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. 2025 Apr 3;13(1):336.
doi: 10.1186/s40359-025-02637-9.

What factors influence thriving in adolescent and young adult cancer patients? A focus on psychological health, biological markers, and quality of life

Yi Zhou  1 , Yinglong Duan  1 , Jian Zhou  2 , Qinqin Cheng  3 , Ning Qin  4 , Xing Zhou  4 , Yuxuan Li  4 , Juan Luo  4 , Huiyi Zhang  4 , Jiayi Zhu  4 , Jianfei Xie  5 , Andy S K Cheng  6
Affiliations

What factors influence thriving in adolescent and young adult cancer patients? A focus on psychological health, biological markers, and quality of life

Yi Zhou et al. BMC Psychol. .

Abstract

Purpose: This study explores the role of psychological health, biological markers, and quality of life (QoL) in influencing thriving - defined as resilience and enhanced well-being - among adolescent and young adult (AYA) cancer patients.

Methods: A total of 148 AYA cancer patients were assessed for psychological health indicators (anxiety, depression, character strengths), physiological markers (cortisol awakening response [CAR], melatonin), and QoL. Thriving levels were evaluated using ordinary least squares regression and quantile regression to identify predictors across different thriving percentiles.

Results: Psychological health was the strongest predictor of thriving. Depression negatively impacted thriving at lower levels, while inquisitiveness consistently enhanced it. CAR and melatonin played roles at higher and median thriving levels, respectively, and QoL was most influential at lower levels. These factors collectively explained 23.0% of the variance in thriving scores.

Conclusions: This study highlights depression, inquisitiveness, CAR, and QoL as key factors influencing thriving in AYA cancer patients. Depression affects thriving at lower levels, inquisitiveness enhances thriving consistently, CAR is significant at higher levels, and QoL is crucial at lower levels. These findings underscore the need for tailored interventions to support thriving across varying levels of adaptation.

Keywords: Adolescent and young adult; Biomarker; Psychological health; Quality of life; Thriving.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Adherence to the Declaration of Helsinki’s guidelines was ensured in this research, with ethical clearance granted by the Institutional Review Board (IRB) of the Third Xiangya Hospital, Central South University (Approval No. 2020-S063). All study participants provided informed consent prior to their inclusion in the research. For participants under the age of 16, informed consent was obtained from their parents or legal guardians, in accordance with ethical guidelines. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Tree metaphor of thriving. The tree metaphor conceptualizes thriving as a dynamic and interconnected process. “Roots and soil” (Means) represent foundational resources like quality of life. “Trunk and branches” (Process) reflect biological and psychological mechanisms, such as cortisol awakening response, melatonin, depression, anxiety and character strengths. “Leaves and flowers” (Outcome) symbolize flourishing results, including enhanced well-being and life satisfaction. This framework highlights how thriving is shaped by the interplay of foundational resources, adaptive processes, and individual outcomes [4]. Reproduced from Fabian et al. (2023), published under a Creative Commons CC BY license in Journal of Happiness Studies (DOI: 10.1007/s10902-023-00682-y)
Fig. 2
Fig. 2
Coefficients of biological markers, psychological health indicators, and quality of life across various quantiles of thriving levels. Quantile regression analysis demonstrates the coefficients of biological markers (CAR, melatonin), psychological indicators [anxiety, depression, character strengths (self-control, inquisitiveness, caring)], and quality of life across thriving quantiles (25th, 50th, and 75th percentiles). The results reveal the varying impact of these factors on thriving at different levels. Abbreviation: CAR: Cortisol awakening response
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References

    1. National Comprehensive Cancer Network. NCCN guidelines for patients adolescent and young adult cancer 2023 [cited 2024 08/29]. Available from: https://www.nccn.org/patients/guidelines/content/PDF/aya-patient.pdf
    1. Cho E, Docherty SL. Beyond resilience: A concept analysis of human flourishing in adolescents and young adults with cancer. ANS Adv Nurs Sci. 2020;43(2):172–89. 10.1097/ans.0000000000000292. - PubMed
    1. Brown DJ, Arnold R, Fletcher D, Standage M. Human thriving. Eur Psychol. 2017;22(3):167–79. 10.1027/1016-9040/a000294.
    1. Fabian M, Alexandrova A, Nair YC. Coproducing wellbeing policy: A theory of thriving in financial hardship. J Happiness Stud. 2023;24(7):2309–30. 10.1007/s10902-023-00682-y.
    1. Baxter R, Lövheim H, Björk S, Sköldunger A, Edvardsson D. Exploring changes to resident thriving and associated factors in Swedish nursing homes: A repeated cross-sectional study. Int J Geriatr Psychiatry. 2022;37(6). 10.1002/gps.5731. - PMC - PubMed

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