Coping in caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation

Abstract

Caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT) must cope with substantial caregiving burden, high rates of psychological distress, and diminished quality of life (QOL). However, data describing coping strategies pre-HSCT and the association between coping, QOL, and psychological outcomes in this population are lacking. We conducted a secondary analysis of data collected during a multi-site randomized clinical trial of a supportive care intervention in HSCT recipients and their caregivers. Caregivers completed the Brief COPE, Hospital Anxiety and Depression Scale, and the Caregiver Oncology Quality of Life Questionnaire to measure coping strategies, psychological distress, and QOL, respectively. We grouped coping into two higher order domains: approach-oriented (i.e., emotional support, active coping) and avoidant (i.e., self-blame, denial) We used the median split method to describe the distribution of coping and multivariate linear regression models to assess the relationship between coping and caregiver outcomes. We enrolled 170 caregivers, with a median (range) age of 53 (47-64) years. Most were White (87%), non-Hispanic (96%), and female (77%). Approach-oriented coping was associated with less anxiety (β=-0.210, p=0.003) and depression symptoms (β=-0.160, p=0.009), and better QOL (β=0.526, p=0.002). In contrast, avoidant coping was associated with more anxiety (β=0.687, p<0.001) and depression symptoms (β=0.579, p<0.001), and worse QOL (β=-1.631, p<0.001). Our findings suggest that coping is related to distress and QOL among caregivers of HSCT recipients even pre-transplant. Hence, caregivers of patients with hematologic malignancies undergoing HSCT may benefit from resources that facilitate adaptive coping with the demands of caregiving.

Emotional Coping Strategies for Informal Caregivers of Hospitalized Patients: A Study of Distress and Overload

“… 17 Therefore is necessary understand these survival mechanisms to help informal caregivers cope with the demands of providing care. 18 …”

“…17 Therefore is necessary understand these survival mechanisms to help informal caregivers cope with the demands of providing care. 18 Coping strategies are classified as adaptive and maladaptive. Adaptive strategies focus on managing the conflict, promoting the caregiver's adaptation to the conflict.…”