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BRIEF RESEARCH REPORT article
Front. Psychol.
Sec. Psycho-Oncology
Volume 15 - 2024 |
doi: 10.3389/fpsyg.2024.1423106
The impact of negative COVID-19 experiences on cancer survivors' health-related quality of life and psychological distress: A moderated mediation model
Provisionally accepted
Blanca S. Noriega Esquives
1*
Akina Natori
2
Michael Antoni
1,3
Amy K. Otto
4*
Sarah Prinsloo
5,6
Richard W. Wagner
5*
Telma I. Gomez
7*
Cassandra A. Hathaway
8*
Cornelia M. Ulrich
9*
Anita Peoples
10
Lorenzo G. Cohen
5*
Frank J. Penedo
1,11,12*- 1 Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida, United States
- 2 Division of Medical Oncology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States
- 3 Department of Psychiatry and Behavioral Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States
- 4 School of Medicine, University of Minnesota Duluth, Duluth, Georgia, United States
- 5 Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Ohio, United States
- 6 Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, United States
- 7 Department of Pediatrics Hematology-Oncology, Baylor College of Medicine, Houston, United States
- 8 Westat (United States), Rockville, Maryland, United States
- 9 Department of Population Health Sciences, School of Medicine, The University of Utah, Salt Lake City, Utah, United States
- 10 Huntsman Cancer Institute, School of Medicine, The University of Utah, Salt Lake City, Utah, United States
- 11 Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, Florida, United States
- 12 Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States
Introduction: Cancer survivors experienced poorer health-related quality of life (HRQoL) and greater psychological distress during the COVID-19 pandemic than those without cancer. However, the underlying mechanisms that may explain how negative experiences during the pandemic are associated with distress and HRQoL remain unknown. We examined whether psychosocial risk factors (i.e., healthcare disruption, disruption to daily activities and social interaction [DDASI], and financial hardship) mediated the relationship between negative COVID-19-related experiences and cancer survivor's HRQoL and psychological distress (i.e., depressive symptoms, and anxiety) and whether the mediating effects were moderated by psychosocial protective factors (i.e., stress management ability and social support).Methods: A total of 9,651 cancer survivors completed a questionnaire assessing negative COVID-19-related experiences, psychosocial and practical experiences, and HRQoL. Conditional process analysis was used to evaluate the proposed moderated mediation models.Results: Participants had a mean age of 63.8 years (SD=12.3) and were mostly non-Hispanic White (82.3%). DDASI and financial hardship mediated the relationship between negative COVID-19related experiences and cancer survivor's HRQoL and psychological distress. Stress management ability buffered the indirect effect of DDASI on cancer survivor's HRQoL and psychological distress. Social support buffered the indirect effect of financial hardship on HRQoL and depressive symptoms.Conclusions: Financial resources and social interactions may buffer negative effects of major disruptions such as the COVID-19 pandemic. Future studies should assess the longitudinal impact of these associations.
Keywords: cancer survivors, COVID-19 pandemic, Financial hardship, health-related quality of life, moderated mediation analysis, psychological distress
Received: 25 Apr 2024; Accepted: 29 Aug 2024.
Copyright: © 2024 Noriega Esquives, Natori, Antoni, Otto, Prinsloo, Wagner, Gomez, Hathaway, Ulrich, Peoples, Cohen and Penedo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Blanca S. Noriega Esquives, Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, 33136, Florida, United States
Amy K. Otto, School of Medicine, University of Minnesota Duluth, Duluth, 55812, Georgia, United States
Richard W. Wagner, Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, 77030, Ohio, United States
Telma I. Gomez, Department of Pediatrics Hematology-Oncology, Baylor College of Medicine, Houston, United States
Cassandra A. Hathaway, Westat (United States), Rockville, 20850, Maryland, United States
Cornelia M. Ulrich, Department of Population Health Sciences, School of Medicine, The University of Utah, Salt Lake City, 84108, Utah, United States
Lorenzo G. Cohen, Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, 77030, Ohio, United States
Frank J. Penedo, Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, 33136, Florida, United States
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