Chang Ming-Wei, Wang Ashley Wei-Ting, Chang Cheng-Shyong
Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan.
Department of Psychology, Soochow University, Taipei 111002, Taiwan.
Cancers (Basel). 2025 Sep 8;17(17):2934. doi: 10.3390/cancers17172934.
The goal of this longitudinal study was to explore how gastrointestinal-symptom distress and benefit finding together influence health-related quality of life (HRQOL) over time in colorectal cancer (CRC) survivors. Colorectal cancer (CRC) survivorship may differ from other cancer types due to the persistent burden of gastrointestinal symptoms. The highly visible and socially sensitive nature of these sequelae may influence the trajectory of benefit finding compared with other cancers. Specifically, we explored whether increases in symptom distress predicted declines in physical and mental HRQOL whether benefit finding was directly related to or buffered the negative impact of symptom distress on HRQOL. Participants were 73 Taiwanese women and men who underwent surgery for CRC. Using a three-time-point, multilevel framework, participants were assessed at 1, 3, and 6 months after surgery. Hierarchical linear modeling was used to investigate whether gastrointestinal-symptom distress and benefit finding covary over time with HRQOL. The results indicated that increases in gastrointestinal-symptom distress were linked to declines in both physical and mental HRQOL. Benefit finding had no direct association with HRQOL but significantly moderated the symptom-HRQOL relationship, weakening the negative impact of symptom distress among those with higher benefit finding. Rises in a CRC survivor's gastrointestinal-symptom distress went hand-in-hand with drops in both physical and mental HRQOL. This study adds to the literature in that benefit finding has a favorable effect on cancer adjustment when patients face higher symptom distress after the surgery and treatment. Further implications on possible mechanisms were discussed.
这项纵向研究的目的是探讨胃肠道症状困扰和益处发现如何共同影响结直肠癌（CRC）幸存者随时间推移的健康相关生活质量（HRQOL）。由于胃肠道症状的持续负担，结直肠癌（CRC）幸存者的情况可能与其他癌症类型不同。与其他癌症相比，这些后遗症高度明显且具有社会敏感性，可能会影响益处发现的轨迹。具体而言，我们探讨了症状困扰的增加是否预示着生理和心理HRQOL的下降，益处发现是否与症状困扰对HRQOL的负面影响直接相关或起到缓冲作用。参与者为73名接受CRC手术的台湾男性和女性。采用三个时间点的多层次框架，在术后1个月、3个月和6个月对参与者进行评估。使用分层线性模型来研究胃肠道症状困扰和益处发现在随时间推移过程中是否与HRQOL共同变化。结果表明，胃肠道症状困扰的增加与生理和心理HRQOL的下降均有关联。益处发现与HRQOL没有直接关联，但显著调节了症状与HRQOL的关系，减弱了在益处发现较高者中症状困扰的负面影响。CRC幸存者胃肠道症状困扰的增加与生理和心理HRQOL的下降同时出现。这项研究补充了相关文献，即当患者在手术和治疗后面临更高的症状困扰时，益处发现对癌症适应有积极影响。文中还讨论了对可能机制的进一步启示。
