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.

Michel, G., Rijken, M., Kokla, M., Sleurs, C., Lemiere, J., Frederiksen, L.E., Mader, L., Follin, C., Oberti, S., Winther, J.F., S.R. van den Oever, Kremer, L.C.M., Pal, H.J.H. van der, Spreeuwenberg, P., Bouwman, E., Te Dorsthorst, J., Essiaf, S., Feijen, E.A.M.L., Gsell, H., Haupt, R., Helvoirt, M. van, Hermens, R.P.M.G., Hjorth, L., Kepak, T., Kepakova, K., Kienesberger, A., Muraca, M., Renard, M., Schneider, C., Skinner, R., Uyttebroeck, A., Vanrusselt, D., Verschueren, S., Loonen, J., Pluijm, S.M..F, Roser, K. 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. Pediatric Blood & Cancer: 2026.

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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.