Protective psychosocial factors in patients undergoing bone marrow transplantation: A secondary analysis of longitudinal data.

摘要

Bone marrow transplant (BMT) is a highly toxic, and increasingly common, treatment for leukemia and other disorders. Several negative psychosocial impacts of BMT have been well established, and include depression, anxiety, and anger. There is also evidence that psychosocial factors, such as distress and poor social support, can adversely influence survival after BMT. There has been relatively little focus, however, on potential protective psychological and psychosocial factors in BMT patients. In this analysis of longitudinal data, the influence of three positive psychosocial factors (coherence, satisfaction with social support, and low uncertainty) on morbidity (higher medical complications and distress, and lower quality of life [QOL]) and mortality post-transplant were evaluated. Data from patients receiving BMT for leukemia were collected pretransplant, and 90 days and 1 year post-transplant. Results indicate that coherence, satisfaction with social support, and low uncertainty do not significantly impact survival (mortality) after BMT. However, these positive psychosocial factors do have varying impacts on morbidity after BMT. Although no impact on medical complications post-transplant was found, the positive psychosocial factors were correlated with distress at the pre-transplant and 90 day post-transplant time points. These factors were also associated with QOL measured post-transplant, such that high coherence and low uncertainty predicted better QOL pre-transplant, and high satisfaction with social support predicted better QOL at 90 days. Results are discussed in the context of cancer treatment as a psychosocial transition. These findings may be useful in designing prospective interventions for patients undergoing BMT.