Longitudinal Changes in Quality of Life and Distress among Cancer Survivors Enrolled in a Community Survivorship Program
Funk, Rachel Katherine
MetadataShow full item record
BACKGROUND: Cancer can be a life-threatening illness with long-term consequences beyond the initial phases of diagnosis and treatment. The post-treatment period presents unique challenges to psychosocial functioning (i.e., psychological distress and quality of life [QOL]), but little is known about the efficacy of psychological and behavioral interventions for cancer survivors, especially in the community setting. OBJECTIVE: This longitudinal study assessed the relationship between participation in a community-based survivorship program and psychosocial functioning among cancer survivors. Aims also addressed how individual characteristics and program participation related to changes in psychosocial functioning over time. METHOD: Participants included 152 cancer survivors receiving psychosocial and behavioral services (e.g., exercise, dietary consult, psychological counseling) through the Fort Worth Program for Community Survivorship at the University of Texas Southwestern Moncrief Cancer Institute. Participants completed measures of psychological distress and QOL at enrollment and at 3, 6, and 12 months post-enrollment. Service attendance was recorded throughout the 12-month study period. ANALYSIS: Linear mixed modeling techniques examined changes in psychosocial functioning over time. RESULTS: Significant improvements in both QOL and distress were noted for participants during the 12-month study period. The largest improvements in QOL and distress occurred during the first 3 months and appeared to level out during the last 6 months of program participation. This pattern mirrored participants’ attendance in program services, which was highest during the first 3 months of enrollment. Participants with low levels of comorbidity displayed a less pronounced improvement in both psychosocial outcomes over time than those with more comorbid symptoms. Individuals attending exercise and dietary services demonstrated a greater rate of improvement in QOL than those not attending these services. DISCUSSION: Results suggest that the cancer survivorship program was effective in addressing the unmet psychosocial needs of cancer survivors, especially during the first few months of program participation. Uptake of exercise and dietary interventions appeared especially impactful for QOL improvement. Future research should expand assessment of survivorship interventions and utilize non-interventional groups to better understand the specific impact of psychosocial and behavioral survivorship care on psychosocial functioning.