PO.PS01.10 · 人群科学
多样化青年癌症幸存者群体中身体形象困扰的变化轨迹
Trajectories of body image distress among diverse young adult cancer survivors
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
引言：身体形象困扰（BID）是青年癌症幸存者（YACS）面临的一种心理应激源，但由于该人群的纵向数据有限，其随时间变化的轨迹仍未得到充分探索。我们考察了BID轨迹如何随YACS在生存期中的推进而演变，并评估了按西班牙裔/拉丁裔（H/L）族裔划分的差异。
方法：在两家综合癌症中心和一家安全网医院招募了18-39岁、在新发癌症诊断3个月内、涵盖所有癌症分期的YACS。9条目身体形象量表（BIS）以5分Likert量表评估癌症特异性BID，范围从“完全没有”到“非常严重”。BIS在三个时间点（基线、3个月和12个月）施测；平均得分≥10被视为具有临床意义。采用潜增长曲线模型（LGCM）建模并估计纵向BID轨迹，其中无条件模型（模型1）用于整体轨迹，条件模型（模型2）用于族裔并纳入了性别、社会经济状况（SES）、诊断时年龄和教育程度等协变量。以模型拟合指数评估各模型。
结果：在119名YACS的样本中，56.3%为H/L来源，67.2%为女性，44.5%为低SES（<$40k），47.9%为大学毕业及以上；参与者诊断时的平均年龄为32.0（SD：5.45）。BID轨迹在所有时间点均略高于临床阈值（基线=10.7；3个月=10.9；12个月=10.6；p > .10），提示BID未随时间改善。模型1拟合良好（CFI = 1.00），斜率不显著（p = .89），截距显示出显著的变异性（p < .001），表明BID严重程度存在个体差异。模型2也拟合良好（CFI = 1.00）；性别可预测更高的BID，因为女性在所有时间点的BID均显著更高（p < .001）。按族裔而言，非H/L的YACS的BID随时间逐渐上升，而H/L的YACS的BID随时间略有下降，提示存在一种保护性趋势；然而该趋势不显著（p = .87）。未发现SES、教育程度与诊断时年龄之间存在关联。
结论：在本队列的YACS中，具有临床意义的BID贯穿生存期的第一年持续存在，且未随时间改善。研究结果揭示了对BID进行纵向监测的必要性，以及在整个生存期内需要针对性别的干预措施以减轻BID。尽管不显著，但按族裔划分的分化性方向趋势提示可能存在受文化影响的保护性因素，值得在更大样本中进一步评估。
查看英文原文 English abstract
Introduction: Body image distress (BID) is a psychological stressor for young adult cancer survivors (YACS), but its trajectory over time remains underexplored due to limited longitudinal data among this population. We examined how BID trajectories evolve as YACS progress throughout survivorship and assessed differences by Hispanic/Latino (H/L) ethnicity.
Methods: YACS aged 18-39 years were recruited within 3 months of a de novo cancer diagnosis from two comprehensive cancer centers and a safety-net hospital, across all cancer stages. The 9-item Body Image Scale (BIS) assesses cancer-specific BID on a 5-point Likert scale, ranging from “not at all” to “very much”. The BIS was administered at three time points (baseline, 3 months, and 12 months); mean scores ≥ 10 were considered clinically meaningful. Latent Growth Curve Modeling (LGCM) was used to model and estimate longitudinal BID trajectories, with an unconditional model (model 1) for the overall trajectory and a conditional model (model 2) for ethnicity that included covariates of gender, socioeconomic status (SES), age at diagnosis, and education. Model fit indices evaluated the models.
Results: Among the sample of 119 YACS, 56.3% were of H/L origin, 67.2% female, 44.5% were of low SES (<$40k), and 47.9% were college graduates or higher; participants had a mean age at diagnosis of 32.0 ( SD : 5.45). BID trajectories were slightly above the clinical threshold at all timepoints (baseline = 10.7; 3-month = 10.9; 12-month = 10.6; p > .10), suggesting that BID did not improve over time. Model 1 fit well (CFI = 1.00), the slope was non-significant ( p = .89), and the intercept showed significant variability ( p < .001), indicating individual differences in BID severity. Model 2 also fit well (CFI = 1.00); gender predicted higher BID, as females had significantly greater BID across all time points ( p < .001). By ethnicity, non-H/L YACS showed a gradual rise in BID over time, while H/L YACS had a slight decrease in BID over time, suggesting a protective trend; however, this trend was not significant ( p = .87). No relationship was found between SES, education, and age at diagnosis.
Conclusion: Among YACS in this cohort, clinically significant BID persisted throughout the first year of survivorship and did not improve over time. Findings reveal a need for longitudinal monitoring of BID and the need for gender-specific interventions to mitigate BID throughout survivorship. Though non-significant, divergent directional trends by ethnicity suggest possible culturally informed protective factors that warrant further evaluation in larger samples.
利益披露 Disclosure
M. B. Echeverria, None..
D. Ruiz, None..
J. Stla, None..
M. Cairns, None..
P. Marin, None..
J. Kaslander, None..
K. A. Miller, None.