A Prospective Study of Social Competence in Pediatric Brain Tumor Survivors

儿科脑肿瘤幸存者社交能力的前瞻性研究

• 批准号: 8566235
• 负责人: Matthew C. Hocking
• 金额: $ 11.72万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-23 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8566235
• 关键词: Address; Affect; Affective; Aftercare; Age; Animal Tarsus; Area; Attention; Award; Biological; Brain; Brain Diseases; Brain Neoplasms; Brain region; Cancer Center; Caregivers; Central Nervous System Diseases; Child; Childhood; Childhood Brain Neoplasm; Clinical; Data Collection; Development; Disease; Doctor of Philosophy; Exhibits; Family; Focus Groups; Friendships; Funding; Goals; Grant; Health; Intervention; Investigation; Journals; Knoll brand of cerivastatin sodium; Late Effects; Malignant Childhood Neoplasm; Measures; Medical; Mentorship; Methods; Modeling; Neuraxis; Neurocognitive; Outcome; Parent-Child Relations; Parents; Participant; Pathway interactions; Patients; Pediatric Brain Injury; Pediatric Hospitals; Pediatric Oncology; Phase; Philadelphia; Population; Problem Solving; Prospective Studies; Publications; Quality of life; Recruitment Activity; Research; Research Peer Review; Research Personnel; Risk; Sampling; Scientific Advances and Accomplishments; Secondary to; Shapes; Short-Term Memory; Social Adjustment; Social Environment; Social Functioning; Social Interaction; Social Problems; Solid Neoplasm; Survival Rate; Survivors; Testing; Time; Training; Training Support; Traumatic Brain Injury; Treatment Factor; Writing; base; cancer therapy; career; childhood cancer survivor; clinical care; cognitive neuroscience; design; experience; family influence; functional outcomes; health care economics; health related quality of life; heuristics; improved; information processing; memory process; neuro-oncology; peer; prospective; psychologic; psychosocial; psychosocial adjustment; resilience; skills; social; social model; social skills; survivorship; symposium; tumor

DESCRIPTION (provided by applicant): Childhood brain tumor survivors experience significant neurocognitive and social deficits secondary to their disease and related medical treatments that contribute to them having the poorest health- related quality of life among childhood cancer survivors. Although children surviving brain tumors have significant social adjustment difficulties (e.g., fewer friendships, less accepted by peers), little research has examined their social competence over time or identified predictors of their social adjustment. Findings from other pediatric brain injury populations (e.g., traumatic brain injury) suggests deficits in social information processing and illustrates the influence of family functioning on social outcomes yet these associations have not been explored in pediatric brain tumor survivors. This proposal would be the first known prospective investigation of survivor social competence and one of the few studies to examine the interrelations between components of social information processing, family functioning and social adjustment. The specific aims of this application are to 1) qualitatively describe caregivers' perspectives on the factors contributing t survivor social adjustment after treatment; 2) compare components of social information processing (social problem- solving, social affective functions, neurocognitive functioning) between pediatric brain tumor and solid tumor survivors and examine associations between components of social information processing and social adjustment over time; and 3) examine the influence of risk and resilience factors (treatment intensity, family functioning, parent-survivor relationship quality) on survivor social information processing and social adjustment. Methods: Participants will be recruited from The Cancer Center at The Children's Hospital of Philadelphia. A qualitative phase at the outset of the project with a separate sample of caregivers of long-term pediatric BT survivors will inform the prospective design by exploring perspectives on the factors that shape survivor social adjustment outcomes. In the longitudinal phase, participants will include survivors of pediatric brain tumor and survivors of pediatric soli tumor, ages 7-14, and a parent or caregiver. Data collection will occur about one month after the end of tumor-directed treatment and again one and two years later. Assessments at each time point will include measures of survivor social information processing, neurocognitive functioning, social skills and social adjustment, as well as family functioning and parent-survivor relationship quality. It is hypothesized that(1) pediatric brain tumor survivors will have worse social information processing than solid tumor survivors, (2) poorer social-affective function and social problem-solving will be associated with worse survivor social adjustment over time, (3) neurocognitive functioning will be associated with poorer social-affective functioning, social problem-solving and social adjustment, and (4) better family functioning at baseline will be associated with smaller declines across domains of social information processing and social adjustment over time. Career Goals: This K07 award will provide the necessary training and mentorship for Matthew Hocking, Ph.D. to become an independent clinical researcher and leader in the field of pediatric psycho-oncology and pediatric neuro-oncology survivorship. Through this award, Dr. Hocking will 1) gain expertise in specific content areas relevant to understanding the interplay between biological, psychological and social context factors in contributing to survivor psychosocial outcomes; 2) acquire expertise in methodological (e.g., healthcare economics, cognitive neuroscience) and statistical approaches to examining the neurodevelopmental late effects of pediatric brain tumor survivors; 3) enhance skills related to the development and testing of psychosocial interventions directed at improving the social functioning of pediatric cancer survivors; and 4) advance scientific skills in grant writing and peer-reviewed research publication. To advance these training goals, Dr. Hocking has assembled a highly experienced mentorship team, led by Drs. Lamia Barakat and Anne Kazak, and a carefully constructed training plan that includes coursework, seminars, journal clubs, national research conferences, writing groups, and different research lab experiences. With the outlined training and support associated with this award, Dr. Hocking will be well poised to initiate an independent research career dedicated to improving the social functioning and quality of life of pediatric brain tumor survivors Importance: Findings from this study could inform clinical care with childhood brain tumor patients and subsequent research among a broader group of survivors affected by central nervous system disease. This study might identify potential mechanisms that mitigate the effects of cancer treatment on survivor social functioning and improve quality of life for survivors and their families. The proposed K07 award will prepare Dr. Hocking to apply for R01-level funding to advance this research and for R21-level funding to pilot a family- based intervention directed at improving social adjustment outcomes in pediatric brain tumor survivors.

