Profiles of quality of life among US young adult cancer survivors and their associations with potential psychosocial intervention targets of hope and psychological flexibility

Purpose: Given the growing population of young adult (YA) cancer survivors, understanding their different quality of life (QOL) profiles is important for informing interventions to promote QOL, which may target constructs like hope or psychological flexibility. This study assessed YA survivors’ QOL profiles and their associations with these 2 constructs. Methods: Latent class analysis (LCA) was conducted on PROMIS QOL measures (physical functioning, social functioning, fatigue, sleep disturbance, pain interference, anxiety, depression) among 155 YA survivors (ages 18–39; M_age = 32.89, 87.7% female, 8.4% Hispanic, 22.6% racial minority) within 3 years post-treatment. Multivariable regressions assessed sociodemographic and cancer-related factors in relation to class (multinomial logistic), and class in relation to scores on Snyder’s Hope Scale and the Acceptance and Action Questionnaire-II assessing psychological inflexibility (linear). Results: LCA identified 4 classes: (1) low physical/social functioning with high symptoms (i.e., fatigue, sleep disturbance, pain interference, anxiety, depression; 43.2%); (2) high physical/social functioning with high symptoms (23.9%); (3) high physical/social functioning with low symptoms (17.4%); and (4) low physical functioning, moderate social functioning and physical symptoms, and low mental health symptoms (15.5%). Compared to class 3 (referent), classes 1 and 4 more likely had chemotherapy (aOR = 6.54, CI 1.22–34.48; aOR = 12.82, CI 1.05–28.67), and class 2 had higher monthly income (≥ vs. < $4,200: aOR = 1.16, CI 1.02–1.54). Additionally, classes 1 and 2 had lower hope (B = −10.95, CI −14.42, −7.48; B = -5.50, CI −9.28, −1.71) and higher psychological inflexibility (B = 12.41, CI 9.06, 15.76; B = 8.21, CI 4.57, 11.86). Conclusions: YA survivors demonstrated varied QOL profiles, often with considerable symptoms. Interventions targeting hope and/or psychological flexibility may promote QOL.