title: Psychosocial factors associated with impact of cancer in longterm haematological cancer survivors.
abstract: To assess the impact of cancer (IOC) on subsequent quality of life (QOL), 718 long-term haematological cancer survivors completed validated psychosocial, functional and QOL scales, including IOC. Fifteen percent reported significant psychological distress, 18% high levels of fatigue and 10% moderate to severe functional impairment. These groups of participants also showed poorer QOL. There were no significant differences in psychological distress (P = 0·76), fatigue (P = 0·23) or functional impairment (P = 0·74) across different cancer subtypes. Two separate hierarchical regression analyses examined the combined association of disease-type, psychosocial and other factors on negative and positive IOC scores respectively. Higher negative IOC scores were significantly associated (P ≤ 0·001) with medical comorbidity, psychological distress, lower social support, high fatigue levels and functional impairment. Paediatric patients (diagnosed at <17 years) had significantly higher negative IOC scores than adult patients (P = 0·001); greater years since diagnosis was significantly (P < 0·001) associated with less negative IOC. Higher positive IOC was associated with acute leukaemia (P = 0·01); lower positive IOC with paediatric patients (P < 0·001), white ethnicity (P < 0·001), higher education (P = 0·003), no partner (P = 0·01) and lower social support (P = 0·01). Screening for medical comorbidity, psychological distress and fatigue identifies those needing most support and should allow earlier interventions to address negative and positive IOC to improve the well-being of cancer survivors.
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
authors.forename: Ania
authors.initials: A
authors.lastname: Korszun
authors.forename: Shah-Jalal
authors.initials: SJ
authors.lastname: Sarker
authors.forename: Kashfia
authors.initials: K
authors.lastname: Chowdhury
authors.forename: Charlotte
authors.initials: C
authors.lastname: Clark
authors.forename: Paul
authors.initials: P
authors.lastname: Greaves
authors.forename: Rachel
authors.initials: R
authors.lastname: Johnson
authors.forename: Judith
authors.initials: J
authors.lastname: Kingston
authors.forename: Gill
authors.initials: G
authors.lastname: Levitt
authors.forename: Janet
authors.initials: J
authors.lastname: Matthews
authors.forename: Peter
authors.initials: P
authors.lastname: White
authors.forename: Andrew
authors.initials: A
authors.lastname: Lister
authors.forename: John
authors.initials: J
authors.lastname: Gribben
mesh_terms: D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D019337:Hematologic Neoplasms / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*
keywords: depression; haematological cancer; long-term survivors; psychosocial factors; quality of life