Wickramasinghe Bethany, Fern Lorna A, Taylor Rachel M, Feltbower Richard G
Department of Targeted Intervention, University College London, London WC1E 6BT, UK.
Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK.
Cancers (Basel). 2025 Jun 9;17(12):1918. doi: 10.3390/cancers17121918.
BACKGROUND/OBJECTIVES: Social support can enhance psychosocial health-related quality of life (PSQOL) in adult cancer patients. Adolescents and young adults (AYAs) with cancer face unique psychosocial challenges that intersect with key developmental milestones. Theoretical models propose that illness perceptions and social support are key determinants of coping strategies and long-term health outcomes in this context. These may be especially salient for AYAs, for whom peer relationships and identity formation are central.
We explored how perceived social support and illness perceptions influence PSQOL over time in AYA cancer patients through a secondary analysis of the BRIGHTLIGHT longitudinal cohort study.
BRIGHTLIGHT followed 830 young people aged 13-24 across five time points (6-36 months post-diagnosis). Multi-level modelling revealed that PSQOL improved over time but remained consistently lower in females (mean: 69.62, 95% CI: 70.69 to -68.55). Greater perceived support from friends was associated with poorer PSQOL (β: -0.77, 95% CI: -1.007 to -0.54) and linked to negative illness perceptions, longer hospital stays (β: 0.01, 95% CI: 0.00 to -0.02), longer diagnostic intervals (β: -0.009, 95% CI: -0.02 to -0.00), and poorer clinical communication (β: 0.52, 95% CI: 0.01 to -1.03). A patient interpretation exercise with BRIGHTLIGHT's Young Advisory Panel contextualized these findings.
While peer support could promote normalcy, it could also intensify distress through emotional pressure or social isolation. Future research should address not only access to social support but its quality and relevance to AYAs' unique psychosocial needs.
背景/目的：社会支持可提高成年癌症患者与心理社会健康相关的生活质量（PSQOL）。患有癌症的青少年和青年（AYA）面临着与关键发育里程碑相互交织的独特心理社会挑战。理论模型表明，在这种情况下，疾病认知和社会支持是应对策略和长期健康结果的关键决定因素。对于以同伴关系和身份形成为核心的AYA来说，这些因素可能尤为突出。
我们通过对BRIGHTLIGHT纵向队列研究的二次分析，探讨了感知到的社会支持和疾病认知如何随时间影响AYA癌症患者的PSQOL。
BRIGHTLIGHT在五个时间点（诊断后6 - 36个月）对830名13 - 24岁的年轻人进行了跟踪研究。多层次建模显示，PSQOL随时间推移有所改善，但女性的PSQOL始终较低（均值：69.62，95%置信区间：70.69至 - 68.55）。来自朋友的更高感知支持与较差的PSQOL相关（β： - 0.77，95%置信区间： - 1.007至 - 0.54），并与负面疾病认知、更长的住院时间（β：0.01，95%置信区间：0.00至 - 0.02）、更长的诊断间隔（β： - 0.009，95%置信区间： - 0.02至 - 0.00）以及较差的临床沟通（β：0.52，95%置信区间：0.01至 - 1.03）有关。与BRIGHTLIGHT青年咨询小组进行的患者解读活动使这些发现更具背景意义。
虽然同伴支持可以促进正常状态，但也可能通过情感压力或社会隔离加剧痛苦。未来的研究不仅应关注社会支持的获取，还应关注其质量以及与AYA独特心理社会需求的相关性。
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