Children with Cancer: The Quality of Life

By Christine Eiser | Go to book overview

6
Measuring Outcomes:
Children Adjusting to Cancer

Summary

Children with any chronic condition are known to be at higher risk of compromised QOL compared with healthy children. In the absence of comprehensive measures of QOL, a number of proxy indicators have been used, including depression, anxiety, self-esteem, and body image.

Despite all their disadvantages, there is little consistent evidence to suggest that children with cancer routinely compare poorly with healthy children. Although parents of children with cancer often report worse adjustment for their children compared with parents of healthy children, such differences are not found when children rate themselves.

A distinction needs to be made between coping with cancer-related stressors (taking medication) and everyday stressors (going to school or taking exams). Different coping strategies are used depending on the nature of the stressor, and children's ability to use more appropriate strategies appears to increase with age.

A major limitation of much of this work is the focus on single outcomes and failure to acknowledge the relationship between different outcome variables. Thus, cancer may directly affect physical appearance, but how far this matters depends on the child's self-esteem and coping strategies. This work has considerable potential for rehabilitation programs, but this has not been acknowledged.

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