title: Positive and negative life changes experienced by survivors of non-Hodgkin's lymphoma.
abstract: BACKGROUND
  The impact of cancer on adult survivors of aggressive non-Hodgkin's Lymphoma (NHL) is understudied.
  
  
  OBJECTIVE
  We examined positive and negative life changes (health behaviors, relationships, financial situation) experienced by survivors of NHL and their association with physical and mental function.
  
  
  METHODS
  Using the Los Angeles County Cancer Surveillance Program, 744 questionnaires were mailed to adult survivors of NHL: 308 provided complete data for analyses (M age=59.8, SD=14.9).
  
  
  RESULTS
  Perceptions of positive and negative life changes were common in our sample, with 77.9% of NHL survivors reporting at least one positive change and 78.6% reporting at least one negative change. Cancer had the greatest positive change on relationships and the most negative change on survivors' financial situation. There was an equal distribution of survivors classified as having experienced positive change and negative change on health behaviors. Regardless of whether positive and negative life change were entered into separate regression models or the same model, an increase in negative life change in each of the domains was significantly associated with a decrease in physical and mental functioning. Positive change was significantly associated only with physical functioning when examining overall change (p=.018) and health behaviors (p=.013), and the inclusion of negative change attenuated these associations.
  
  
  CONCLUSIONS
  In designing interventions to improve the mental and physical function of NHL survivors, the greatest benefit may likely be achieved by reducing the negative effects of cancer. Perhaps positive life changes are related in more specific ways to other indexes of adjustment, but our findings failed to show a positive relationship with mental and physical function.
authors.affiliation: Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland 20892, USA. bellizzk@mail.nih.gov
authors.forename: Keith M
authors.initials: KM
authors.lastname: Bellizzi
authors.forename: Melissa Farmer
authors.initials: MF
authors.lastname: Miller
authors.forename: Neeraj K
authors.initials: NK
authors.lastname: Arora
authors.forename: Julia H
authors.initials: JH
authors.lastname: Rowland
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005195:Family Relations; D005260:Female; D015438:Health Behavior; D006801:Humans; D008016:Life Change Events; D008228:Lymphoma, Non-Hodgkin / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012803:Sick Role; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology*