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Psychological Distress, Health Behaviors, and Benefit Finding in Survivors of Multiple Primary Cancers: Results From the 2010 Livestrong Survey

Sarah M. Belcher
Carissa A. Low
Donna M. Posluszny
Rebekkah Schear
Raegan E. Kramer
Heidi S. Donovan
ONF 2017, 44(6), 703-711 DOI: 10.1188/17.ONF.703-711

Purpose/Objectives: To evaluate whether survivorship of multiple primary cancers (MPCs) is associated with psychological distress, positive health behaviors, and benefit finding.


Design: Secondary analysis of the 2010 Livestrong cross-sectional survey.


Setting: Online survey.


Sample: 238 MPC survivors and 3,295 single cancer survivors.


Methods: Chi-square and t tests for group comparisons were used. Multivariate linear regression, adjusted for covariates, was used to determine associations between variables.


Main Research Variables: MPC versus single cancer; psychological distress, health behavior (healthy lifestyle and positive healthcare utilization), and benefit-finding scores.


Findings: Survivors of MPCs (compared to single cancer survivors) were significantly older, less likely to have a spouse or partner, further out from original cancer diagnosis, and less likely to be employed full-time, and they differed by cancer diagnoses and survivorship stage. Having MPCs was associated with significantly higher psychological distress and healthcare utilization but not healthy lifestyle or benefit finding.


Conclusions: Relative to those with single cancers, MPC survivors are at increased risk for psychological distress and are more likely to receive recommended cancer screenings. Additional research is needed to understand mechanisms surrounding psychological distress in MPC survivors.


Implications for Nursing: Targeted distress screening in MPC survivors may allow for early identification and interventions to ameliorate distress and reduce negative downstream health effects.

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