Grasping the 'teachable moment': time since diagnosis, symptom burden and health behaviors in breast, colorectal and prostate cancer survivors.
Grasping the 'teachable moment': time since diagnosis, symptom burden and health behaviors in breast, colorectal and prostate cancer survivors.
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DOI：
10.1002/pon.3857
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发表时间：
2015-10
期刊：
影响因子：
3.6
通讯作者：
Demark-Wahnefried W
中科院分区：
文献类型：
--
作者：
Bluethmann SM;Basen-Engquist K;Vernon SW;Cox M;Gabriel KP;Stansberry SA;Carmack CL;Blalock JA;Demark-Wahnefried W
癌症诊断可能会为癌症的康复提供一个“可教的时刻”。为了更好地了解诊断后影响生活方式选择的因素，我们研究了癌症幸存者自确诊以来的时间和症状负担与推荐饮食(例如，每天5+水果/蔬菜)、体力活动(例如，150分钟活动时间，每周3-5次)和吸烟行为(即，戒烟)的关系。我们分析了从德克萨斯大学MD安德森癌症中心积极治疗后的乳腺癌幸存者(n=528)、结直肠癌幸存者(n=106)和前列腺癌幸存者(n=419)收集的横断面调查数据。对感兴趣的行为测试了四个回归模型。此外，我们评估了症状负担作为诊断和行为之间潜在的调节和/或调节因素。受试者多为女性(55%)和非西班牙裔白人(68%)，平均年龄为62.8±11.4岁，平均确诊时间为4.6±3.1年。在回归模型中，诊断时间越长，水果和蔬菜的摄入量越低(B=−0.05，p=0.02)，吸烟越多(B=0.06，p=0.105)。较大的症状负担对体力活动有显著的负面预测作用(B=−0.08，p<；.001)。我们没有发现症状负担缓和或调节确诊后时间和健康行为之间的联系的证据。我们根据幸存者面临的其他挑战，包括确诊后的时间和症状负担，评估了推荐行为的流行率。我们的结果提供了间接证据，表明接近癌症诊断可能为改善饮食和吸烟行为提供一个可教的时刻，症状负担可能会阻碍诊断后的体力活动。
A cancer diagnosis may provide a ‘teachable moment’ in cancer recovery. To better understand factors influencing lifestyle choices following diagnosis, we examined associations between time since diagnosis and symptom burden with recommended dietary (e.g., 5+ fruit/vegetable servings/day), physical activity (e.g., >150 active minutes, 3–5 times/week) and smoking behaviors (i.e., eliminate tobacco use) in cancer survivors. We analyzed cross-sectional survey data collected from breast (n=528), colorectal (n=106) and prostate (n=419) cancer survivors following active treatment at The University of Texas MD Anderson Cancer Center. Four regression models were tested for behaviors of interest. Additionally, we assessed symptom burden as a potential moderator and/or mediator between time since diagnosis and behaviors. Respondents were mostly female (55%) and non-Hispanic white (68%) with a mean age of 62.8 ± 11.4 years and mean time since diagnosis of 4.6 ± 3.1 years. In regression models, greater time since diagnosis predicted lower fruit and vegetable consumption (B=−0.05, p=0.02) and more cigarette smoking (B=0.06, p=0.105). Greater symptom burden was a significant negative predictor for physical activity (B=−0.08, p<.001). We did not find evidence that symptom burden moderated or mediated the association between time since diagnosis and health behaviors. We assessed the prevalence of recommended behaviors in the context of other challenges that survivors face, including time since diagnosis and symptom burden. Our results provide indirect evidence that proximity to a cancer diagnosis may provide a teachable moment to improve dietary and smoking behaviors and that symptom burden may impede physical activity following diagnosis.