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Disability, body image and sports/physical activity in adult survivors of childhood CNS tumors: population-based outcomes from a cohort study

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Abstract

Childhood CNS tumor survivors risk health and functional impairments that threaten normal psychological development and self-perception. This study investigated the extent to which health and functional ability predict adult survivors’ body image (BI) and self-confidence regarding sports and physical activity. The study cohort covered 708 eligible ≥18 year old CNS tumor survivors, and data from 528 (75 %) were analyzed. Disability was estimated using the Health Utilities Index™ Mark2/3, a multidimensional self-report instrument. Physical self-confidence in terms of BI and sports/physical activity-related self-confidence (SPAS) were assessed using the BI and the Sports/Athletics modules of a standardized self-report assessment scale. In adjusted regression models, global health and functional status (GHFS) predicted BI (B = 0.94, 95 % CI 0.69–1.19) and SPAS (B = 0.79, 95 % CI 0.55–1.04). Emotion and pain, and to a lesser degree cognition, speech and vision disability, were associated with poorer BI and SPAS. Gender, sub-diagnosis, and time since diagnosis influenced the relationship between health status and physical self-confidence outcomes. Females had poorer GHFS, BI and SPAS than males. Decreased health and functional ability following childhood CNS cancer intrudes on physical self-confidence, with females being at heightened risk for both disability and negative self-confidence. Identified disability and gender-related risk calls for a follow-up plan that integrates treatment of psychological sequelae in lifetime monitoring of childhood CNS tumor survivors to restore and protect self-image and self-confidence, essential mental health correlates. An expanded plan should recognize the need for such services, optimizing life-long quality of survival for CNS tumor survivors.

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Acknowledgments

The authors express their gratitude to the patients who participated in the study. This work was supported by The Swedish Childhood Cancer Foundation [PROJ09/127], institutional grants, and The Cancer and Traffic Injury Fund, Sweden [C20002].

Conflict of interest

The authors declare that there are no conflict of interests.

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Authors and Affiliations

  1. Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Astrid Lindgren Children’s Hospital, Q6:05, 17176, Stockholm, Sweden

    Krister K. Boman, Lina Hörnquist, Jenny Rickardsson & Göran Gustafsson

  2. Faculty of Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    Lisanne De Graaff

  3. Department of Clinical Sciences, Paediatric Oncology, University of Gothenburg, Gothenburg, Sweden

    Birgitta Lannering

Authors
  1. Krister K. Boman
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  2. Lina Hörnquist
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  3. Lisanne De Graaff
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  4. Jenny Rickardsson
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  5. Birgitta Lannering
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  6. Göran Gustafsson
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Correspondence to Krister K. Boman.

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Boman, K.K., Hörnquist, L., De Graaff, L. et al. Disability, body image and sports/physical activity in adult survivors of childhood CNS tumors: population-based outcomes from a cohort study. J Neurooncol 112, 99–106 (2013). https://doi.org/10.1007/s11060-012-1039-5

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  • DOI: https://doi.org/10.1007/s11060-012-1039-5

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