美国年轻成年癌症幸存者的生活质量概况及其与希望和心理灵活性等潜在心理社会干预目标的关联。
Profiles of quality of life among US young adult cancer survivors and their associations with potential psychosocial intervention targets of hope and psychological flexibility.
作者信息
Berg Carla J, Schubel Laura C, McCready Darcey M, Shajan Sheena, Bhanot Palash, Dopke Campbell, Howlader Afrah, Hinds Pamela S, Levine Jennifer, Lyon Maureen E, Chalasani Pavani, Arem Hannah
机构信息
Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
GW Cancer Center, George Washington University, Washington, District of Columbia, USA.
出版信息
Qual Life Res. 2025 Jun 28. doi: 10.1007/s11136-025-04010-0.
PURPOSE
Given the growing population of young adult (YA) cancer survivors, understanding their different quality of life (QOL) profiles is important for informing interventions to promote QOL, which may target constructs like hope or psychological flexibility. This study assessed YA survivors' QOL profiles and their associations with these 2 constructs.
METHODS
Latent class analysis (LCA) was conducted on PROMIS QOL measures (physical functioning, social functioning, fatigue, sleep disturbance, pain interference, anxiety, depression) among 155 YA survivors (ages 18-39; M = 32.89, 87.7% female, 8.4% Hispanic, 22.6% racial minority) within 3 years post-treatment. Multivariable regressions assessed sociodemographic and cancer-related factors in relation to class (multinomial logistic), and class in relation to scores on Snyder's Hope Scale and the Acceptance and Action Questionnaire-II assessing psychological inflexibility (linear).
RESULTS
LCA identified 4 classes: (1) low physical/social functioning with high symptoms (i.e., fatigue, sleep disturbance, pain interference, anxiety, depression; 43.2%); (2) high physical/social functioning with high symptoms (23.9%); (3) high physical/social functioning with low symptoms (17.4%); and (4) low physical functioning, moderate social functioning and physical symptoms, and low mental health symptoms (15.5%). Compared to class 3 (referent), classes 1 and 4 more likely had chemotherapy (aOR = 6.54, CI 1.22-34.48; aOR = 12.82, CI 1.05-28.67), and class 2 had higher monthly income (≥ vs. < $4,200: aOR = 1.16, CI 1.02-1.54). Additionally, classes 1 and 2 had lower hope (B = -10.95, CI -14.42, -7.48; B = -5.50, CI -9.28, -1.71) and higher psychological inflexibility (B = 12.41, CI 9.06, 15.76; B = 8.21, CI 4.57, 11.86).
CONCLUSIONS
YA survivors demonstrated varied QOL profiles, often with considerable symptoms. Interventions targeting hope and/or psychological flexibility may promote QOL.
TRIAL REGISTRATION
NCT05905250.
目的
鉴于年轻成人癌症幸存者群体不断壮大，了解他们不同的生活质量（QOL）概况对于制定促进生活质量的干预措施很重要，这些干预措施可能针对希望或心理灵活性等构念。本研究评估了年轻成人幸存者的生活质量概况及其与这两个构念的关联。
方法
对155名年轻成人幸存者（年龄18 - 39岁；M = 32.89，87.7%为女性，8.4%为西班牙裔，22.6%为少数族裔）在治疗后3年内的患者报告结局测量信息系统（PROMIS）生活质量指标（身体功能、社会功能、疲劳、睡眠障碍、疼痛干扰、焦虑、抑郁）进行潜在类别分析（LCA）。多变量回归评估了社会人口学和癌症相关因素与类别之间的关系（多项逻辑回归），以及类别与斯奈德希望量表得分和评估心理僵化程度的接受与行动问卷 - II得分之间的关系（线性回归）。
结果
潜在类别分析确定了4个类别：（1）身体/社会功能低下且症状严重（即疲劳、睡眠障碍、疼痛干扰、焦虑、抑郁；43.2%）；（2）身体/社会功能良好但症状严重（23.9%）；（3）身体/社会功能良好且症状轻微（17.4%）；（4）身体功能低下、社会功能和身体症状中等、心理健康症状轻微（15.5%）。与第3类（参照组）相比，第1类和第4类更有可能接受过化疗（调整后比值比[aOR] = 6.54，置信区间[CI] 1.22 - 34.48；aOR = 12.82，CI 1.05 - 28.67），第2类月收入较高（≥ vs. < 4200美元：aOR = 1.16，CI 1.02 - 1.54）。此外，第1类和第2类的希望较低（B = -10.95，CI -14.42，-7.48；B = -5.50，CI -9.28，-1.71），心理僵化程度较高（B = 12.41，CI 9.06，15.76；B = 8.21，CI 4.57，11.86）。
结论
年轻成人癌症幸存者表现出不同的生活质量概况，通常伴有相当多的症状。针对希望和/或心理灵活性的干预措施可能会提高生活质量。
试验注册
NCT05905250
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