Health behaviour practices and expectations for a local cancer survivorship programme: a cross-sectional study of survivors of childhood cancer in Hong Kong.

INTRODUCTION: Lifestyle choices may influence health outcomes in cancer survivors. This study of childhood cancer survivors in Hong Kong investigated factors associated with health-protective and health-damaging behaviours; it also examined expectations of a survivorship programme. METHODS: This cross-sectional study recruited survivors of childhood cancer ≥2 years after treatment. Survivors completed a structured questionnaire to report their health practices and the perceived values of survivorship programme components. Multivariable logistic regression analysis was conducted to identify factors associated with health behaviours. RESULTS: Two hundred survivors were recruited (mean age=23.4 ± 8.8 years; mean duration since treatment, 13.4 ± 7.6 years). Comparatively few survivors exercised ≥4 days/week (16.0%), used sun protection (18.0%), and had a balanced diet (38.5%). Furthermore, comparatively few survivors reported that they had not undergone any immunisation (24.5%) or were unsure (18.5%) about their immunisation history. Most adult survivors were never-drinkers (71.0%) and never-smokers (93.0%). Brain tumour survivors were more likely to have unhealthy eating habits, compared with haematological malignancy survivors (odds ratio [OR]=2.45; 95% confidence interval [CI]=1.29-4.68). Lower socioeconomic status was associated with inadequate sun protection (OR=0.20; 95% CI=0.05-0.83), smoking (OR=5.13; 95% CI=1.48-17.75), and exposure to second-hand smoke (OR=3.52; 95% CI=1.42-8.69). Late-effects screening (78.5%) and psychosocial services to address psychological distress (77%) were considered essential components of a survivorship programme. CONCLUSIONS: Despite the low prevalences of health-damaging behaviours, local survivors of childhood cancer are not engaging in health-protective behaviours. A multidisciplinary programme addressing late effects and psychosocial aspects may address the multifaceted needs of this special population.

Affect as a mediator between self-efficacy and quality of life among Chinese cancer survivors in China.

Previous studies have shown that self-efficacy influences cancer survivors' quality of life. As most of the relevant findings are based on Caucasian cancer survivors, whether the same relationship holds among Asian cancer patients and through what mechanism self-efficacy influences quality of life are unclear. This study examined the association between self-efficacy and quality of life among Chinese cancer survivors, and proposed affect (positive and negative) as a mediator between self-efficacy and quality of life. A sample of 238 Chinese cancer survivors (75% female, mean age = 55.7) were recruited from Beijing, China. Self-efficacy, affect (positive and negative) and quality of life were measured in a questionnaire package. Self-efficacy was positively associated with quality of life and positive affect, and negatively associated with negative affect. Path analyses revealed the direct effect from self-efficacy to quality of life and the indirect effects from self-efficacy to quality of life through positive affect and negative affect. The beneficial role of self-efficacy in Chinese cancer survivors' quality of life and the mediating role of affect in explaining the relationship between self-efficacy and quality of life are supported. Future interventions should include self-care and affect regulation skills training to enhance cancer survivors' self-efficacy and positive affect, as this could help to improve Chinese cancer survivors' quality of life.