title: Health-related quality of life in haematopoietic stem cell transplant survivors: a qualitative study on the role of psychosocial variables and response shifts.
abstract: OBJECTIVE
  Psychosocial assessment prior to haematopoietic stem cell transplants (HSCT) can help to identify patients at risk of impaired health-related quality of life (HRQOL) post-transplant. According to the response-shift model, certain antecedents and mechanisms, along with changes in internal standards, values or conceptualizations of HRQOL, facilitate adjustment to changes in health circumstances. This study sought to explore the role of psychosocial variables in adjustment to compromised HRQOL following HSCT, from the theoretical basis of the response-shift model.
  
  
  METHODS
  Semi-structured interviews were conducted with 28 patients (15 women, 13 men; 22-71 years), post-HSCT. Time since transplant ranged from 1 month to 28 years. Verbatim transcripts were analysed using template analysis.
  
  
  RESULTS
  Patients provided narrative examples of changing their values and internal standards. Optimism, social support, social comparisons, changing expectations and setting goals were identified as important in managing threats to HRQOL.
  
  
  CONCLUSIONS
  The response-shift model is a useful theoretical basis for exploring HRQOL in HSCT patients. Response shifts and psychosocial variables may help patients to cope and enabling them to experience good HRQOL despite the negative effects of HSCT. Understanding the adjustment processes has implications for patient care.
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London,, WC1E 7HB, UK. r.beeken@ucl.ac.uk
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Beeken
authors.forename: Christine
authors.initials: C
authors.lastname: Eiser
authors.forename: Christopher
authors.initials: C
authors.lastname: Dalley
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult
references.citation: Oncol Nurs Forum. 2006 May 03;33(3):614-24
references.pmid: 16676017
references.citation: Brain Inj. 2005 Dec 20;19(14):1181-90
references.pmid: 16286333
references.citation: J Clin Psychol Med Settings. 1996 Dec;3(4):355-66
references.pmid: 24226845
references.citation: Qual Life Res. 2001;10(6):487-501
references.pmid: 11789550
references.citation: J Pers Soc Psychol. 1989 Dec;57(6):1024-40
references.pmid: 2614656
references.citation: J Pers Soc Psychol. 1985 Nov;49(5):1169-83
references.pmid: 4078672
references.citation: Cancer Nurs. 1992 Jun;15(3):153-60
references.pmid: 1611601
references.citation: J Med Ethics. 1984 Sep;10(3):124-7
references.pmid: 6334159
references.citation: Bone Marrow Transplant. 2001 Sep;28(5):503-9
references.pmid: 11593325
references.citation: Nurs Sci Q. 1994 Spring;7(1):29-32
references.pmid: 8139813
references.citation: Soc Sci Med. 2006 Sep;63(6):1602-13
references.pmid: 16716478
references.citation: Soc Sci Med. 1999 Jun;48(11):1517-30
references.pmid: 10400254
references.citation: Psychooncology. 2009 Feb;18(2):113-27
references.pmid: 18677717
references.citation: Psychooncology. 1997 Mar;6(1):1-11
references.pmid: 9126711
references.citation: Health Psychol. 1985;4(3):249-88
references.pmid: 4029107
references.citation: Soc Sci Med. 1999 Jun;48(11):1507-15
references.pmid: 10400253
references.citation: Qual Life Res. 2000;9(8):951-60
references.pmid: 11284214
references.citation: Bone Marrow Transplant. 2007 Jun;39(12):789-99
references.pmid: 17417661
references.citation: J Behav Med. 1996 Jun;19(3):221-40
references.pmid: 8740467
references.citation: Cancer Nurs. 1996 Jun;19(3):170-6
references.pmid: 8674025
references.citation: J Pers Soc Psychol. 1989 Feb;56(2):267-83
references.pmid: 2926629
references.citation: Swiss Med Wkly. 2006 Apr 29;136(17-18):281-90
references.pmid: 16741851
references.citation: Ann Hematol. 2001 Mar;80(3):137-43
references.pmid: 11320897
references.citation: Psychosom Med. 2000 Nov-Dec;62(6):873-82
references.pmid: 11139008
references.citation: Bone Marrow Transplant. 1998 Sep;22(5):409-22
references.pmid: 9733263
references.citation: J Psychosom Res. 2007 Jan;62(1):93-100
references.pmid: 17188126
references.citation: J Psychosom Res. 2002 May;52(5):285-93
references.pmid: 12023125
references.citation: Cancer Nurs. 2007 Mar-Apr;30(2):125-38
references.pmid: 17413778
references.citation: Qual Life Res. 2001;10(8):671-82
references.pmid: 11871588
references.citation: Med Decis Making. 2000 Apr-Jun;20(2):186-93
references.pmid: 10772356
references.citation: Psychol Rev. 1989 Oct;96(4):569-75
references.pmid: 2678204