Profiles of quality of life among US young adult cancer survivors and their associations with potential psychosocial intervention targets of hope and psychological flexibility

Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. carlaberg@gwu.edu.
Laura C. Schubel, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Darcey M. McCready, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Sheena Shajan, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Palash Bhanot, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Campbell Dopke, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Afrah Howlader, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Pamela S. Hinds, Division of Nursing, Department of Nursing Science, Professional Practice & Quality at Children's National and the Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA.
Jennifer Levine, Division of Nursing, Department of Nursing Science, Professional Practice & Quality at Children's National and the Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA.
Maureen E. Lyon, Division of Nursing, Department of Nursing Science, Professional Practice & Quality at Children's National and the Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA.
Pavani Chalasani, GW Cancer Center, George Washington University, Washington, District of Columbia, USA.
Hannah Arem, Implementation Science, Healthcare Delivery Research, MedStar Health Research Institute, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

6-28-2025

Journal

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation

DOI

10.1007/s11136-025-04010-0

Keywords

Acceptance and commitment therapy; Cancer survivorship; Health promotion; Hope; Positive psychology; Quality of life; Young adult cancer survivors

Abstract

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.

Department

Prevention and Community Health

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