• Child Health Nursing Research
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• v.19 no.3
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• pp.238-245
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• 2013

Purpose: The purposes of this study were to assess social adjustment of childhood cancer survivors and to identify factors affecting social adjustment. Methods: Data were collected from 79 childhood cancer survivors and his/her parents. The survey consisted of questions related to characteristics, physical functioning, depression, self-esteem and coping strategies. The Social Competence Inventory was used to measure social adjustment in the children. Results: The level of social adjustment of childhood cancer survivors was 83.5 out of a possible 155. Physical functioning, depression, self-esteem, and aggressive or proactive coping strategies were associated with social adjustment. Only physical functioning independently affected social adjustment. Conclusion: The results of this study indicate that there are several factors influencing social adjustment of childhood cancer survivors, and therefore there is a need for programs that deal with all aspects of children's physical as well as emotional health in order to enhance their social adjustment.

• Child Health Nursing Research
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• v.12 no.3
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• pp.304-313
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• 2006

Purpose: This study was done to describe psychosocial adjustment of adolescents who have survived childhood acute lymphocytic leukemia (ALL). Method: Out of a total of 16 adolescents ($11{\sim}20$ years old) registered at the Pediatric Oncology Clinic at one university affiliated hospital, 13 adolescents agreed to participate in this study. The data were collected through in-depth interviews using a semi-structured questionnaire. The contents of the interviews were analyzed using the inductive content analysis method. Result: Three main categories were identified 'personal characteristics', 'coping patterns', and 'interpersonal relationship'. Personal characteristics included self-praise, self-confidence, altruism, being worrisome, and being difficult. Coping patterns included positive thinking, activeness, and avoidance. Interpersonal relationship included appreciation, intimacy, burdened by over protectiveness, and feelings of regret and equality as peers. Conclusion: The results indicate that adolescents who have survived childhood cancer have both positive and negative experiences. It is suggested that care providers identify and support the strengths of the adolescents in order to help them to adjust more positively after the experience of childhood cancer.

• Child Health Nursing Research
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• v.29 no.4
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• pp.280-289
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• 2023

Purpose: This study investigated weight status in survivors of childhood acute lymphocytic leukemia (ALL) and identified related factors. Methods: A retrospective review of the electronic medical records of survivors of childhood ALL (n=230) was conducted. We analyzed the survivors' characteristics, including sex, age, weight status at diagnosis, central nervous system involvement, risk classification, length of treatment, radiation therapy, and hematopoietic stem cell transplantation. Analysis of variance and the chi-squared test were applied to investigate influencing factors. Results: The weight status distribution was as follows: 23 individuals (10.0%) were classified as underweight, 151 individuals (65.7%) were healthy weight, and 56 individuals (24.3%) were overweight/obese. Age at diagnosis (F=10.03, p<.001), weight status at diagnosis (x²=43.41, p<.001), and risk classification (F=10.98, p=0.027) showed significant differences among the weight status groups. Survivors who were older at diagnosis and those in the very high-risk category had a higher likelihood of experiencing underweight status during their survivorship, while survivors who were overweight/obese at diagnosis were more likely to remain overweight/obese at the time of survival. Conclusion: Considering the potential health implications related to an unhealthy weight status in survivors of ALL, it is imperative to undertake early identification and implement interventions for at-risk individuals.

• Child Health Nursing Research
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• v.27 no.3
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• pp.201-210
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• 2021

Purpose: This study analyzed research trends related to childhood and adolescent cancer survivors (CACS) using word co-occurrence network analysis on studies registered in the Korean Citation Index (KCI). Methods: This word co-occurrence network analysis study explored major research trends by constructing a network based on relationships between keywords (semantic morphemes) in the abstracts of published articles. Research articles published in the KCI over the past 10 years were collected using the Biblio Data Collector tool included in the NetMiner Program (version 4), using "cancer survivors", "adolescent", and "child" as the main search terms. After pre-processing, analyses were conducted on centrality (degree and eigenvector), cohesion (community), and topic modeling. Results: For centrality, the top 10 keywords included "treatment", "factor", "intervention", "group", "radiotherapy", "health", "risk", "measurement", "outcome", and "quality of life". In terms of cohesion and topic analysis, three categories were identified as the major research trends: "treatment and complications", "adaptation and support needs", and "management and quality of life". Conclusion: The keywords from the three main categories reflected interdisciplinary identification. Many studies on adaptation and support needs were identified in our analysis of nursing literature. Further research on managing and evaluating the quality of life among CACS must also be conducted.

• Clinical and Experimental Pediatrics
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• v.54 no.6
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• pp.253-259
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• 2011

Purpose: Long-term survivors of childhood cancer appear to have an increased risk for the metabolic syndrome, subsequent type 2 diabetes and cardiovascular disease in adulthood compared to healthy children. The purpose of this study was to investigate the frequency of the metabolic syndrome and associated factors in childhood cancer survivors at a single center in Korea. Methods: We performed a retrospective review of medical records of 98 childhood cancer survivors who were diagnosed and completed anticancer treatment at Samsung Medical Center, Seoul, Korea between Jan. 1996 and Dec. 2007. Parameters of metabolic syndrome were evaluated between Jan. 2008 and Dec. 2009. Clinical and biochemical findings including body fat percentage were analyzed. Results: A total of 19 (19.4%) patients had the metabolic syndrome. The median body fat percentage was 31.5%. The body mass index and waist circumference were positively correlated with the cranial irradiation dose (r=0.38, P<0.001 and r=0.44, P<0.00, respectively). Sixty-one (62.2%) patients had at least one abnormal lipid value. The triglyceride showed significant positive correlation with the body fat percentage (r=0.26, P=0.03). The high density lipoprotein cholesterol showed significant negative correlation with the percent body fat (r=- 0.26, P=0.03). Conclusion: Childhood cancer survivors should have thorough metabolic evaluation including measurement of body fat percentage even if they are not obese. A better understanding of the determinants of the metabolic syndrome during adolescence might provide preventive interventions for improving health outcomes in adulthood.

