P20.07.a identifying self-efficacy differences in adult rare cns patients participating in a novel web-based natural history

Abstract BACKGROUND A cancer diagnosis can diminish self-efficacy (sense of control and confidence), which can be essential for self-management. Perceived control in coping effectively with the adverse effects of a diagnosis has been correlated with improved mood, self-regulation, and decreased symptom distress. Using data collected in our global web-based NCI-CONNECT Natural History study (https://www.cancer.gov/rare-brain-spine-tumor/ ), we explored the relationship between self-efficacy levels in managing social interactions (SEMSI), sample characteristics, and mood-related inference (REM) in adult patients with rare CNS tumors. MATERIAL AND METHODS Interested adult patients completed a study enrollment confirming a rare diagnosis. Eligibility and consent forms were reviewed with the study coordinator before consent was signed. A unique link to complete the online survey was sent to enrolled patients. This web-based survey captured current demographic/clinical data, symptom burden, and REM (mood, relations with others, enjoyment of life, scores ≥ 2=moderate-severe (M-S)) from the MDASI-BT & MDASI-SP and the PROMIS SEMSI (t-scores: Low=<40 (lower confidence), Average=50 (US general population), High= >60 (greater confidence)). RESULTS Evaluated patients (n=166) were predominantly female (72%), the median age was 45 (19-75, and 15% were on active treatment. An ependymoma diagnosis (66%), no recurrence (80%), and tumor location in the brain (53%) were common. Median time since diagnosis was 14 months (0-402 months). Most patients reported average SEMSI, none reported high, and 28% of brain vs. 7% of spine reported low SEMSI. Among demographic/clinical factors, low SEMSI correlated with lower education (r=0.22) and a prolonged time between symptoms and surgery (r= -0.29) among brain patients. Additionally, married (42%) brain patients had a higher chance of endorsing low SEMSI. No associations were identified for spine patients. Brain patients, reporting low (92%) and average (48%) SEMSI, also endorsed M-S REM (p<0.001, OR=12.1, n=87). Additionally, all M-S REM symptoms (fatigue, disturbed sleep, distress, sadness, irritability) were associated with low SEMSI. As REM worsened, SEMSI decreased in brain patients (r= -0.54), with no relationship found in spine patients. CONCLUSION We found that brain tumor patients reported less confidence in managing social interactions with low self-efficacy levels linked to marital status, education, a longer time between symptoms and surgery, and worsened mood-related interference, but surprisingly no association in those with spine tumors. Identifying patient characteristics associated with self-efficacy within tumor locations can lead to targeted cognitive and behavioral interventions motivating patients to mitigate distress that can help with adjustment to one’s disease.