Abstract
Childhood CNS tumor survivors risk health and functional impairments that threaten normal psychological development and self-perception. This study investigated the extent to which health and functional ability predict adult survivors’ body image (BI) and self-confidence regarding sports and physical activity. The study cohort covered 708 eligible ≥18 year old CNS tumor survivors, and data from 528 (75 %) were analyzed. Disability was estimated using the Health Utilities Index™ Mark2/3, a multidimensional self-report instrument. Physical self-confidence in terms of BI and sports/physical activity-related self-confidence (SPAS) were assessed using the BI and the Sports/Athletics modules of a standardized self-report assessment scale. In adjusted regression models, global health and functional status (GHFS) predicted BI (B = 0.94, 95 % CI 0.69–1.19) and SPAS (B = 0.79, 95 % CI 0.55–1.04). Emotion and pain, and to a lesser degree cognition, speech and vision disability, were associated with poorer BI and SPAS. Gender, sub-diagnosis, and time since diagnosis influenced the relationship between health status and physical self-confidence outcomes. Females had poorer GHFS, BI and SPAS than males. Decreased health and functional ability following childhood CNS cancer intrudes on physical self-confidence, with females being at heightened risk for both disability and negative self-confidence. Identified disability and gender-related risk calls for a follow-up plan that integrates treatment of psychological sequelae in lifetime monitoring of childhood CNS tumor survivors to restore and protect self-image and self-confidence, essential mental health correlates. An expanded plan should recognize the need for such services, optimizing life-long quality of survival for CNS tumor survivors.
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Acknowledgments
The authors express their gratitude to the patients who participated in the study. This work was supported by The Swedish Childhood Cancer Foundation [PROJ09/127], institutional grants, and The Cancer and Traffic Injury Fund, Sweden [C20002].
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The authors declare that there are no conflict of interests.
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Boman, K.K., Hörnquist, L., De Graaff, L. et al. Disability, body image and sports/physical activity in adult survivors of childhood CNS tumors: population-based outcomes from a cohort study. J Neurooncol 112, 99–106 (2013). https://doi.org/10.1007/s11060-012-1039-5
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DOI: https://doi.org/10.1007/s11060-012-1039-5