title: Pre-Surgery Depression and Confidence to Manage Problems Predict Recovery Trajectories of Health and Wellbeing in the First Two Years following Colorectal Cancer: Results from the CREW Cohort Study.
abstract: This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery.
  
  
  
  872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing.
  
  
  
  Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support.
  
  
  
  Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences.
authors.affiliation: Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Foster
authors.affiliation: Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Haviland
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom.
authors.forename: Jane
authors.initials: J
authors.lastname: Winter
authors.affiliation: Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Chloe
authors.initials: C
authors.lastname: Grimmett
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Kim
authors.initials: K
authors.lastname: Chivers Seymour
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Lynn
authors.initials: L
authors.lastname: Batehup
authors.affiliation: Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Lynn
authors.initials: L
authors.lastname: Calman
authors.affiliation: Executive Office, University of Nottingham, Nottingham, NG7 2RD, United Kingdom.
authors.forename: Jessica
authors.initials: J
authors.lastname: Corner
authors.affiliation: Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Amy
authors.initials: A
authors.lastname: Din
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Deborah
authors.initials: D
authors.lastname: Fenlon
authors.affiliation: Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Christine M
authors.initials: CM
authors.lastname: May
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.|University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom.
authors.forename: Alison
authors.initials: A
authors.lastname: Richardson
authors.affiliation: Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Smith
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000601:surgery*; D003863:Depression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D011795:Surveys and Questionnaires