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Relationships among uncertainty, post-traumatic stress disorder symptoms, and quality of life in non-muscle-invasive bladder cancer survivors

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Abstract

Purpose

The aim of this study was to examine relationships among uncertainty, PTSD symptoms (PTSS), and quality of life (QOL) in non-muscle-invasive bladder cancer (NMIBC) survivors.

Methods

Eligible NMIBC survivors were identified through the North Carolina Central Cancer Registry, and 398 survivors participated in a mailed survey that measured survivor’s outcomes (uncertainty, PTSS, and QOL). Structural equation modeling was used to examine the mediating effect of uncertainty and PTSS on the association between personal characteristics and QOL in NMIBC survivors.

Results

NMIBC survivors experienced cancer-related uncertainty; higher uncertainty was associated with male, lower income, lack of cure, and lower cognition-ability. Uncertainty was significantly and negatively associated with QOL. In addition, PTSS completely mediated the effect of uncertainty on QOL, and higher PTSS had a strong association with poorer QOL. Additionally, comorbidities, cognition-general concerns, uncertainty, and PTSS had strong negative effects on QOL.

Conclusion

This study has identified modifiable psychosocial factors which affect QOL in NMIBC survivors. The study findings can be used in the development of interventions to improve QOL for NMIBC survivors.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

Ahrang Jung was supported in part by UNC Lineberger Comprehensive Cancer Center (LCCC) Cancer Outcomes Research Program Research Award, Sigma Theta Tau International Alpha Alpha Chapter Research Grant, and Linda Waring Matthews Research Fund Scholarship for conducting this study.

Author information

Authors and Affiliations

  1. School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Ahrang Jung, Jamie L. Crandell, Ashley Leak Bryant & Deborah K. Mayer

  2. School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA

    Ahrang Jung

  3. School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Matthew E. Nielsen

  4. UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

    Matthew E. Nielsen & Ashley Leak Bryant

  5. School of Nursing, Duke University, Durham, NC, USA

    Sophia K. Smith

Authors
  1. Ahrang Jung
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  2. Jamie L. Crandell
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  4. Sophia K. Smith
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  5. Ashley Leak Bryant
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  6. Deborah K. Mayer
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Ahrang Jung. Statistical analysis was performed by Ahrang Jung and Jamie Crandell. The original draft of the manuscript was written by Ahrang Jung, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ahrang Jung.

Ethics declarations

Ethics approval

This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. The study was approved by the Institutional Review Board (IRB) at the University of North Carolina at Chapel Hill (IRB number: 16–0696).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Conflict of interest

The authors declare no competing interests.

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Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Dr. Jung conducted this study at UNC-Chapel Hill. She is currently at UNC-Greensboro.

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Jung, A., Crandell, J.L., Nielsen, M.E. et al. Relationships among uncertainty, post-traumatic stress disorder symptoms, and quality of life in non-muscle-invasive bladder cancer survivors. Support Care Cancer 30, 6175–6185 (2022). https://doi.org/10.1007/s00520-022-07034-1

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