Noriega Esquives Blanca S, Natori Akina, Antoni Michael H, Otto Amy K, Prinsloo Sarah, Wagner Richard W, Gomez Telma I, Hathaway Cassandra A, Ulrich Cornelia M, Peoples Anita R, Cohen Lorenzo, Penedo Frank J
Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States.
Division of Medical Oncology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, United States.
Front Psychol. 2024 Sep 12;15:1423106. doi: 10.3389/fpsyg.2024.1423106. eCollection 2024.
Cancer survivors experienced poorer health-related quality of life (HRQoL) and greater psychological distress during the COVID-19 pandemic than those without cancer. However, the underlying mechanisms that may explain how negative experiences during the pandemic are associated with distress and HRQoL remain unknown. We examined whether psychosocial risk factors (i.e., healthcare disruption, disruption to daily activities and social interaction [DDASI], and financial hardship) mediated the relationship between negative COVID-19-related experiences and cancer survivors' HRQoL and psychological distress (i.e., depressive symptoms, and anxiety) and whether the mediating effects were moderated by psychosocial protective factors (i.e., stress management ability and social support).
A total of 9,651 cancer survivors completed a questionnaire assessing negative COVID-19-related experiences, psychosocial and practical experiences, and HRQoL. Conditional process analysis was used to evaluate the proposed moderated mediation models.
Participants had a mean age of 63.8 years (SD = 12.3) and were mostly non-Hispanic White (82.3%). DDASI and financial hardship mediated the relationship between negative COVID-19-related experiences and cancer survivor's HRQoL and psychological distress. Stress management ability buffered the indirect effect of DDASI on cancer survivors' HRQoL and psychological distress. Social support buffered the indirect effect of financial hardship on HRQoL and depressive symptoms.
Financial resources and social interactions may buffer negative effects of major disruptions such as the COVID-19 pandemic. Future studies should assess the longitudinal impact of these associations.
与没有患癌症的人相比，癌症幸存者在新冠疫情期间的健康相关生活质量（HRQoL）较差，心理困扰更大。然而，可能解释疫情期间负面经历如何与困扰及健康相关生活质量相关联的潜在机制仍不明确。我们研究了心理社会风险因素（即医疗保健中断、日常活动和社交互动中断[DDASI]以及经济困难）是否介导了与新冠相关的负面经历与癌症幸存者的健康相关生活质量及心理困扰（即抑郁症状和焦虑）之间的关系，以及中介效应是否受到心理社会保护因素（即压力管理能力和社会支持）的调节。
共有9651名癌症幸存者完成了一份问卷，评估与新冠相关的负面经历、心理社会和实际经历以及健康相关生活质量。采用条件过程分析来评估所提出的调节中介模型。
参与者的平均年龄为63.8岁（标准差=12.3），大多数为非西班牙裔白人（82.3%）。DDASI和经济困难介导了与新冠相关的负面经历与癌症幸存者的健康相关生活质量及心理困扰之间的关系。压力管理能力缓冲了DDASI对癌症幸存者的健康相关生活质量及心理困扰的间接影响。社会支持缓冲了经济困难对健康相关生活质量和抑郁症状的间接影响。
财政资源和社会互动可能缓冲新冠疫情等重大干扰的负面影响。未来的研究应评估这些关联的纵向影响。
