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

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.

Body image among adolescents and young adults diagnosed with cancer: A scoping review

“…Among the 45 quantitative studies, 12,34,35,37–39,41–44,61–95 body image was an outcome in 32 studies (71.1%), a predictor in eight studies (17.8%), and was included only descriptively in three studies (6.8%). The remaining two studies (6.7%) did not identify the type of variable body image was.…”

“…Among the 45 quantitative studies, 12,34,35,[37][38][39][41][42][43][44] body image was an outcome in 32 studies (71.1%), a predictor in eight studies (17.8%), and was included only descriptively in three studies (6.8%).…”

“…Across study designs, 12 articles reported intervention or program studies with body image as a primary (n = 8) or secondary (n = 4) outcome. [33][34][35][36][37][38][39][40][41][42][43][44] These studies described 11 unique interventions or programs focused on mindfulness and self-compassion (n = 3), body image and self-esteem (n = 3), exercise/physical activity (n = 2), social support (n = 2), psychosexual development (n = 1), resilience in stress management (n = 1), and general AYA-specific education and resources (n = 1), with two studies having multiple aims (e.g., mindfulness and social support). The interventions were delivered within single (n = 3) or multiple sessions (n = 8), with programs lasting a maximum of 8 weeks (n = 5).…”

A novel combined resilience and advance care planning intervention for adolescents and young adults with advanced cancer: A feasibility and acceptability cohort study

“…In a phase 2 randomized‐controlled trial of AYAs with cancer, PRISM was feasible, highly valued, and efficacious in improving AYA resilience and quality of life and minimizing distress 14,15 . A limitation of that study, however, was that it focused on AYAs with newly diagnosed cancer; we were unable to fully assess PRISM's feasibility and acceptability among AYAs with progressive or refractory disease 14,16 . The few AYAs who enrolled with AC reported additional unmet needs they thought PRISM could help them meet.…”

The Manifestations of Social Maladjustment in Children With leukemia at Different Ages: A Descriptive Qualitative Study based on Phenomenology

“…Medical staff should give timely explanation and help to promote them to adapt to a series of changes brought by the disease and better cooperation with the treatment. During hospitalization, through resilience intervention in stress management [23], children's coping ability and appropriate use of relaxation techniques can be improved, such as taking deep breaths to relieve pain. In addition, sand play therapy is a kind of psychotherapy suitable for children with emotional and behavioral disorders [24], which can be considered for children with leukemia.…”