Quality of life (QOL), supportive care, and spirituality in hematopoietic stem cell transplant (HSCT) patients

Abstract

For many patients, a hematopoietic stem cell transplant (HSCT) can be challenging to physical and emotional health. Supportive care needs can be overwhelming for many patients and families. The purpose of this study was to evaluate the effect of quality of life (QOL), spiritual well-being, and supportive care resources post-HSCT. This descriptive, repeated-measures study included people over the age of 18 years undergoing HSCT for any cancer diagnosis. The Functional Assessment in Cancer Therapy--Bone Marrow Transplant scale, the Functional Assessment of Chronic Illness Therapy--Spiritual--12 scale, and a resource questionnaire were administered prior to HSCT and following HSCT at 30, 60, 90, and 180 days. Three groups of HSCT patients were examined: allogeneic, autologous, and overall. Data analysis included descriptive statistics and correlations. In the sample (n = 159), the autologous HSCT group reported the highest QOL scores. Spirituality scores increased for the autologous HSCT group at 90 days, but decreased for the overall and allogeneic groups. The type of supportive care resources most used were information from the physician and nurse, the Leukemia and Lymphoma Society Support as the most used form of support group, and Faith, Prayer and Spiritual Healing. QOL and spiritual well-being scores correlated best at 180 days (6 months) for autologous and allogeneic patients.

Music Therapy for Patients Who Have Undergone Hematopoietic Stem Cell Transplant

“…Moreover, independent of group assignment, individuals reported significant improvements in QOL from baseline to 1 month after intervention, echoing previous research suggesting that QOL continues to improve during the first 100 days after transplant [1, 2]. There are several possible reasons for the lack of benefit.…”

“…The procedure is regarded as one of the most difficult oncologic interventions due to the common and intense side effects of high dose chemotherapy and graft-versus-host disease such as organ toxicity (e.g., pulmonary and cardiac), osteoporosis, infection, cataracts, and infertility [1–8]. Not surprisingly, HSCT has been associated with diminished quality of life (QOL), especially in the first 100 days after transplant period [2–5]. The period of lowest white blood cell count, nadir, which typically occurs within the first 30 days after transplant, has been identified as the time when patients report the greatest symptom distress [9] although patients may report symptom distress for as long as 3–5 years after transplant [10].…”

“…The acute complications of HSCT may prevent patients from participating in common symptom management interventions [6]. Thus, finding effective methods to alleviate distress and improve coping skills and emotional well-being may improve post-transplant QOL as well as reduce symptom distress [2, 7, 8, 11]. …”

Quality of life of patients with graft-versus-host disease (GvHD) post-hematopoietic stem cell transplantation

“…A similar result was evidenced in a study of 159 patients diagnosed with cancer at a HSCT unit in the United States (19) , unlike what was found in a public hospital in the state of São Paulo with 12 patients submitted to HSCT. In this, QoL was preserved in the prehospital discharge period except for the physical aspects (20) .…”

Spirituality, religiousness and health: implications for the field of hematology

“…In the field of hematology, spirituality and religiousness have been associated with several positive outcomes: better quality of life in hematopoietic stem cell transplant patients, 6 in patients with multiple myeloma 7 and in patients with myelodysplastic syndromes 8 ; slower passage of subjective time (which could be a sign of mental suffering) in patients with hematological malignancies 9 ; lower post-traumatic stress symptoms in acute leukemia patients 10 and fewer hospital admissions among adults with sickle cell disease 11 …”