School of Social Work, University of Michigan, Ann Arbor, Michigan, USA.
School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Cancer Med. 2024 Oct;13(20):e70328. doi: 10.1002/cam4.70328.
Quality of life (QOL) among young breast cancer survivors (YBCS) is often worse than QOL of older breast cancer survivors or age-matched peers without a history of cancer. Families commonly support YBCS, particularly during treatment, but little is known about long-term YBCS and family member QOL. The purpose of this study was to identify demographic, clinical, and psychosocial predictors of physical and mental QOL in YBCS and biological relatives and investigate associations between their QOL (i.e., QOL interdependence).
This secondary data analysis includes a random sample of long-term YBCS (≤ 45 years old at diagnosis) and up to two female relatives at baseline (post-treatment) and 18-month follow-up. The sample consists of 189 dyads (YBCS and one relative) and 121 triads (YBCS and two relatives). Actor-partner interdependence models (APIMs) were used to estimate the influence of YBCS's and relatives' demographic, clinical, and psychosocial factors on their own QOL (actor effects) and the other persons' QOL (partner effects).
For YBCS and relatives, QOL at the baseline was associated with their QOL at 18-months. YBCS's perceived cancer risk was associated with their own and relatives' QOL. Older relatives' physical QOL at baseline was associated with younger relatives' physical QOL at follow-up. Age, race, marital status, years since diagnosis, education, out-of-pocket costs of care, routine sources of care, income, family support, fear of recurrence, anxiety, and depression were also significant predictors of QOL.
Findings revealed independent and interdependent effects on QOL. These predictors point to potential targets of support for families.
ClinicalTrials.gov ID: NCT01612338.
年轻乳腺癌幸存者（YBCS）的生活质量（QOL）通常比老年乳腺癌幸存者或无癌症病史的年龄匹配同龄人差。家庭通常会支持 YBCS，特别是在治疗期间，但对长期 YBCS 和家庭成员的 QOL 知之甚少。本研究的目的是确定人口统计学、临床和心理社会因素对 YBCS 及其生物学亲属的身体和心理健康 QOL 的预测作用，并探讨他们的 QOL（即 QOL 相互依存）之间的关系。
这项二次数据分析包括一个长期 YBCS（诊断时≤45 岁）的随机样本，以及基线（治疗后）和 18 个月随访时最多两名女性亲属。该样本包括 189 对（YBCS 和一名亲属）和 121 对（YBCS 和两名亲属）。采用演员-伙伴相互依赖模型（APIM）来估计 YBCS 和亲属的人口统计学、临床和心理社会因素对他们自己的 QOL（演员效应）和他人的 QOL（伙伴效应）的影响。
对于 YBCS 和亲属，基线时的 QOL 与 18 个月时的 QOL 相关。YBCS 对癌症风险的感知与其自身和亲属的 QOL 相关。基线时年长亲属的身体 QOL 与随访时年轻亲属的身体 QOL 相关。年龄、种族、婚姻状况、诊断后年限、教育程度、自付医疗费用、常规护理来源、收入、家庭支持、对复发的恐惧、焦虑和抑郁也是 QOL 的重要预测因素。
研究结果揭示了对 QOL 的独立和相互依存影响。这些预测因素为家庭提供支持提供了潜在目标。
ClinicalTrials.gov 编号：NCT01612338。
