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Caregivers matter: Neurological vulnerability for pediatric brain tumor survivors
Emily L Moscato1, Allison P Fisher1, Natasha Pillay-Smiley2,3
1Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center; Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA.
Insights
Parenting warmth and control impact quality of life (QOL) for pediatric brain tumor survivors (PBTS) exposed to neurotoxic treatments. Supportive parenting may mitigate negative QOL effects from intensive therapies.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Psychology
Background:
- Pediatric brain tumor survivors (PBTS) face risks to quality of life (QOL) from neurotoxic treatments.
- Parenting factors, like protectiveness, may influence QOL in childhood cancer survivors.
- The specific impact of parenting behaviors on PBTS QOL requires further investigation.
Purpose of the Study:
- To examine if parenting behaviors moderate the association between neurotoxic treatment intensity and QOL in PBTS.
- To explore the roles of caregiver warmth and psychological control in the context of neurotoxicity and survivor QOL.
Main Methods:
- 40 PBTS (ages 10-25) and 47 caregivers completed QOL and parenting behavior measures.
- Neurotoxicity was categorized as moderate/high or low using the Pediatric Neuro-Oncology Rating of Treatment Intensity.
- Moderator effects of parenting behaviors on the neurotoxicity-QOL relationship were analyzed.
Main Results:
- Survivor-reported caregiver warmth moderated QOL outcomes; lower warmth amplified negative QOL effects of moderate/high neurotoxicity.
- Caregiver-reported psychological control also moderated QOL; high psychological control intensified the negative impact of neurotoxicity on QOL.
Conclusions:
- Parenting behaviors significantly interact with neurotoxic treatment effects on PBTS QOL.
- Family support systems are crucial for optimizing QOL in PBTS.
- Future research should focus on prospective studies to develop targeted psychosocial interventions.
Background:
Pediatric brain tumor survivors (PBTS) are at risk of worse quality of life (QOL) due to the impact of neurotoxic treatments on the developing nervous system. Parenting factors such as protectiveness have been linked to worse QOL in childhood cancer survivors generally, but have yet to be explored for PBTS. We examined whether parenting behaviors moderated the association between neurotoxic treatment and QOL for PBTS.
Methods:
PBTS (n = 40; ages 10-25) and their caregivers (n = 47) completed measures of parenting behaviors including warmth (support/connectedness) and psychological control (protectiveness) and QOL. We divided the sample into moderate/high and low neurotoxicity groups based on chart review using the Pediatric Neuro-Oncology Rating of Treatment Intensity and examined moderator effects.
Results:
Survivor-reported primary caregiver warmth moderated the relationship between neurotoxicity and caregiver-reported QOL. Moderate/high neurotoxicity was associated with lower caregiver-reported QOL only when survivor-reported primary caregiver warmth was low, P = .02. Similar results were found for survivor-reported QOL. Caregiver-reported psychological control moderated the association between neurotoxicity and caregiver-reported QOL such that neurotoxicity only affected QOL at high levels of psychological control, P = .01.
Conclusions:
Heightened associations between parenting and QOL in the context of neurotoxic treatments underscore the need to better support PBTS. Findings are consistent with research suggesting that family factors may be particularly important for children with other neurological insults. Limitations include cross-sectional design and a small/heterogeneous clinical sample with low ethnic/racial diversity. Prospective studies are needed to refine evidence-based screening and develop psychosocial intervention strategies to optimize QOL for PBTS and their families.
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