title: What a Pain: The Impact of Physical Symptoms and Health Management on Pursuit of Personal Goals Among Adolescents with Cancer.
abstract: OBJECTIVE
  This study examined health-related hindrance (HRH) of personal goals among adolescents receiving treatment for cancer and healthy peers.
  
  
  METHODS
  Adolescents and parents completed measures of demographics and psychosocial variables. Adolescents reported on their HRH, measured by ratings of the impact of pain, fatigue, other physical symptoms, and doing things to manage their health on self-identified personal goals. Disease-related information was abstracted from patient charts.
  
  
  RESULTS
  Adolescents with cancer experienced significantly more HRH than healthy peers, and their HRH was significantly associated with poorer health-related quality of life (p < 0.001), negative affect (p = 0.03), and depressive symptoms (p = 0.03). Risk and resilience factors associated with HRH for those with cancer included pain (current and past month severity, frequency, and pain-related quality of life), fatigue, nausea, cognitive problems, worse parent-reported family functioning, and female gender. When testing these significant associates in a regression model predicting HRH among adolescents with cancer, those with more severe pain (p < 0.001) and worse parent-reported family functioning (p = 0.01) were significantly associated with HRH; fatigue was marginally (p = 0.09) significant.
  
  
  CONCLUSIONS
  Results suggest that HRH is a significant problem for adolescents with cancer, particularly those who are experiencing pain. Addressing pain and other symptom management, enhancing family functioning, and helping adolescents adjust their goals or enhance support for goal pursuit may reduce HRH among adolescents with cancer. This may improve psychosocial well-being, address adolescent unmet needs, and ultimately help adolescents with cancer maintain normal developmental trajectories.
authors: 1 Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.|2 Perelman School of Medicine, The University of Pennsylvania , Philadelphia, Pennsylvania.
authors: Lisa A
authors: LA
authors: Schwartz
authors: 3 Department of Psychology, The University of Pennsylvania , Philadelphia, Pennsylvania.
authors: Lauren D
authors: LD
authors: Brumley
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000523:psychology; D010146:Pain / Q000523:psychology*; D059408:Pain Management / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult
keywords: health-related quality of life; morbidity; pain management; psychosocial; supportive care