title: Are lifestyle behavioral factors associated with health-related quality of life in long-term survivors of non-Hodgkin lymphoma?
abstract: BACKGROUND
  The objective of the current study was to determine whether survivors of non-Hodgkin lymphoma are meeting select American Cancer Society (ACS) health-related guidelines for cancer survivors, as well as to examine relationships between these lifestyle factors and health-related quality of life (HRQoL) and posttraumatic stress (PTS).
  
  
  METHODS
  A cross-sectional sample of 566 survivors of NHL was identified from the tumor registries of 2 large academic medical centers. Respondents were surveyed regarding physical activity, fruit and vegetable intake, body weight, tobacco use, HRQoL using the Medical Outcomes Study Short Form-36, and PTS using the Posttraumatic Stress Disorder CheckList-Civilian form. Lifestyle cluster scores were generated based on whether individuals met health guidelines and multiple linear regression analysis was used to evaluate relationships between lifestyle behaviors and HRQoL scores and PTS scores.
  
  
  RESULTS
  Approximately 11% of participants met all 4 ACS health recommendations. Meeting all 4 healthy recommendations was related to better physical and mental QoL (standardized regression coefficient [β], .57 [P<.0001] and β, .47 [P = .002]) and to lower PTS scores (β, -0.41; P = .01).
  
  
  CONCLUSIONS
  Survivors of NHL who met more ACS health-related guidelines appeared to have better HRQoL and less PTS. Unfortunately, many survivors are not meeting these guidelines, which could impact their overall well-being and longevity.
authors.affiliation: Division of Medical Oncology, Duke Cancer Institute, Durham, North Carolina.|Duke University School of Nursing, Durham, North Carolina.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Spector
authors.affiliation: Duke University School of Nursing, Durham, North Carolina.
authors.forename: Devon
authors.initials: D
authors.lastname: Noonan
authors.affiliation: Lineberger Comprehensive Cancer Center and the School of Nursing, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Mayer
authors.affiliation: Department of Statistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Habtamu
authors.initials: H
authors.lastname: Benecha
authors.affiliation: Cecil G. Sheps Center for Health Services Research and the School of Social Work, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.affiliation: Duke University School of Nursing, Durham, North Carolina.|Duke Cancer Institute, Durham, North Carolina.
authors.forename: Sophia K
authors.initials: SK
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D017741:Survivors
keywords: health behaviors; health-related quality of life; non-Hodgkin lymphoma survivors; physical activity; posttraumatic stress