Disability, body image and sports/physical activity in adult survivors of childhood CNS tumors: population-based outcomes from a cohort study.
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.
Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Astrid Lindgren Children's Hospital, Q6:05, 17176 Stockholm, Sweden. krister.boman@ki.se
Krister K
KK
Boman
Lina
L
Hörnquist
Lisanne
L
De Graaff
Jenny
J
Rickardsson
Birgitta
B
Lannering
Göran
G
Gustafsson
D000203:Activities of Daily Living; D000328:Adult; D001828:Body Image; D016543:Central Nervous System Neoplasms / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D018672:Community Health Planning; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D012044:Regression Analysis; D012649:Self Concept; D013177:Sports; D055815:Young Adult