244899 Quality of life among children with and without cancer: The role of socioeconomic and family factors

Monday, October 31, 2011: 2:50 PM

Kristin Litzelman, BA , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison
Kristine Catrine, MD , Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Diane Puccetti, MD , Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Peggy Possin, RN , Clinics-Pediatric Specialties, UW Hospital and Clinics, Madison, WI
Whitney P. Witt, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
     
Background: The relationship between low socioeconomic status and adverse child health outcomes has been well established. The purpose of this study was to evaluate whether family functioning mediated this relationship for children with and without cancer.

Methods: In this cross-sectional study, parents of 71 children with and 135 children without cancer or brain tumors completed in-person interviewer-assisted surveys assessing sociodemographics, child health-related quality of life (QOL), and family functioning. Cancer-related clinical characteristics were captured through medical record abstraction. Chi-squared tests examined parent, child, and family characteristics. Staged multivariate regressions were used to determine the relationship between socioeconomic status and child QOL; Sobel tests were used to evaluate significant attenuation.

Results: Lower income and parental education were associated with worse child QOL. The effect of income differed by case status; income had a much larger effect on QOL in children with cancer than healthy children. Among children with cancer, income was significantly associated with child QOL (beta=7.89), controlling for child age and time since diagnosis. This relationship was significantly attenuated by family burden (2.85 point reduction) and caregiver burden (2.63 point reduction). Sobel tests confirmed significant mediation (p-values<0.05).

Conclusions: Family functioning partially explains the relationship between low socioeconomic status and poor QOL outcomes among children with cancer. Low-income families may have fewer resources to cope with their child's illness, resulting in greater burden that may adversely impact child QOL. Increased support, monitoring, and referrals to reduce burden for low-income families may lead to improved QOL in children with cancer.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
1) Describe the role of family factors in the association between low socioeconomic status and adverse quality of life outcomes among children with cancer. 2) Explain the potential mechanism(s) behind this finding.

Keywords: Quality of Life, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I assisted in recruitment and data collection for this study, and conducted the data analyses and interpretation presented in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Cancer Prevention and Control
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