1190 - Individual Differences in Resilience and Optimism in Relation to PROMs Commonly Used in Head and Neck Cancer Trials: A Prospective Longitudinal Observational Study
Presenter(s)
L. J. McDowell1,2, J. Corry3, T. Fua4,5, A. Coleman2, G. Adrian1,6, D. Rischin5,7, and K. Gough8; 1Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, QLD, Australia, 2Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia, 3GenesisCare St. Vincent's Hospital, Melbourne, Australia, 4Peter MacCallum Cancer Centre, Melbourne, VIC, Australia, 5Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia, 6Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden, 7Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia, 8Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Melbourne, Australia
Purpose/Objective(s):
The aim of this prespecified sub-study was to explore the relationship between resilience and optimism measured before curative (chemo)radiation therapy ([C]RT) for HPV-associated oropharyngeal cancer (HPVOPC) and quality of life (QoL), symptom burden and emotional distress measured before, at the end of, and 3, 12 and 24 months after [C]RT.Materials/Methods:
Eligible patients had HPVOPC and were scheduled for curative [C]RT. Study measures were administered online using REDCap, including the Connor-Davidson Resilience Scale (CDRS, resilience), Life Orientation Test-Revised (LOT-R, optimism), EORTC QLQ-C30 (global QoL and functioning), MDASI-HN (symptom severity and interference with general activity) and PROMIS Emotional Distress-Anxiety 7a and -Depression 8b (anxiety and depression). Higher scores on the CDRS, LOT-R and QLQ-C30 scales are better. Higher scores on the MDASI-HN and PROMIS scales are worse. Analysis included descriptive statistics and linear mixed models. Outcomes (QLQ-C30, MDASI-HN and PROMIS) were modelled with each covariate (CDRS and LOT-R) separately using all available data. Missing data were not imputed. Models included fixed effects for time and the covariate, and a random participant effect.Results:
100/129 eligible patients were enrolled to the longitudinal study. Those who completed the CDRS and LOT-R were eligible for the sub-study (n=99): median age 61 years (range 44-79 years), 87% male, 53% stage I and 97% receiving concurrent [C]RT. Resilience was positively associated with global QoL (p<0.001), role functioning (p=0.016), and emotional, cognitive and social functioning (all p<0.001), and negatively associated with anxiety, depression, and symptom severity and interference (all p<0.001). Associations were similar but typically weaker for optimism, with positive associations with global QoL (p=0.009) and physical (p=0.005), role (p=0.033), emotional (p=0.003) and cognitive (p=0.017) functioning, and negative associations with symptom severity (p=0.011) and interference (p=0.005), and anxiety and depression (both p<0.001).Conclusion:
Individual differences in resilience and optimism are significant and often underappreciated sources of variance in self-ratings of QoL, symptom burden and emotional distress. Self-ratings may reflect different cognitive, behavioural and emotional styles rather than objective life conditions or health status. Recognising these influences is important when analysing and interpreting PROMs in research and clinical practice. Interventions that strengthen the ability to adapt to adversity and promote positive expectances may optimise meaningful improvements in QoL, as well as physical and psychological symptoms.