Relationships among symptoms, psychosocial factors, and health-related quality of life in hematopoietic stem cell transplant survivors

Abstract

Objective To evaluate the mediating effect of depressive symptoms on the relationship between physical symptoms and health-related quality of life (HRQOL) in hematopoietic stem cell transplant survivors (HSCT); and to test a conceptual model of psychosocial factors, in addition to physical and psychological symptoms, that might contribute to HRQOL. Methods This is a secondary data analysis using subjects (N=662) identified from the Center for International Blood and Marrow Transplant Research for HSCT survivors who were treated in 40 North American Medical Centers. Data were collected through mailed surveys, phone interviews, and medical records. We used structural equation modeling to test the mediating role of depressive symptoms on the relationship of physical symptoms with HRQOL. We also tested comprehensive pathways from physical symptoms to HRQOL by adding other psychosocial factors including optimism, coping, and social constraints. Results In the depressive symptom mediation analyses, physical symptoms had a stronger direct effect on physical HRQOL (b=−0.98, p<0.001) than depressive symptoms (b=0.23, p>0.05). Depressive symptoms were associated with mental HRQOL and mediated the relationship between physical symptoms and mental HRQOL. In the comprehensive pathway analyses, physical symptoms remained the most significant factor to be associated with physical HRQOL. In contrast, depressive symptoms had a direct effect (b=−0.76, p<0.001) on mental HRQOL and were a significant mediator. Psychosocial factors were directly associated with mental HRQOL and indirectly associated with mental HRQOL through depressive symptoms. Conclusion Physical symptoms are most strongly associated with physical HRQOL; while depressive symptoms and psychosocial factors impact mental HRQOL more than physical HRQOL. Interventions targeting physical/psychological symptoms and psychosocial factors may improve HRQOL of HSCT survivors.

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

“…This data corroborates a national study carried out with 30 participants in São Paulo (15) , as well as an American study conducted with 662 participants (16) . Regarding gender, the study is not compatible with the cancer estimates for the years of 2014 and 2015, when hematologic malignancies presented higher incidence in men (17) .…”

“…Regarding gender, the study is not compatible with the cancer estimates for the years of 2014 and 2015, when hematologic malignancies presented higher incidence in men (17) . Regarding the diagnosis, the predominance of leukemias corroborates the findings of a North American study in which 60% were leukemias (16) . It is in line with the estimate for cancer in 2015 in Brazil, in which this diagnosis presents an absolute superior frequency in comparison to other hematological malignancies (17) .…”

Spiritual Well-Being in Hispanic and Non-Hispanic Survivors of Allogeneic Hematopoietic Stem Cell Transplantation

“…Transplant complications arise as a result of the conditioning regimen, the new donor-derived immune system, sequelae from prolonged immunosuppressant treatments that prevent acute and chronic graft-versus-host disease and side effects from supportive medications (Arnaout et al, 2014; Bevans et al, 2014; Mitchell et al, 2010; Pidala, Anasetti, & Jim, 2009; Tichelli, Rovo, & Socie, 2012). In addition to these biological effects, unpleasant symptoms, functional impairment, and psychosocial distress (for example fear of recurrence) can have a deleterious impact on several patient-centered outcomes, including health-related quality of life (HRQL) (Bevans et al, 2014; Gifford, Sim, Horne, & Ma, 2014; Kenzik, Huang, Rizzo, Shenkman, & Wingard, 2014; Mitchell et al, 2010; Mohty & Mohty, 2011; Norkin, Hsu, & Wingard, 2012; Pidala et al, 2009; Sarkar et al, 2014; Syrjala et al, 2012; Tichelli et al, 2012). …”

Qualidade De Vida Nos Primeiros Seis Meses Pós-Transplante De Células-Tronco Hematopoéticas

“…Studies conducted in the Netherlands and the United States with adult patients confirm this result. [19][20][21] Higher education fosters understanding questions related to treatment, especially with regard to the guidelines during hospital stay and after discharge. It is essential that this understanding occurs, making the patient predisposed to developing self-care and active participation in their attempt for succeeding in their therapeutic path and to recover their life activities.…”