Objectives/Purpose
Colorectal cancer (CRC) survivors frequently face enduring challenges that affect their health-related quality of life (HRQOL), even after completing treatment. Two commonly reported concerns are cancer-specific symptoms—such as bowel dysfunction and stoma-related issues—and heightened perceptions of physical vulnerability, often expressed through fears of recurrence or treatment side effects. Their combined effects on general HRQOL have received limited attention. Moreover, few studies have explored the role of psychological resilience factors, such as positive affect (PA), in buffering these impacts.
This study aimed to (1) examine how cancer-specific symptoms and perceptions of vulnerability predict general HRQOL among colorectal cancer (CRC) survivors, and (2) evaluate whether PA moderates these associations.
Sample and Setting
The sample included 73 newly diagnosed Taiwanese CRC patients (Age range= 28~72; M=50.20, 36% male) who were recruited during inpatient hospitalization for cancer surgery at a medical center in Taiwan. Most participants were Stage I (n = 42).
Procedures
This longitudinal study followed participants for two years post-surgery. Assessments included cancer-specific symptoms, perceptions of vulnerability, PA, and HRQOL (the SF-36) at multiple follow-up time points. Hierarchical regression and moderation analyses were conducted to examine predictors and potential buffering effects.
Results
Greater cancer-specific symptom burden (t=-5.16, p<.001) and stronger vulnerability perception (t=-4.06, p<.001) significantly predicted lower general HRQOL across the two-year follow-up period. PA moderated the effect of symptom burden on HRQOL (t=2.089, p=.038): patients with higher levels of PA showed a weaker negative association between symptom burden and HRQOL, indicating a buffering effect. However, PA did not significantly moderate the relationship between vulnerability perceptions and HRQOL.
Conclusion and Clinical Implications
Findings highlight the importance of early identification of physical and psychological challenges in CRC patients. Interventions that support emotional well-being—particularly by fostering positive affect—may help sustain HRQOL during survivorship.