Characterizing Psychological Resources and Resilience in Patients With Bladder Cancer: Associations With Frailty and Quality of Life.

Abstract

Purpose: Resilience, the ability to maintain or restore baseline function following a stressor, remains unexplored in patients with bladder cancer. Our objective was to demonstrate the feasibility of prospectively characterizing baseline resilience, related psychological resources and frailty in patients with bladder cancer and evaluate associations with quality of life and mental health outcomes over time.

Materials and methods: We enrolled patients with bladder cancer (N = 67, September 2020-July 2021) into a prospective observational cohort study. At intake, subjects completed validated assessments of frailty domains and psychological resources (resilience, psychological capital, self-compassion, and thriving, collectively PsyResources). Validated quality of life surveys were completed at 2 weeks, 3- and 6-months post-treatment selection. Correlation matrices were constructed to quantify correlations between baseline PsyResources and frailty measures (reported with Spearman's correlation coefficient [ρ]). Associations between PsyResources and quality of life outcomes were evaluated with linear regression.

Results: Median age was 71 years (83.6% male) and 77.6% had muscle-invasive bladder cancer (cN+: 21%, M1: 7.6%). Baseline PsyResources were inversely correlated with the Geriatric Depression Scale (ρ = -0.50-0.65, P < .0001). Higher baseline PsyResources were associated with improved global symptoms and emotional function and decreased anxiety and depression over time (B: -0.17 to -2.5; P < .05).

Conclusion: We present the first prospective characterization of baseline PsyResources in patients with bladder cancer. We observed positive correlations with improved mental health and quality of life outcomes over time. Ongoing work is exploring the relationship between resilience, frailty domains and their role in functional recovery following treatment. Future work is needed to understand associations between PsyResources and treatment tolerance, recovery trajectories, and oncologic outcomes.