{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:20:58Z","timestamp":1790313658717,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001607","name":"Eye and Ear Foundation of Pittsburgh","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001607","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a growing cohort of head and neck cancer (HNC) patients affected by late\u2010 and long\u2010term posttreatment side effects. Our study evaluates the relationship between the demographics, clinical characteristics, and posttreatment symptom burden with the subjective sense of flourishing among HNC survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional, single\u2010center study of adult survivors of squamous cell cancer of the oral cavity, oropharynx, and larynx\/hypopharynx who completed the Secure Flourishing Index (SFI) and patient\u2010reported outcomes related to depression, anxiety, swallowing dysfunction, neck disability, and insomnia between November 2020 and April 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 100, predominantly male (86%), survivors with an average age of 63.0\u00a0\u00b1\u00a09.6 were included in the study. Univariable analysis showed a significant association between higher flourishing scores and advanced age (95% CI: [0.011, 0.84],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0441), normal diet (95% CI: [5.79, 31.18],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0149), employment (95% CI: [1.24, 17.20],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0239), higher income (95% CI: [7.30, 27.72],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0248), and decreased reported difficulty paying for needs (95% CI: [\u221233.46, \u221218.88],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Flourishing was inversely associated with higher symptoms of depression (95% CI: [\u22122.23, \u22121.15],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), anxiety (95% CI: [\u22121.92,\u20100.86],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), swallowing dysfunction (95% CI: [\u22120.77, \u22120.26],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), neck disability (95% CI: [\u22121.05, \u22120.35],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and insomnia (95% CI: [\u22121.12, \u22120.22],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004) in the multivariable analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Common late\u2010 and long\u2010term side effects of HNC treatment and financial hardship are associated with lower levels of flourishing or a more negative perception of life after treatment. Results highlight the importance of symptom burden for survivors' overall evaluation of their quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.4636","type":"journal-article","created":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T00:28:50Z","timestamp":1647044930000},"page":"2561-2575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Flourishing in head and neck cancer survivors"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0336-4438","authenticated-orcid":false,"given":"Alexandria","family":"Harris","sequence":"first","affiliation":[{"name":"School of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Department of Otolaryngology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karley","family":"Atchison","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Center for Health Equity Research and Promotion Veterans Affairs Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"Geriatric Research Educational and Clinical Center Veterans Affairs Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"Wolff Center UPMC  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"VanderWeele","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard T. 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