Grant Details
Grant Number: |
5R03CA093185-02 Interpret this number |
Primary Investigator: |
Soliday, Elizabeth |
Organization: |
Washington State University |
Project Title: |
Steroid Effects in Pediatric All Patients |
Fiscal Year: |
2002 |
Abstract
DESCRIPTION (provided by applicant):
Clinicians and families generally acknowledge the tremendous impact that
high-dose steroid therapy can have on pediatric cancer patients' quality of
life, yet only four studies on the psychological/behavioral effects of
steroids in pediatric cancer patients have been published in the past 30
years. The objectives of this pilot study are to: a) identify areas of
intervention need by assessing the frequency and severity of steroid-related
changes in children's behavior, cognition, and disease-related psychosocial
adjustment; b) examine how specific risk and resistance variables predict
children's behavior and quality of life during steroid administration; c)
explore relationships between steroids' effects and adherence. This will be
the first theoretically based, prospective, longitudinal, repeated measures
study of the psychosocial and neurocognitive effects of steroids. Guided by a
stress and resistance framework and previous research, the pre-treatment
baseline assessment of predictors could lead to early identification of and
intervention with children at risk for adverse responses. It will also be the
first study to control for maturation and test sensitivity by including a
healthy sibling comparison group. In the early post-diagnosis period before
remission induction treatment, children's primary caregivers will complete
baseline measures of their own psychological functioning, family functioning,
their children's behavior and health-related quality of life; children will
complete neuropsychological measures of memory and attention. Assessments will
be repeated on day ten of induction and twice during consolidation. Healthy
siblings will be assessed at the same time points. Compared to healthy sibling
controls, it is expected that children with ALL will experience greater
adjustment difficulties during steroid administration. It is also expected
that a physician rating of less severe disease status/better prognosis, older
child age, male sex, and more positive family functioning will predict more
positive psychosocial (behavior and quality of life) outcomes during steroid
administration. Repeated measures analyses of variance will be used to test
effects of treatment period (baseline, 3 steroid periods) and group status
(ALL, healthy sibling) on dependent measures. Multiple regression models will
be used to test predictive effects of stress and resistance factors on
children's functioning during steroid dosing. Correlations will be used to
test relationships between steroid effects and adherence. This study will
contribute to the knowledge of steroids' effects and the predictors thereof so
that prophylactic interventions to improve quality of life can be advanced.
Publications
None