Social Vulnerability and the Relationship Between Maternal Caregiver Condition Management Ability and Transition Readiness in Young Adult Survivors of Childhood Brain Tumors.
In 53 maternal caregivers of young adult childhood brain-tumor survivors living at home, cognitive late effects were associated with lower transition readiness, while caregiver condition-management ability showed a limited and subscale-specific relationship among families with lower social vulnerability.
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In 53 maternal caregivers of young adult childhood brain-tumor survivors living at home, cognitive late effects were associated with lower transition readiness, while caregiver condition-management ability showed a limited and subscale-specific relationship among families with lower social vulnerability.
Research significance
The record provides observational evidence linking cognitive late effects with transition-readiness difficulties; it suggests—but does not test—that cognitive rehabilitation and caregiver-focused condition-management support tailored to social vulnerability could improve selected transition skills.
Source abstract
PURPOSE: To utilize the social-ecological model of adolescent and young adult readiness to transition to understand the interplay of social determinants of health with condition management ability (CMA) of caregivers of young adult survivors of childhood brain tumors (YAS). METHODS: Maternal caregivers (N = 53) of 18- to 29-year-old YAS ≥2 years off-treatment living at home were screened into a problem-solving intervention randomized trial based on their risk of poorer CMA. They completed the Transition Readiness Assessment Questionnaire (TRAQ) and rated YAS cognitive late effect severity prior to randomization. Medical experts scored cognitive medical sequelae and treatment intensity. Social vulnerability was rated using the CDC/ATSDR social vulnerability index. RESULTS: CMA was not related to transition readiness when accounting for cognitive late effects. Cognitive late effects were associated with transition readiness (p < 0.01). For families with less social vulnerability, higher cognitive late effects were associated with poorer CMA, which was in turn related to lower managing daily activities and tracking health issues subscales of transition readiness. There were no other significant relationships. CONCLUSION: For families with more resources, CMA may explain the relationship between cognitive late effects and transition readiness, although findings were inconsistent by the TRAQ subscale. Additional investigation of social vulnerability in CMA and transition readiness is needed. Findings highlight the saliency of mitigating cognitive late effects resulting from childhood brain tumors and their treatment. There is a significant need for ongoing resources to support both ongoing condition management and transition readiness in the period of young adulthood for YAS.