Objective To identify coping trajectories from diagnosis through survivorship and test whether particular trajectories exhibit better health-related quality of life (HRQOL) at 5 years post-diagnosis. Methods Families of children with cancer (ages 5-17; M = 10.48, SD = 4.03) were recruited following a new diagnosis of cancer (N = 248). Three follow-up assessments occurred at 1-year (N = 185), 3-years (N = 101), and 5-years (N = 110). Mothers reported on children’s coping using the Responses to Stress Questionnaire for Pediatric Cancer. Survivor HRQOL was measured at 5-year follow-up using self-report on the PedsQL 4.0. Longitudinal patterns of coping were derived using Latent Class Growth Analysis and mean-levels of survivor-report HRQOL were compared across classes. Results Two primary control coping trajectories emerged, “Moderate and Stable” (50%) and “Low-moderate and Decreasing” (50%), with no significant differences in HRQOL across trajectories. Three secondary control coping trajectories emerged, “Moderate-high and Increasing” (54%), “Moderate and Stable” (40%), and “High and Increasing” (6%), with survivors in the last trajectory showing better HRQOL. Two disengagement coping trajectories emerged, “Low and Stable” (85%) and “Low and Variable” (15%), with no significant differences in HRQOL across trajectories. Conclusions Coping trajectories were relatively stable from diagnosis to 5 years. A small group of survivors with high and increasing secondary control coping over time, per mother-report, reported better HRQOL. Future research should consider tailoring coping interventions to children with cancer to improve survivors’ HRQOL.

中文翻译：

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儿童癌症幸存者的应对轨迹和与健康相关的生活质量

目的 确定从诊断到生存的应对轨迹，并测试特定轨迹在诊断后 5 年是否表现出更好的健康相关生活质量 (HRQOL)。方法 在新诊断出癌症（N = 248）后招募患有癌症的儿童（5-17 岁；M = 10.48，SD = 4.03）的家庭。1 年 (N = 185)、3 年 (N = 101) 和 5 年 (N = 110) 进行了三项后续评估。母亲们使用小儿癌症压力反应问卷报告了孩子的应对情况。幸存者 HRQOL 在 5 年随访时使用 PedsQL 4.0 上的自我报告进行测量。纵向应对模式是使用潜在类别增长分析得出的，并比较了不同类别的幸存者报告 HRQOL 的平均水平。结果出现了两个主要的控制应对轨迹，“中度和稳定”（50%）和“低中度和下降”（50%），不同轨迹的 HRQOL 没有显着差异。出现了三个二级控制应对轨迹，“中高和增加”（54%）、“中度和稳定”（40%）和“高和增加”（6%），最后一个轨迹中的幸存者显示出更好的 HRQOL。出现了两种脱离接触应对轨迹，“低且稳定”（85%）和“低且可变”（15%），不同轨迹的 HRQOL 没有显着差异。结论 从诊断到 5 年，应对轨迹相对稳定。根据母亲的报告，随着时间的推移，一小群具有较高和不断增加的二级控制应对能力的幸存者报告了更好的 HRQOL。未来的研究应考虑为癌症儿童量身定制应对干预措施，以提高幸存者的 HRQOL。