title: Health-related quality of life and life satisfaction in colorectal cancer survivors: trajectories of adjustment.
abstract: BACKGROUND
  This longitudinal study describes the five year trajectories of health-related quality of life (HR-QOL) and life satisfaction in long term colorectal cancer survivors.
  
  
  METHODS
  A population-based sample of 1966 colorectal cancer survivors were surveyed at six time points from five months to five years post-diagnosis. Predictor variables were: socio-demographic variables, optimism; cancer threat appraisal; perceived social support. Quality of life was assessed with the Functional Assessment of Cancer Therapy-Colorectal (HR-QOL); and the Satisfaction with Life Scale. Growth mixture models were applied to identify trajectory classes and their predictors.
  
  
  RESULTS
  Distinct adjustment trajectories were identified for HR-QOL and life satisfaction. Lower optimism, poorer social support, a more negative cognitive appraisal, and younger age were associated with poorer life satisfaction, while survivors with less than 8 years of education had higher life satisfaction. This pattern was similar for overall HR-QOL except that educational level was not a significant predictor and later stage disease and female gender emerged as related to poorer outcomes. One in five survivors reported poorer constant HR-QOL (19.2%) and a small group had poor life satisfaction (7.2%); 26.2% reported constant high HR-QOL and 48.8% had high constant life satisfaction. Socioeconomic disadvantage and remoteness of residence uniquely predicted poorer outcomes in the colorectal cancer specific HR-QOL sub domain.
  
  
  CONCLUSIONS
  Although HR-QOL and subjective cognitive QOL share similar antecedents their trajectory patterns suggested they are distinct adjustment outcomes; with life satisfaction emerging as temporally stable phenomenon. Unique patterns of risk support suggest the need to account for heterogeneity in adjustment in longitudinal QOL studies with cancer survivors.
authors.forename: Jeff
authors.initials: J
authors.lastname: Dunn
authors.forename: Shu Kay
authors.initials: SK
authors.lastname: Ng
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
authors.forename: Joanne
authors.initials: J
authors.lastname: Aitken
authors.forename: Pip
authors.initials: P
authors.lastname: Youl
authors.forename: Peter D
authors.initials: PD
authors.lastname: Baade
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Chambers
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003071:Cognition / Q000145:classification; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D005260:Female; D006305:Health Status Indicators; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011204:Poverty Areas; D011594:Psychometrics / Q000295:instrumentation; D011788:Quality of Life; D011793:Queensland; D018434:Sickness Impact Profile; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult