Factors influencing Non-Hodgkin Lymphoma survivors' quality of life Public Deposited

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  • March 20, 2019
Creator
  • Leak, Ashley N.
    • Affiliation: School of Nursing
Abstract
  • Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy. Survivors of NHL are living longer, and their adaption to the disease long-term is a needed research area. Therefore, this retrospective, cross-sectional analysis using a preexisting data set (1) explored demographic and disease characteristics associated with quality of life (QOL) for NHL survivors, (2) tested a conceptual model to determine if adaptation to NHL mediated the relationship between the demographic and disease characteristics of that QOL, and (3) determined whether age moderated demographic and disease characteristics and examined their relationships with QOL. The model framework was adapted from the cancer survivor adaptation model (Naus, Ishler, Parrott, & Kovacs, 2009). It was proposed and tested to determine statistically significant relationships among the three components of cancer survivorship: personal characteristics, adaptation, and outcomes. The NHL survivors were predominantly Caucasian, married/living with a partner, 62 years old on average, and 10 years past diagnosis on average. The second aim used a SEM model and provided adequate goodness-of-fit indices with direct effects from personal characteristics on QOL: current age, income, total comorbidity score, and years since diagnosis. The other three effects were partially mediated by either negative adaptation (comorbidity, years since diagnosis) or both negative adaptation and positive adaptation (current age). The remaining personal characteristics had no direct effects on QOL, but they had fully mediated effects through negative adaptation (bone marrow transplant), positive adaptation (gender), or both (education and current treatment status). A moderation model was used to determine how personal characteristics impacted QOL using age as a moderator for the third aim. The analyses included a comparison of younger (< 65 years of age) and older (≥ 65 years of age) participants and differences in interaction effects on them. Younger age was associated with a greater likelihood of being female, earning less than $30,000 annually, and poorer QOL outcomes. Income was most strongly correlated with age and was negatively associated with QOL for younger survivors. This study's results suggest that both positive and negative perceptions mediate relationships between demographic and disease characteristics and QOL for NHL survivors.
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  • In Copyright
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  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Nursing"
Advisor
  • Mayer, Deborah
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  • Chapel Hill, NC
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  • Open access
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