Document Detail

Restricted access to the environment and quality of life in adult survivors of childhood brain tumors.
MedLine Citation:
PMID:  23143294     Owner:  NLM     Status:  MEDLINE    
Survivors of pediatric brain tumors (BTs) are at-risk for late effects which may affect mobility within and access to the physical environment. This study examined the prevalence of and risk factors for restricted environmental access in survivors of childhood BTs and investigated the associations between reduced environmental access, health-related quality of life (HRQOL), and survivors' social functioning. In-home evaluations were completed for 78 BT survivors and 78 population-based controls matched on age, sex, and zip-code. Chi-square tests and multivariable logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) for poor environmental access and reduced HRQOL. The median age of survivors was 22 years at the time of study. Compared to controls, survivors were more likely to report avoiding most dimensions of their physical environment, including a single flight of stairs (p < 0.001), uneven surfaces (p < 0.001), traveling alone (p = 0.01), and traveling to unfamiliar places (p = 0.001). Overall, survivors were 4.8 times more likely to report poor environmental access (95 % CI 2.0-11.5, p < 0.001). In survivors, poor environmental access was associated with reduced physical function (OR = 3.6, 95 % CI 1.0-12.8, p = 0.04), general health (OR = 6.0, 95 % CI 1.8-20.6, p = 0.002), and social functioning (OR = 4.3, 95 % CI 1.1-17.3, p = 0.03). Adult survivors of pediatric BTs were more likely to avoid their physical environment than matched controls. Restricted environmental access was associated with reduced HRQOL and diminished social functioning. Interventions directed at improving physical mobility may have significant impact on survivor quality of life.
Tara M Brinkman; Zhenghong Li; Joseph P Neglia; Amar Gajjar; James L Klosky; Rachel Allgood; Marilyn Stovall; Kevin R Krull; Gregory T Armstrong; Kirsten K Ness
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-11-11
Journal Detail:
Title:  Journal of neuro-oncology     Volume:  111     ISSN:  1573-7373     ISO Abbreviation:  J. Neurooncol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-15     Completed Date:  2013-06-26     Revised Date:  2014-04-23    
Medline Journal Info:
Nlm Unique ID:  8309335     Medline TA:  J Neurooncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  195-203     Citation Subset:  IM    
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MeSH Terms
Age Factors
Brain Neoplasms / complications,  mortality,  psychology*
Cognition / physiology
Logistic Models
Middle Aged
Motor Activity
Quality of Life*
Retrospective Studies
Social Adjustment*
Stress, Psychological / etiology
Survivors / psychology*
Young Adult
Grant Support
P30 CA021765/CA/NCI NIH HHS; R25 CA023944/CA/NCI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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