Factors influencing quality of life among childhood cancer survivors in Korea: A quantile regression approach

Abstract

Cancer treatment in childhood may negatively affect survivors' quality of life. In this study, we aimed to determine the contributing factors for health‐related quality of life (HRQOL) in survivors of childhood cancer in Korea using quantile regression analysis. This study was a secondary analysis. Data were collected from 130 childhood cancer survivors (CCS) from November 2018 to July 2019. Participants completed the Memorial Symptom Assessment Scale, Depression Anxiety Stress Scale, Health‐Promoting Lifestyle Profile‐II, and 36‐Item Short Form Health Survey (physical component summary [PCS] and mental component summary [MCS]). Quantile and multiple linear regressions were used to analyze the factors contributing to HRQOL. The quantile and linear regression models revealed different results on the contributing factors to HRQOL in CCS. Mean PCS and MCS scores were 78.55 (SD = 15.08) and 64.02 (SD = 18.00), respectively. Symptoms (e.g., difficulty concentrating, worrying, pain, and lack of energy), physical activity, spiritual growth, interpersonal relationships, stress management, depression, and anxiety were significant influencing factors in some PCS quantiles, while symptoms, spiritual growth, interpersonal relationships, depression, and stress were significant influencing factors in some MCS quantiles. The findings of this study showed specific contributing factors in CCS with different levels of HRQOL. There is a need for targeted interventions related to risk reduction and stratification for CCS with different HRQOL levels. Symptom management strategies, early detection programs for CCS with psychological distress, and clinical and counseling interventions for CCS with poor HRQOL need to be developed.

Living with the Late Effects of Childhood Cancer Treatment: A Descriptive Qualitative Study

“…Survivors of traumatic events such as being diagnosed with cancer and going through painful treatment processes try to understand the stressor, and spirituality plays an important role in coping with such events [61,62]. In our previous research, we have also found a positive relationship between spiritual growth and quality of life among CCS [63]. Our participants reported that they were positively influenced by mentors and parents who had children with childhood cancer during their survivorship periods, which indicates the importance of providing support after cancer treatment completion.…”

A systematic review and pooled prevalence of symptoms among childhood and adolescent and young adult cancer survivors

“…Although more than 80% of individuals survive after childhood and adolescent cancer, as many as 60%-90% of long-term survivors experience unfavourable late effects or symptoms that can last months to years due to aggressive cancer treatments such as chemotherapy, radiation and surgery (National Cancer Institute, 2021c). Drowsiness, worrying, feeling nervous and dry mouth, which were prevalent in our review, were shown to affect the quality of life, increasing the risk of substance use and inadequate physical activity in CCSs who were relatively young and socially active (Hong et al, 2021;McDonnell et al, 2021;Noronha & Macdonald, 2016). However, the number of studies included for pooled prevalence ranged from 2-5, thus indicating a need for further studies to assess these symptoms and their relationships with health outcomes in the future.…”

“…Most cancer survivors have follow‐up schedules lasting up to 5 years post‐treatment, and symptom assessment and management are often not included in survivorship care plans. Hong et al (2021) reported that CCS were perplexed and frustrated when they experienced symptoms, not knowing where to seek help for symptom management during their survivorship period. CCS and AYA cancer survivors should therefore be educated about possible symptoms due to cancer treatment right from the time they receive the treatment, which should be monitored throughout their survivorship.…”

“…Considerable physical and psychosocial symptoms have been reported among CCS and AYA cancer survivors, including fatigue (Baker & Syrjala, 2018; Jacobs et al, 2019; Meeske et al, 2005), pain (Huang et al, 2013; Lu et al, 2011), emotional distress (Mertens & Gilleland Marchak, 2015), poor vitality and sleep (Clanton et al, 2011), cognitive and psychological impairment (Michel et al, 2010; Zeltzer et al, 2009), and anxiety, depression, social withdrawal, as well as attention problems (Brinkman et al, 2016; Jacobs et al, 2019). Further, these symptoms are associated with poor quality of life (Finnegan et al, 2009; Hong et al, 2021; Quinn et al, 2015), suicidal ideation (Brinkman et al, 2014), increased healthcare utilisation, and cost (Tai et al, 2012) in CCS and AYA cancer survivors.…”

Religiosidade/espiritualidade no câncer infantojuvenil: implicações psicossociais para crianças/adolescentes adoecidos, familiares/cuidadores e equipe de saúde

“…Por ser um componente cultural presente na maioria dos contextos sociais, a religiosidade/espiritualidade é um recurso subjetivo significativo presente nas vivências de familiares cuidadores de crianças e adolescentes com câncer, podendo interferir positiva ou negativamente na forma como lidam com a doença de seus filhos . Essa dimensão tem sido descrita na literatura científica como um elemento presente nos contextos de cuidado em saúde, sendo significativa para as pessoas, principalmente para aquelas que valorizam subjetivamente esses aspectos e os utilizam na adoção de determinados comportamentos e hábitos de vida (Hong et al, 2022;Zadeh et al, 2021).…”