Symptom distress, coping style and biological variables as predictors of survival after bone marrow transplantation.
Psychological assessments made at the time of bone marrow transplantation (BMT) were examined in 31 patients at 1-2 years posttransplantation and factors associated with survival were explored. Psychological assessments were carried out soon after admission to hospital for the BMT and about 3-4 weeks later. Cox regression survival analysis revealed that an interactive biopsychological model could explain survival status. Shorter survival was associated with mismatched marrow grafts (p = 0.04), prior experience with chemoradiotherapy (p-0.02), disease stage (p = 0.04), higher symptom distress during BMT (p = 0.008), less hopefulness (p = 0.005), and more acceptance of the situation (p = 0.02). These psychological/psychosomatic and personality characteristics may act directly by interacting with immune function or indirectly by leading to other behaviors known to affect survival in cancer patients. Enhancing more effective coping strategies and altering high symptom-related distress during BMT seem important means not only for improving psychosocial adjustment (quality of life), as has been shown in the literature, but also for increasing survival (quantity of life).
Molassiotis
A
A
Institute of Health Care, University of Malta, G'Mangia.
Van Den Akker
O B
OB
Milligan
D W
DW
Goldman
J M
JM
D000223:Adaptation, Psychological; D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality* / Q000523:psychology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004739:England / Q000453:epidemiology; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010551:Personality; D016016:Proportional Hazards Models; D013315:Stress, Psychological / Q000401:mortality; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D016896:Treatment Outcome