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Difficulties encountered by physicians and mental health professionals in evaluating and caring for affective and behavioral problems in pediatric brain tumor survivors

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Abstract

Background

Pediatric brain tumor survivors (PBTS) present a high risk for emotional and behavioral disorders. When addressing these difficulties, differences in study designs; variety of and disagreement about diagnoses; and intricate links of emotional, behavioral, and cognitive issues may complicate the interpretation of studies and probably also the work of clinicians. We aimed to survey the difficulties perceived by physicians and mental health professionals in their practice and their interest in developing a new evaluative tool.

Methodology

We surveyed 29 health professionals involved in the follow-up of this population. They completed questionnaires about their clinical practice (difficulties, needs, activities) and indicated diagnosis hypotheses and treatment plans on a clinical case developed for this study.

Results

Emotional and behavioral disorders were reported as difficult to assess for 93% of participants. The overlap of symptoms (90%) and the lack of an adapted diagnostic framework (90%) were the main reasons mentioned. Respectively 93%, 90%, and 65% of participants would at least “often” make referrals to psychological (93%), neuropsychological (90%), and psychiatric (65%) assessments and care. Family and group therapy were less common as was drug management. All participants were in favor of creating a tool to help with diagnosis and treatment. When responding to a clinical case, the heterogeneity of participants’ responses highlighted their issues in diagnosing and managing these patients.

Conclusion

This survey exemplifies the difficulties of health professionals related to the evaluation and management of affective and behavioral disorders experienced by PBTS. It underlines the need to help professionals by initiating systematic assessment strategies with this vulnerable population.

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Data availability

We have full control of all primary data and we allow the journal to review them if necessary.

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Acknowledgements

The authors would like to acknowledge all health professionals who participated in this survey.

Author information

Authors and Affiliations

Authors

Contributions

Conception and design of the study: Clémentine Lopez, Serge Sultan, Cécile Flahault; screening and recruitment of the participants of the study: Clémentine Lopez, Christelle Dufour; data analysis and interpretation: Clémentine Lopez, Kristopher Lamore, Serge Sultan, Cécile Flahault; draft and revision of the paper: Clémentine Lopez, Serge Sultan, Kristopher Lamore, Christelle Dufour, Estelle Favré, Léonor Fasse, Cécile Flahault.

Corresponding author

Correspondence to Clémentine Lopez.

Ethics declarations

Ethics approval

In France, studies assessing health professionals’ practice anonymously do not require ethics committee approval. In our study, all answers were fully anonymous and untraceable. However, this survey is a preliminary study associated to PsyCog Family study, a larger research including pediatric brain tumor survivors and their parents. PsyCog Family study was approved by Ethic Committee of Ile-de France VI (ID RCB: 2014-A00924-43).

Consent to participate

Information on the study and its objectives was provided to the participants. Informed consent was obtained from all individual participants included in the study.

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We confirm that the manuscript has been read and approved for submission by all authors, that all persons listed as authors have contributed to preparing the manuscript, and that no persons other than the authors listed have contributed significantly to its preparation.

Conflict of interest

The authors declare no competing interests.

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Lopez, C., Sultan, S., Lamore, K. et al. Difficulties encountered by physicians and mental health professionals in evaluating and caring for affective and behavioral problems in pediatric brain tumor survivors. Support Care Cancer 29, 6771–6780 (2021). https://doi.org/10.1007/s00520-021-06250-5

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