描述（由申请人提供）：儿童脑肿瘤幸存者因疾病和相关医疗治疗而经历严重的神经认知和社会缺陷，这导致他们在儿童癌症幸存者中拥有最差的健康相关生活质量。尽管脑肿瘤幸存的儿童存在严重的社会适应困难（例如，友谊较少，同龄人较少接受），但很少有研究随着时间的推移检查他们的社交能力或确定其社会适应的预测因素。其他儿科脑损伤人群（例如创伤性脑损伤）的研究结果表明，社会信息处理存在缺陷，并说明了家庭功能对社会结果的影响，但尚未在儿科脑肿瘤幸存者中探索这些关联。该提案将是第一个已知的对幸存者社会能力的前瞻性调查，也是为数不多的研究社会信息处理、家庭功能和社会适应各组成部分之间相互关系的研究之一。该应用程序的具体目的是 1) 定性描述护理人员对治疗后幸存者社会适应影响因素的看法； 2）比较儿科脑肿瘤和实体瘤幸存者之间的社会信息处理组成部分（社会问题解决、社会情感功能、神经认知功能），并检查社会信息处理组成部分与社会适应之间随时间的关联； 3）考察风险和复原力因素（治疗强度、家庭功能、父母与幸存者关系质量）对幸存者社会信息处理和社会适应的影响。方法：参与者将从费城儿童医院癌症中心招募。项目开始时的定性阶段将采用长期儿科 BT 幸存者的照顾者单独样本，通过探索影响幸存者社会适应结果的因素的观点，为未来的设计提供信息。在纵向阶段，参与者将包括 7-14 岁的儿科脑肿瘤幸存者和儿科孤立性肿瘤幸存者，以及父母或照顾者。数据收集将在肿瘤定向治疗结束后大约一个月进行，并在一年和两年后再次收集。每个时间点的评估将包括幸存者社会信息处理、神经认知功能、社交技能和社会适应以及家庭功能和父母与幸存者关系的测量 质量。假设：(1) 儿童脑肿瘤幸存者的社会信息处理能力比实体瘤幸存者差，(2) 较差的社会情感功能和社会问题解决能力将与随着时间的推移幸存者的社会适应能力较差有关，(3) 神经认知功能功能将与较差的社会情感功能、社会问题解决和社会适应相关，并且（4）基线上更好的家庭功能将与随着时间的推移社会信息处理和社会适应领域较小的下降相关。职业目标：该 K07 奖项将为 Matthew Hocking 博士提供必要的培训和指导。成为儿科心理肿瘤学和儿科神经肿瘤学生存领域的独立临床研究员和领导者。通过该奖项，霍金博士将 1) 获得特定内容领域的专业知识，以了解生物、心理和社会背景因素之间的相互作用，从而影响幸存者的心理社会结果； 2) 获得方法论（例如医疗经济学、认知神经科学）和统计方法方面的专业知识，以检查儿科脑肿瘤幸存者的神经发育后期影响； 3) 增强与开发和测试旨在改善儿科癌症幸存者社会功能的社会心理干预措施相关的技能； 4) 提高资助写作和同行评审研究发表的科学技能。为了推进这些培训目标，霍金博士组建了一支经验丰富的指导团队，由 Drs. Lamia Barakat 和 Anne Kazak 以及精心制定的培训计划，包括课程、研讨会、期刊俱乐部、国家研究会议、写作小组和不同的研究实验室经验。凭借与该奖项相关的培训和支持，霍金博士将做好准备开始独立的研究生涯，致力于改善儿科脑肿瘤幸存者的社会功能和生活质量。 重要性：这项研究的结果可以为临床护理提供信息儿童脑肿瘤患者以及随后对更广泛的受中枢神经系统疾病影响的幸存者群体进行的研究。这项研究可能会确定减轻癌症治疗对幸存者社会功能的影响并改善幸存者及其家人的生活质量的潜在机制。拟议的 K07 奖项将为霍金博士申请 R01 级资金来推进这项研究，并申请 R21 级资金来试点基于家庭的干预措施，旨在改善儿科脑肿瘤幸存者的社会适应结果。