• Child Health Nursing Research
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• v.20 no.1
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• pp.49-57
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• 2014

Purpose: The purpose of this qualitative study was to explore how adolescent survivors of childhood cancer grieve the death of cancer peers. Methods: Data were obtained from Korean adolescents with cancer between the ages of 13 and 18 (N=12) through semi-structured interviews (face-to-face, telephone, and Internet chatting), observations of the social dynamics of participants in self-help groups, and retrieval of personal Web journals. Based on the grounded theory methodology, data collection and analysis were conducted simultaneously, and constant comparative methods were used. Clarke's situational analysis was adopted, and this paper focused on presenting "how to" and "what we can learn" from this analytic strategy. Results: Mapping examples were visualized using of three modes of maps. Adolescent cancer survivors coped with reminders of the "darkness" that ultimately featured their overall grief. Additionally, adolescents' encounters and avoidance of grief were triggered by introspection and interactions with family and friends. Conclusion: Situational analysis provided an efficient way to analyze the experiences of adolescent survivors of childhood cancer by systematizing possible information within the relational social contexts of the research phenomenon.

• Journal of Music and Human Behavior
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• v.16 no.2
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• pp.27-51
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• 2019

This case study aimed to investigate changes in self-expression following participation in a rap making program with adolescent survivors of childhood cancer. The rap making program was constructed based on the contextual support music therapy model. Three adolescent survivors of childhood cancer participated in six 80-minute individual sessions. During the sessions, each participant engaged in the following tasks: song discussion, lyric creation, and rapping over a selected beat. At pre and posttest, the Self-Expression Scale was completed by participants. Their verbal expressions lyrics were observed during the sessions, and individual interviews with the participants were conducted at the completion of the program. The results demonstrated that the mean rating of the Self-Expression Scale increased after the rap making intervention. Analysis of the participants' verbal expressions and lyrics demonstrated that participants were experiencing difficulties adjusting to school that they wanted to resolve. Furthermore, the analysis of the interviews at posttest found that participants experienced positive changes in self-perception, self-expression, and expectations for their future, compared to the pretest when the participants expressed negative self-perceptions due to difficulties in interpersonal relationships at school and physical limitations. This indicates that rap making can be an effective resource for providing this population with the means to recognize positive attributes about themselves and improve self-expression.

• Child Health Nursing Research
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• v.29 no.2
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• pp.111-127
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• 2023

Purpose: This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). Methods: Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. Results: Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO₂, exercise capacity-upper body, body mass index) revealed no statistical significance. Conclusion: Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.

• Korean Journal of Health Psychology
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• v.16 no.3
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• pp.483-500
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• 2011

Since the introductionof modern therapies, more children with cancer have survived their illness. As a result, an interest in the degree of adjustment achieved by cancer survivors has increased. In this study, quality of life and behavior problemsof child and adolescent cancer survivors were compared with those of healthy controls. Also, the patternsof the discrepancy between parent-report and self-report were compared. Childhood cancer survivors aged 8-18 and their mothers were participated in the study. Parent and self report versions of PedQL were administered to assess the quality of life. K-CBCL and K-YSR were further completed to assess internalizing and externalizing behavior problem. Results suggested that cancer survivors generally showed lower quality of life in physical and social domains and more internalizing behavior problem than healthy control group. However, the results were affected by the domain, age group, and informant. The pattern of discrepancy between parent and self report was similar. All parents reported higher levelsof quality of life and lower levels of behavior problems compared to the self reports of their siblings. In assessing internalizing problem behaviors, cancer survivor group showed greater discrepancy than the healthy control group.The implications, limitations, and directions for future research were also discussed.

• Journal of Ginseng Research
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• v.48 no.1
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• pp.68-76
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• 2024

Background: Although the survival outcomes of childhood cancer patients have improved, childhood cancer survivors suffer from various degrees of immune dysfunction or delayed immune reconstitution. This study aimed to investigate the effect of Korean Red Ginseng (KRG) on T cell recovery in childhood cancer patients who underwent autologous hematopoietic stem cell transplantation (ASCT) from the perspective of inflammatory and senescent phenotypes. Methods: This was a single-arm exploratory trial. The KRG group (n = 15) received KRG powder from month 1 to month 12 post-ASCT. We compared the results of the KRG group with those of the control group (n = 23). The proportions of T cell populations, senescent phenotypes, and cytokine production profiles were analyzed at 1, 3, 6, and 12 months post-ASCT using peripheral blood samples. Results: All patients in the KRG group completed the treatment without any safety issues and showed a comparable T cell repopulation pattern to that in the control group. In particular, KRG administration influenced the repopulation of CD4⁺ T cells via T cell expansion and differentiation into effector memory cell re-expressing CD45RA (EMRA) cells. Although the KRG group showed an increase in the number of CD4⁺ EMRA cells, the expression of senescent and exhausted markers in these cells decreased, and the capacity for senescence-related cytokine production in the senescent CD28^- subset was ameliorated. Conclusions: These findings suggest that KRG promotes the repopulation of CD4⁺ EMRA T cells and regulates phenotypical and functional senescent changes after ASCT in pediatric patients with cancer.