Effects of a combined physical and psychosocial intervention program for childhood cancer patients on quality of life and psychosocial functioning: results of the QLIM randomized clinical trial.
Although survival rates in childhood cancer have improved, prevention and reduction of late effects remain important. This study evaluates the effects of a combined physical exercise and psychosocial intervention on health-related quality of life (HrQoL) and psychosocial functioning in childhood cancer patients.



In this multicenter randomized controlled trial, cancer patients (aged 8-18 years) and their parents filled in questionnaires on HrQoL, depressive symptoms, behavioral problems, and self-esteem. Measurements were conducted at baseline, shortly after the 12-week intervention period and 12 months after baseline. Generalized estimating equations analyses were performed to assess short-term and long-term psychosocial effects.



Of the 174 eligible patients, 68 (39.1%) participated. The intervention group consisted of 30 participants at baseline [mean age 13.0 (SD 3.0) years; 53% male], 26 at short-term and 22 at long-term follow-up. The 'care as usual' control group consisted of 38 participants at baseline [mean age 12.6 (SD 3.1) years; 53% male], 33 at short-term and 31 at long-term follow-up. Overall, the intervention did not improve psychosocial functioning and HrQoL. According to parent-proxy reports, the intervention leads to a greater improvement on pain-related HrQoL on both the short (β = 13.4; 95% CI: 3.0; 23.8) and long term (β = 13.0; 95% CI: 1.6; 24.4) and to greater improvement on procedural anxiety immediately after the intervention (β = 12.6; 95% CI: 1.9; 23.3).



A combined physical and psychosocial training for children with cancer did not have effects on HrQoL or psychosocial functioning, with exception of modest positive effects on parent-reported pain and procedural anxiety Copyright © 2015 John Wiley & Sons, Ltd.
Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
Elisabeth M
EM
van Dijk-Lokkart
Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.
Katja I
KI
Braam
Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.
Eline
E
van Dulmen-den Broeder
Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.
Gertjan J L
GJ
Kaspers
Child Development & Exercise Center, Wilhelmina's Children's Hospital, UMC Utrecht, Utrecht, The Netherlands.
Tim
T
Takken
Psychosocial department, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Martha A
MA
Grootenhuis
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Isabelle C
IC
Streng
Department of Pediatric Oncology/Hematology, Wilhelmina's Childrens Hospital, UMC Utrecht, Utrecht, The Netherlands.
Marc
M
Bierings
Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Johannes H
JH
Merks
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.|Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Marry M
MM
van den Heuvel-Eibrink
Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.
Margreet A
MA
Veening
Department of Medical Psychology, Wilhelmina's Children's Hospital, UMC Utrecht, Utrecht, The Netherlands.
Jaap
J
Huisman
D000293:Adolescent; D001007:Anxiety / Q000517:prevention & control; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D003376:Counseling / Q000379:methods*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D010290:Parents / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors / Q000523:psychology*