{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:06:33Z","timestamp":1790863593781,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,27]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Data on how positive psychological traits and perceived spousal support are related to head and neck cancer (HNC)-specific health-related quality of life (QOL) using validated instruments in the Malay language in oncology settings are scarce. Hence, this study: (1) evaluated the association between demographic and clinical characteristics, optimism, posttraumatic growth (PTG), hope, perceived spousal support and HNC specific health-related QOL; and (2) assessed the mediation associations of PTG, perceived spousal support and hope on the relationship between optimism and HNC specific health-related QOL among a cohort of patients with HNC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>This study was conducted in two tertiary referral centres for oncology treatment in Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Data were collected from a total of 240 patients with HNC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was HNC specific health-related QOL assessed with the 35-item European Organisation for Research and Treatment of Cancer Quality of Life-Head and Neck Module, while the secondary outcomes were optimism measured with the Life Orientation Test-Revised, PTG measured with the Posttraumatic Growth Inventory-Short Form, perceived spousal support evaluated with the Sources of Social Support Scale and hope assessed with the Dispositional Hope Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher perceived spousal support (B=\u22120.454, 95% CI \u22120.781 to \u22120.126, p=0.007) and optimism (B=\u22122.001, 95% CI \u22122.660 to \u22121.342, p&lt;0.001) were significantly associated with greater HNC specific health-related QOL but not PTG (p=0.772) and hope (p=0.081). In addition, those with nasopharyngeal carcinoma and those on chemotherapy alone had significantly greater HNC specific health-related QOL than those with other HNC tumours (B=\u22128.586, 95% CI 2.927 to 14.245, p=0.003) and those who combined surgery, chemotherapy and radiotherapy, respectively (B=\u221210.864, 95% CI \u221218.897 to \u22122.831, p=0.008). Meanwhile, greater perceived spousal support partially mediated the association of optimism and improved HNC-specific health-related QOL but not PTG and hope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Optimism and perceived spousal support may have a positive association with HNC-specific health-related QOL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-122154","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:42:55Z","timestamp":1790862175000},"page":"e122154","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship between positive psychological traits, perceived spousal support and head and neck cancer-specific health-related quality of life: a cross-sectional study in oncology treatment settings"],"prefix":"10.1136","volume":"16","author":[{"given":"Yamunaa Sai","family":"Mohana Rao","sequence":"first","affiliation":[{"name":"Universiti Sultan Zainal Abidin Fakulti Perubatan, Kuala Terengganu, Terengganu, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Jalil","sequence":"additional","affiliation":[{"name":"Tun Abdullah Ahmad Badawi Cancer Centre, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7762-4052","authenticated-orcid":false,"given":"Mohammad Farris Iman","family":"Leong Bin Abdullah","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health, Universiti Sultan Zainal Abidin Fakulti Perubatan, Kuala Terengganu, Terengganu, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"2026100106201972000_16.10.e122154.1","doi-asserted-by":"crossref","first-page":"1665019","DOI":"10.3389\/fonc.2025.1665019","article-title":"Global burden of head and neck cancer: Epidemiological transitions, inequities, and projections to 2050","volume":"15","author":"Sun","year":"2025","journal-title":"Front Oncol"},{"key":"2026100106201972000_16.10.e122154.2","first-page":"e61173","article-title":"Treatment complications of head and neck cancers and rehabilitation measures: A narrative review","volume":"16","author":"Sharma","year":"2024","journal-title":"Cureus"},{"key":"2026100106201972000_16.10.e122154.3","unstructured":"American Psychological Association . 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