abstract:
Helplessness/hopelessness, minimization and optimism predict survival in women with invasive ovarian cancer: a role for targeted support during initial treatment decision-making?
AOCS—Quality of Life Study Investigators on behalf of the Australian Ovarian Cancer Study Group
PURPOSE:
Women with advanced ovarian cancer
generally have a poor prognosis but there is significant variability in
survival despite similar disease characteristics and treatment
regimens. The aim of this study was to determine whether psychosocial
factors predict survival in women with ovarian cancer, controlling for potential confounders.
METHODS:
The sample comprised 798 women with invasive ovarian cancer recruited into the Australian Ovarian Cancer
Study and a subsequent quality of life study. Validated measures of
depression, optimism, minimization, helplessness/hopelessness, and
social support were completed 3-6 monthly for up to 2 years. Four
hundred nineteen women (52.5 %) died over the follow-up period.
Associations between time-varying psychosocial variables and survival
were tested using adjusted Cox proportional hazard models.
RESULTS:
There
was a significant interaction of psychosocial variables measured prior
to first progression and overall survival, with higher optimism, higher minimization, and lower helplessness/hopelessness associated with longer survival. After disease progression,
these variables were not associated with survival and
helplessness/hopelessness. Depression and
social support were not associated with survival.
CONCLUSIONS:
In women with invasive ovarian cancer,
psychosocial variables prior to disease progression appear to impact on
overall survival, suggesting a preventive rather than modifying role.
Addressing psychosocial responses to cancer
and their potential impact on treatment decision-making early in the
disease trajectory may benefit survival and quality of life.
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