Objective This article reviews recent literature on adults’ quality of life following hematopoietic stem cell transplantation (HSCT). Methods We identified 22 prospective reports with at least 20 participants at baseline through a search of databases (Medline and PsycInfo) and handsearching of articles published from 2002 to October 2007. If longitudinal data were not available or were scarce for a particular topic or time point, cross-sectional studies were reviewed. Results Although physical, psychological, and social aspects of quality of life tend to improve during the years following transplantation, a significant proportion of HSCT survivors experience persistent anxiety and depressive symptoms, fatigue, sexual dysfunction, and fertility concerns. Despite ongoing treatment side effects, the majority of HSCT survivors resume their work, school, or household activities. Conclusion We conclude that theory-driven research with larger samples is needed to identify subgroups of HSCT survivors with adjustment difficulties. Such research would examine survivors’ evolving standards and definitions of quality of life to improve the accuracy and meaningfulness of assessment and incorporate biological, psychological, and contextual factors that may contribute to positive adjustment.

Background-Older cancer survivors are at increased risk for secondary cancers, cardiovascular disease, obesity, and functional decline and, thus, may benefit from health-related interventions. However, little is known regarding older cancer survivors' health behaviors and their associations with quality of life outcomes, especially during the long-term post-treatment period. Methods: A total of 753 older (age ≥ 65 years), long-term (≥ 5 years post-diagnosis) breast, prostate, and colorectal cancer survivors completed two baseline telephone interviews to assess eligibility for a diet and exercise intervention trial. Interviews assessed exercise, diet, weight status, and quality of life. Results-Older cancer survivors reported a median of 10 minutes of moderate-to-vigorous exercise per week, and only 7% had Healthy Eating Index scores above 80 (indicative of healthful eating habits relative to national guidelines). Despite their suboptimal health behaviors, survivors reported mental and physical quality of life that exceeded age-related norms. Greater exercise and better diet quality were associated with better physical quality of life outcomes (e.g., better vitality and physical functioning; ps ≤ .05), whereas greater body mass index was associated with reduced physical quality of life (ps < .001). Conclusions-Results indicate a high prevalence of suboptimal health behaviors among older, long-term breast, prostate, and colorectal cancer survivors who are interested in lifestyle modification. In addition, findings point to the potential negative impact of obesity and positive impact of physical activity and a healthy diet on physical quality of life in this population.

A brief, telephone-administered CBT intervention developed for HSCT survivors is an efficacious treatment for reducing illness-related PTSD symptoms and general distress.

At a northeastern university, 136 African American students completed measures of racial discrimination, social support, depression. and life satisfaction. The results revealed that 98.5 percent of the sample reported having experienced an incident of discrimination in the past year, and racial discrimination was positively associated with depressive symptoms and negatively associated with life satisfaction. Regression analysis failed to support the stressbuffering model, which predicted that social support would buffer the negative effects of discrimination. The social support mobilization model. which predicted that social support networks mobilize to support individuals against discrimination, was also not supported. Only the social support deterioration model, which predicted that social support would deteriorate for those exposed to discrimination, was supported. (35 ref)-Depurtment of Psychology. Stcite University of New Ynrk. Alhrmy.

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ACT shows feasibility and promise in improving fatigue and sleep-related outcomes in MBC patients and warrants further investigation.

Women with metastatic breast cancer and significant psychological distress (N = 87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue, and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p < .05). Findings suggest that expressive writing may improve uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention.

Objective Cancer patients report high rates of distress. The related constructs of meaning in life (MiL) and sense of coherence (SOC) have long been recognized as important factors in the psychological adjustment to cancer; however, both constructs’ associations with distress have not been quantitatively reviewed or compared in this population. Informed by Park’s integrated meaning-making model and Antonovsky’s salutogenic model, the goals of this meta-analysis were the following: (1) to compare the strength of MiL-distress and SOC-distress associations in cancer patients; and (2) to examine potential moderators of both associations (i.e., age, gender, ethnicity, religious affiliation, disease stage, and time since diagnosis). Methods A literature search was conducted using electronic databases. Overall, 62 records met inclusion criteria. The average MiL-distress and SOC-distress associations were quantified as Pearson’s r correlation coefficients and compared using a one-way ANOVA. Results Both MiL and SOC demonstrated significant, negative associations with distress (r = 0.41, 95% CI: −0.47 to −0.35, k = 44; and r = 0.59, 95% CI: 0.67 to −0.51, k = 18, respectively). Moreover, the MiL-distress association was significantly smaller than the SOC-distress association (Qb = 10.42, df = 1, p < 0.01). Neither association varied by the tested moderators. Conclusions Findings provide support for the clinical relevance of MiL and SOC across demographic and medical subgroups of cancer patients. The strength of the SOC-distress association suggests that incorporating aspects of SOC (e.g., the perceived manageability of life circumstances) into meaning-centered interventions may improve their effectiveness for distressed cancer patients.