Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
University of Washington, School of Medicine, Seattle, Washington, USA.
J Adolesc Young Adult Oncol. 2023 Aug;12(4):496-502. doi: 10.1089/jayao.2022.0105. Epub 2022 Oct 25.
Long-term adolescent and young adult hematopoietic stem cell transplantation (HCT) survivors face complex physical and psychological treatment effects that contribute to cancer-related health burden. We aimed to identify the role of social support and coping strategies on cancer-related health burden. This cross-sectional analysis included HCT recipients from the INSPIRE trial [NCT00799461], who received their first transplant between ages 15 and 39. As our primary outcome, we used the health burden subscale of the Cancer and Treatment Distress measure. We assessed correlates using the Short Form-36v2 physical component summary, brief Coping Orientation to Problems Experienced (COPE), and ENRICHD Social Support Inventory. We used hierarchical multivariable linear regression to identify factors associated with cancer-related health burden, with the first step including sociodemographic and clinical factors, the second step adding physical function, and the third step including social support and coping. Participants ( = 293) were 52% male and 93% white, non-Hispanic, with a mean age of 30.2 (standard deviation 6.6) at first transplant. In step one, sex accounted for ∼3% of the variance ( = 0.006). Adding physical function explained an additional 33% of the variance ( = <0.001). Social support and coping strategies explained 11% of the variance ( = <0.001). The final model explained 47% of the variance; better physical function, more social support, and active coping were associated with lower cancer-related health burden, while female sex, venting, and distraction were associated with higher cancer-related health burden. Supporting physical function and fostering social support and active coping may help mitigate cancer-related health burden in this population. NCT00799461.
长期青少年和年轻成人造血干细胞移植(HCT)幸存者面临复杂的身体和心理治疗效果,这些效果导致了癌症相关的健康负担。我们旨在确定社会支持和应对策略在癌症相关健康负担中的作用。这项横断面分析包括来自 INSPIRE 试验的 HCT 受者[NCT00799461],他们在 15 至 39 岁之间接受了第一次移植。作为我们的主要结果,我们使用癌症和治疗困扰量表的健康负担亚量表。我们使用短式健康调查 36 简表第二版物理成分综合评分、简短应对方式问卷和 ENRICHD 社会支持量表评估相关性。我们使用分层多变量线性回归来确定与癌症相关健康负担相关的因素,第一步包括社会人口统计学和临床因素,第二步加入身体功能,第三步包括社会支持和应对。参与者(n=293)中 52%为男性,93%为白人,非西班牙裔,首次移植时的平均年龄为 30.2(标准差 6.6)。在第一步中,性别占方差的约 3%(=0.006)。加入身体功能后,解释了另外 33%的方差(=<0.001)。社会支持和应对策略解释了 11%的方差(=<0.001)。最终模型解释了 47%的方差;更好的身体功能、更多的社会支持和积极应对与较低的癌症相关健康负担相关,而女性性别、发泄和分散注意力与较高的癌症相关健康负担相关。支持身体功能和培养社会支持和积极应对可能有助于减轻该人群的癌症相关健康负担。NCT00799461。