title: Self-efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well-being after hematopoietic stem cell transplant.
abstract: OBJECTIVE
  Cognitive problems are commonly reported by hematopoietic stem cell transplant (HSCT) survivors and are associated with poorer physical and mental well-being. It was hypothesized that adverse effects of subjective cognitive impairment occur because cognitive difficulties reduce survivors' confidence that they can manage HSCT-related symptoms-that is, self-efficacy for symptom management.
  
  
  METHODS
  Hematopoietic stem cell transplant survivors (n = 245), 9 months to 3 years post-HSCT, completed measures of subjective cognitive functioning, self-efficacy for symptom management, and clinically important outcomes: depressed mood, anxiety, and quality of life. Mediation analyses using bootstrapping were conducted to investigate whether effects of subjective cognitive impairment on these outcomes were mediated by self-efficacy for cognitive, emotional (SE-Emotional), social (SE-Social), and physical (SE-Physical) symptom management.
  
  
  RESULTS
  Self-efficacy mediated relations between subjective cognitive impairment and depressed mood (total indirect effect = -0.0064 and 95% CI -0.0097 to -0.0036), anxiety (total indirect effect = -0.0045, CI -0.0072 to -0.0021), and quality of life (total indirect effect = 0.0952, CI 0.0901 to 0.2642). SE-Emotional was a unique mediator when the outcome was depressed mood and anxiety. SE-Social, SE-Physical, and SE-Emotional were specific mediators when outcome was quality of life.
  
  
  CONCLUSIONS
  Findings support the conclusion that subjective cognitive impairment reduces HSCT survivors' confidence in their ability to manage common post-HSCT symptoms, with implications for physical and mental well-being. Interventions that help enhance survivors' self-efficacy, particularly self-efficacy for the management of emotional symptoms, are likely to benefit HSCT survivors who report subjective cognitive impairment.
authors: Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA. lisa.wu@mssm.edu.
authors: Lisa M
authors: LM
authors: Wu
authors: Jane
authors: J
authors: Austin
authors: Jada G
authors: JG
authors: Hamilton
authors: Heiddis
authors: H
authors: Valdimarsdottir
authors: Luis
authors: L
authors: Isola
authors: Scott
authors: S
authors: Rowley
authors: Rachel
authors: R
authors: Warbet
authors: Gary
authors: G
authors: Winkel
authors: William H
authors: WH
authors: Redd
authors: Christine
authors: C
authors: Rini
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000523:psychology*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D020377:Self Efficacy; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology; D017741:Survivors / Q000523:psychology*