A Psychosocial Intervention's Impact on Quality of Life in AYAs with Cancer: A Post Hoc Analysis from the Promoting Resilience in Stress Management (PRISM) Randomized Controlled Trial.

Angela Steineck,Samantha Scott,Nancy Lau,Miranda C Bradford,Abby R Rosenberg,Joyce P Yi-Frazier

doi:10.3390/children6110124

Abstract

Promoting Resilience in Stress Management (PRISM), a psychosocial intervention for adolescents and young adults (AYAs) with serious illness, enhances resilience resources via four skills-based training sessions. A recent randomized controlled trial showed PRISM improved health-related quality of life (HRQOL) compared to usual care (UC). This post hoc exploratory analysis aimed to better understand the effect of PRISM on HRQOL by describing changes in HRQOL subdomain scores. English-speaking AYAs (12–25 years) with cancer were randomized to PRISM or UC. At enrollment and six months later, HRQOL was assessed using the Pediatric Quality of Life Inventory (PedsQL) Generic Short Form (SF-15) and Cancer Module. Scores at each time point were summarized descriptively and individual HRQOL trajectories were categorized (<70 vs. ≥70). “Positive” trajectories indicate participants maintained scores ≥70 or improved from <70 to ≥70 during the study period. Baseline assessments were completed by 92 participants (48 PRISM, 44 UC); six-month assessments were completed by 74 participants (36 PRISM, 38 UC). For the SF-15, positive trajectories in psychosocial domains were more common with PRISM; trajectories in the physical subdomain were similar across groups. For the Cancer Module, positive trajectories were more common with PRISM in the following subdomains: nausea, treatment anxiety, worry, cognitive, physical appearance, and communication. From this, we conclude PRISM may improve HRQOL, especially in psychosocial domains of wellbeing.

Highlights

Pediatric patients undergoing cancer-directed therapy are known to have poorer health-related quality of life (HRQOL) compared to their well peers [1,2]
In order to mitigate the effect of this disruption, a growing number of evidence-based psychosocial interventions have been designed for adolescents and young adults (AYAs) with cancer [22], defined here to be age 12–25 years
Results of the primary outcome analysis have been reported previously [33]. In this post hoc analysis, we report on the secondary outcome of HRQOL, including both cancer-specific and generic HRQOL

Summary

Introduction

Pediatric patients undergoing cancer-directed therapy are known to have poorer health-related quality of life (HRQOL) compared to their well peers [1,2]. This distress has longstanding consequences, with reported associations between poor psychosocial outcomes and physical limitations [11,12,13,14], difficulties developing intimate relationships [15,16], lower educational attainment [17,18], and increased economic burden among adult survivors of childhood cancer [19,20]. In order to mitigate the effect of this disruption, a growing number of evidence-based psychosocial interventions have been designed for adolescents and young adults (AYAs) with cancer [22], defined here to be age 12–25 years.

Methods

Results

Discussion

Conclusion