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Psychological resiliency explains the relationship between emotional distress and quality of life in neurofibromatosis
Journal of Neuro-Oncology ( IF 3.9 ) Pub Date : 2021-09-27 , DOI: 10.1007/s11060-021-03852-1
Ryan A Mace 1, 2 , James Doorley 1, 2 , Jafar Bakhshaie 1, 2 , Joshua E Cohen 1 , Ana-Maria Vranceanu 1, 2
Affiliation  

Purpose

Neurofibromatoses (NF; NF1, NF2, and schwannomatosis) are incurable tumor suppressor syndromes with heterogeneous symptoms. Emotional distress (e.g., depression, anxiety, stress) is common in NF and impairs quality of life (QoL). Several modifiable dimensions of resiliency can contribute to enhanced QoL in medical populations but have been overlooked as treatment mechanisms for NF. Our goal was to determine, using data from an ongoing efficacy RCT testing a mind–body program for NF, if resiliency explains the relationship between emotional distress and QoL.

Methods

We performed structural equation modeling mediation analysis on baseline measures of QoL (physical health, psychological, social relationships, environmental), emotional distress (depression, anxiety, stress), and resiliency (gratitude, optimism, coping, mindfulness, empathy) completed by adults with NF (N = 228). We controlled for variables known to impact psychosocial functioning in NF (age, diagnosis, learning disability, and education).

Results

After adjusting for covariates, resiliency had a significant and large indirect effect on the negative relationship between emotional distress and QoL (CSIE = − 0.31, 95% CI = − 0.59 to − 0.19, p = .001). The direct effect of emotional distress on QoL was smaller but remained significant (β = − 0.23, 95% CI = − 0.44 to − 0.03, p = .03), suggesting partial mediation through resiliency.

Conclusions

Resiliency may buffer the high rates of emotional distress in NF. Mind–body interventions targeting multiple modifiable resiliency factors may be a promising path toward promoting QoL in adults with NF.

Trial registration

Clinical Trials.gov Identifier: NCT03406208.



中文翻译:

心理弹性解释了神经纤维瘤病中情绪困扰与生活质量之间的关系

目的

神经纤维瘤病(NF;NF1、NF2 和神经鞘瘤病)是具有异质性症状的无法治愈的肿瘤抑制综合征。情绪困扰(例如,抑郁、焦虑、压力)在 NF 中很常见,会损害生活质量 (QoL)。弹性的几个可修改维度有助于提高医疗人群的生活质量,但作为 NF 的治疗机制却被忽视了。我们的目标是使用来自持续有效性 RCT 测试 NF 身心计划的数据来确定弹性是否解释了情绪困扰和 QoL 之间的关系。

方法

我们对成人完成的生活质量(身体健康、心理、社会关系、环境)、情绪困扰(抑郁、焦虑、压力)和弹性(感恩、乐观、应对、正念、同理心)的基线测量进行了结构方程建模中介分析与 NF (N = 228)。我们控制了已知会影响 NF 心理社会功能的变量(年龄、诊断、学习障碍和教育)。

结果

在调整协变量后,弹性对情绪困扰和 QoL 之间的负相关具有显着且较大的间接影响(CSIE = - 0.31, 95% CI = - 0.59 至 - 0.19, p  = .001)。情绪困扰对 QoL 的直接影响较小但仍然显着(β  = - 0.23, 95% CI = - 0.44 至 - 0.03, p  = .03),表明通过弹性进行部分调节。

结论

弹性可以缓冲 NF 中的高情绪困扰率。针对多种可改变的弹性因素的身心干预可能是促进 NF 成人生活质量的一条有希望的途径。

试用注册

Clinical Trials.gov 标识符:NCT03406208。

更新日期:2021-09-29
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