Health Questionnaire (GHQ) was used to assess parent mental health. Mean differences, correspondences between informants, and partial correlations with parent mental health were assessed at both measurement occasions. Correspondence between parent and child was low to moderate for most domains at both assessments. Low agreement was observed on several domains in our study group compared to reference data. Young siblings (ages 7-11) reported significantly more physical and motor problems at 1 and 24 months and less positive emotions at 24 months than their parents. Adolescent siblings reported more physical complaints at 1 month and more emotional and behavior problems (YSR) at both assessments, but also reported higher social QoL than their parents at 24 months. Parent psychological distress was negatively correlated with parent-reported physical QoL in the sibling. The findings suggest that siblings of children with cancer experience a more serious burden from the illness than is perceived by the parents. Physical complaints and emotional problems remain mostly unnoticed, although distressed parents are more focused on the child's physical health. These results imply that assessment of self-reported well-being is especially relevant in siblings of a critically ill child, to obtain a realistic image of siblings' QoL. Further studies on sibling QoL are needed.

Adolescent↗