Change in Mental Health and Resilience in Childhood Cancer Survivors After Attending a Person-Centred State-of-the-Art Late Effects Clinic-on Behalf of the PanCareFollowUp Consortium.
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BACKGROUND: Person-centred follow-up care based on evidence-based clinical practice guidelines and providing individualised information should help to inform and reassure survivors about their medical and psychosocial situation and provide treatment and support where needed. AIMS: To describe changes in mental health and resilience in survivors before and after a person-centred follow-up care intervention and analyse associations of mental health improvements with socio-demographic and clinical characteristics. METHODS: We implemented the novel person-centred PanCareFollowUp Care Intervention in four clinics across Europe. Survivors aged 16+ years (cancer diagnosed at age < 19 years, 5+ years after diagnosis) completed the Brief Symptom Inventory-18 (BSI-18; somatisation, depression, anxiety, overall distress), Post-traumatic Stress Disorder Checklist and the Connor-Davidson Resilience Scale before (T1) and 6 months after (T2) the clinic visit. We calculated a change score for resilience and a reliable change index for BSI-18 scales and post-traumatic stress symptoms. RESULTS: In total, 798 survivors participated (51.4% males, mean age = 30.3 years [range: 16-60]). Mental health significantly improved, with lower scores for depression (mean change = 0.89, p = 0.001), anxiety (mean change = 0.68, p = 0.025), overall distress (mean change = 0.99, p = 0.004) and post-traumatic stress symptoms (mean change = 1.09, p = 0.004) at T2 as compared to T1. Around one-third of survivors reported significant distress (no change: p = 0.659). Socio-demographic or clinical characteristics were not associated with changes in resilience or overall distress. A reliable reduction of post-traumatic stress symptoms was more likely in those single (p = 0.020), unemployed or in education/studying (p = 0.003) and with poor physical health (p = 0.004). CONCLUSION: Mental health improved after the person-centred PanCareFollowUp Care Intervention. Inclusion in regular follow-up care may help to decrease survivors' distress in the long-term. TRIAL REGISTRATION: Netherlands Trial Register numbers: NL8918, NL-OMON21449.