75 Self-interpretation of Symptoms in Pediatric Brain Tumor Patients: A Comparison Study of Symptoms with Other Cancer Types

Faculty Mentor: Lauri Linder (Nursing, University of Utah)

ABSTRACT

Background: Enhanced survival in pediatric oncology has redirected focus toward long‐term well‐ being, especially for children with brain tumors, who often face enduring neurological, endocrine, and social challenges due to their disease and treatment. However, traditional symptom assessment methods frequently fail to engage younger patients or capture the full breadth of their experiences. Child-centered tools—like the MSAS 7–12—have demonstrated reliability and validity in eliciting accurate self-reports from children aged 7–12, making them promising instruments for this population.

Purpose: The goal of this thesis is to 1) understand how pediatric patients with brain tumors self- report symptoms in comparison to peers with leukemia/lymphoma and other solid tumors, and 2) to examine whether symptom frequency, severity, and distress differ by time since diagnosis among patients with brain tumors.

Methods: This cross-sectional analysis involves 95 children (aged 6–12, mean 9 ± 2 years; 57% male) from an instrument development study. Participants completed the MSAS 7–12, which evaluates the prevalence, frequency, severity, and distress of eight common cancer-related symptoms. Patients were categorized by diagnosis (brain tumor, leukemia/lymphoma, other solid tumor) and, among the brain tumor group, by time since diagnosis (≤ 6 months vs. > 6 months). ANOVA assessed differences across diagnostic groups, and non-parametric tests compared patients with brain tumors based on time since diagnosis.

Results: Fatigue (40%) and pain (28%) were the most frequently reported symptoms across diagnoses. Patients with brain tumors reported fewer symptoms on average (mean = 1.57) and lower severity (1.49) and distress (0.62) compared to those with leukemia/lymphoma (mean = 1.92; severity = 1.66; distress = 0.85) and other solid tumors (mean = 2.63; distress = 1.15). One-way ANOVA tests showed no significant differences between diagnostic groups in average symptoms reported (p = 0.16), severity (p = 0.80), and symptom distress (p = 0.42). Within the brain tumor cohort, children diagnosed within six months reported a higher symptom count (mean = 3.3 vs. 1.3), while average severity and distress remained similar among both groups.

Discussion & Nursing Implications: These findings affirm that fatigue and pain are pervasive across pediatric cancers, echoing prior studies. Although pediatric brain tumor patients reported fewer symptoms, symptom severity, and distress compared to other diagnostic groups, a comparison across time suggests how patients with brain tumors continue to experience distress throughout their diagnosis and treatment. These results underscore that symptom experiences can continue to be distressing and impact lifestyle across timelines. For nursing practice, the study highlights the importance of implementing age-appropriate, engaging self-report tools like MSAS 7–12 to detect subtle differences in symptom burden—especially during the early stages of diagnosis when symptom load appears greatest. Nurses should consider proactive, developmentally suitable symptom-screening and follow-up interventions, particularly aimed at fatigue and pain management.

Conclusion: By applying a validated pediatric tool in a comparative study across cancer types and diagnostic timelines, this thesis advances understanding of symptom self-reporting in pediatric patients with brain tumors. Although limitations exist—such as parent-reported diagnoses, unverified treatment data, and the study’s cross-sectional design—the work lays essential groundwork for future longitudinal, multi-center research and supports the wider integration of tailored symptom-assessment strategies into pediatric oncology nursing care.

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