Psychosocial adjustment of five-year survivors of childhood cancer.

This study assessed the psychosocial adjustment of 31 childhood cancer patients five years after diagnosis compared with their school peers. The children were aged 8 to 18 years at the time of the study. No significant difference was found in self-rated measures of anxiety and self-esteem. However, there were significant differences in teacher ratings of concentration, academic progress, and popularity with peers and in parent and teacher ratings of behavioural adjustment (Rutter Scales A and B), indicating that the survivors of childhood cancer were at increased risk of problems. Relationships between behavioural adjustment scores and child, family, and illness variables were investigated within the cancer-survivor group. No significant relationship was found with illness variables or social class. Significant associations were found between behavioural adjustment and parental psychological distress, parental coping strategies, children's perceptions of their own scholastic competence, and their relationships with peers. In addition, children who had shown considerable problems in school work one year after diagnosis were more at risk for behavioural problems at this later state. The findings have implications for the provision of support to childhood cancer patients, their families, and their teachers that may help to prevent later problems in adjustment.