School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
J Adolesc Young Adult Oncol. 2022 Aug;11(4):410-418. doi: 10.1089/jayao.2021.0104. Epub 2021 Sep 28.
The numbers of adolescent and young adult (AYA) survivors of childhood cancer are exponentially growing. To ensure suitable services are available to meet the needs of this growing population, understanding the experience of late effects, quality of life, and potentially modifiable factors, such as self-efficacy, is required. AYA survivors of childhood cancer recruited through an After Cancer Therapy Service at a Children's Hospital rated their symptoms experience, quality of life, and self-efficacy using the Patient Reported Outcome Common Terminology Criteria for Adverse Events, Functional Assessment of Cancer Therapy-General (FACT-G), and Patient-Reported Outcomes Measurement Information System (PROMIS), respectively. Descriptive statistics were used to characterize the sample. Quality-of-life scores were compared with population norms. Regression analyses were used to explore the relationships between symptom experience, quality of life, and self-efficacy. Thirty participants (mean age 22 ± 4.4 years) reported an average of nine symptoms as persistently experienced at moderate or higher rated intensity among participants (standard deviation ±8.7; range: 0-32; interquartile range: 2-16); over half ( = 17, 56.7%) had finished treatment 10 or more years ago. Participants scored lower on the FACT-G Physical Well-being and Emotional Well-being, and higher on Social Well-being subscales than the general population. Around two-thirds of participants were confident in their ability to self-manage their health based on their health self-efficacy score. Bivariate linear regression identified a statistically significant increase in the overall quality of life with increased self-efficacy, adjusted for age and sex (0.60, 95% confidence interval [CI] 0.30-0.90, < 0.01). Higher symptom burden was associated with a lower overall quality of life after adjusting for age and sex (-0.95, 95% CI: -1.35 to -0.54, < 0.001). Young cancer survivors experience a substantial number of persistent symptoms related to their cancer treatment that may negatively impact aspects of their quality of life. Health self-efficacy is a potential target for future interventions.
儿童癌症的青少年和年轻成人（AYA）幸存者人数呈指数级增长。为确保提供适当的服务来满足这一不断增长的人群的需求，需要了解晚期效应、生活质量以及自我效能等潜在可改变因素的体验。通过儿童医院癌症治疗后服务招募的儿童癌症 AYA 幸存者使用患者报告的结局共同术语标准不良事件、癌症治疗功能评估-一般（FACT-G）和患者报告的结果测量信息系统（PROMIS）分别评估他们的症状体验、生活质量和自我效能。使用描述性统计数据来描述样本。将生活质量评分与人群正常值进行比较。回归分析用于探索症状体验、生活质量和自我效能之间的关系。 30 名参与者（平均年龄 22 ± 4.4 岁）报告平均有 9 种症状在参与者中以中度或更高强度持续存在（标准差 ±8.7；范围：0-32；四分位距：2-16）；超过一半（ = 17，56.7%）治疗结束 10 年以上。与一般人群相比，参与者在 FACT-G 身体和情感幸福感以及社会幸福感方面的评分较低。约三分之二的参与者对自己根据健康自我效能评分管理健康的能力有信心。双变量线性回归表明，随着自我效能的增加，整体生活质量呈统计学显著增加，调整年龄和性别后（0.60，95%置信区间[CI] 0.30-0.90， < 0.01）。调整年龄和性别后，较高的症状负担与整体生活质量较低相关（-0.95，95%CI：-1.35 至-0.54， < 0.001）。 年轻的癌症幸存者经历了大量与癌症治疗相关的持续症状，这些症状可能会对他们的生活质量产生负面影响。健康自我效能是未来干预的潜在目标。
