Social attainment in physically well-functioning long-term survivors of pediatric brain tumour; the role of executive dysfunction, fatigue, and psychological and emotional symptoms

ABSTRACT

The purpose of this cross-sectional study was to investigate long-term social attainment in physically well-functioning adult survivors of pediatric brain tumour (PBT) and identify demographic, medical, and psychological factors related to poor social outcomes, with a special focus on the significance of executive dysfunction. One hundred and fourteen PBT survivors and a healthy control group provided personal data on social outcomes, i.e., education, work, and government benefits, and completed questionnaires on executive function (EF), psychological and emotional difficulties, and fatigue. A significantly higher number of survivors compared to healthy controls reported having received educational adjustments and substantial government benefits, and significantly more survivors than controls were currently not engaged in regular employment/training. PBT survivors and healthy controls did not differ on educational level or living situation. The factors most strongly associated with poor social outcomes were self-reported executive dysfunction, difficulties with adaptive functioning, and fatigue. The findings show that physically well-functioning PBT survivors are at risk of poorer social outcomes and financial dependence in adulthood compared to their healthy peers, and underline the importance of investigating EF in short- and long-term follow-ups. Future rehabilitation efforts should focus more on compensatory strategies for executive dysfunction and improving EF skills.

KEYWORDS:

• Pediatric brain tumour
• Executive functions
• Social outcome
• Long-term
• Fatigue
• Psychological function

Acknowledgements

The authors would like to thank the participants, as well as clinical neuropsychologists Bjørg Eli Eide, Child Habilitation Services, Haukeland University Hospital, and Oddmar Ole Steinsvik, Child Habilitation Services, University Hospital of North Norway, for assistance with data collection.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Norwegian Cancer Society under grant 6865381; the Norwegian ExtraFoundation for Health and Rehabilitation under grant 2013/2/0234; Oslo University Hospital’s Childrens’ Foundation under grant 36219; and The Renée and Bredo Grimsgaard Foundation.