{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:40:02Z","timestamp":1788471602999,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006244","name":"Stichting Kinderen Kankervrij","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006244","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)\u2010LATER cohort (diagnosed 1963\u20132001) part 2 (age\u00a0\u2265\u00a018\u00a0years, diagnosed &lt; 18\u00a0years, \u2265 5\u00a0years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self\u2010Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self\u2010Rating Scale for Post\u2010Traumatic Stress Disorder, TNO\u2010AZL Questionnaire for Adult Health\u2010Related Quality of Life, and Short Form\u201036). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1382 CCS participated, all diagnosed \u2265 15\u00a0years ago. The mean age of participating CCS was 36\u00a0years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self\u2010esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self\u2010esteem (10\u00d7), and perceived burden (9\u00d7). Self\u2010esteem (all <jats:italic>\u03b2<\/jats:italic>\u00a0\u2264\u20090.47) and perceived burden (all <jats:italic>\u03b2<\/jats:italic>\u00a0\u2264\u20090.38) demonstrated strongest associations of medium\/large size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Perceptions of childhood cancer, illness cognitions, self\u2010esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio\u2010demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self\u2010esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.9313","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T04:07:41Z","timestamp":1727928461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Risk and Protective Factors of Psychosocial Functioning in\u00a0Survivors of Childhood Cancer: Results of the DCCSS\u2010LATER Study"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7835-1802","authenticated-orcid":false,"given":"Anne","family":"Maas","sequence":"first","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-3230","authenticated-orcid":false,"given":"Heleen","family":"Maurice\u2010Stam","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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M (Lieke)","family":"Feijen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jop C.","family":"Teepen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alied M.","family":"van der Aa\u2010van Delden","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Streefkerk","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline","family":"van Dulmen\u2010den Broeder","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology\/Hematology Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim J. E.","family":"Tissing","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"Beatrix Children's Hospital University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline J.","family":"Loonen","sequence":"additional","affiliation":[{"name":"Center of Expertise for Cancer Survivorship, Department of Hematology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena J. H.","family":"van der Pal","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrica C. H.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"Sophia Children's Hospital Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marry M.","family":"van den Heuvel\u2010Eibrink","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"Sophia Children's Hospital Erasmus Medical Center  Rotterdam The Netherlands"},{"name":"Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Ronckers","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"Division of Childhood Cancer Epidemiology Institute of Medical Biostatistics Informatics and Epidemiology University Medical Center of the Johannes Gutenberg University  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Neggers","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"Department of Medicine, Section Endocrinology Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorine","family":"Bresters","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"Willem Alexander Children's Hospital Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marloes","family":"Louwerens","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta A. 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