The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment.

The Functional Assessment of Cancer Therapy-Bone Marrow Transplant measures quality of life (QOL) in SCT patients. Prior reports found mixed results regarding QOL differences among autologous and allogeneic SCT patients. In addition, there is a paucity of literature examining differences in QOL patterns over time between autologous and allogeneic patients. The present study examines differences in QOL between patients free of clinical depression undergoing autologous (n ¼ 41) and allogeneic (n ¼ 64) SCT during early stages of treatment. Despite clinical differences, autologous and allogeneic patients demonstrated similar changes in QOL. The exception was the Functional subscale which indicated worse QOL for allogeneic patients at discharge (F test ¼ 4.61, df ¼ 1, Po0.05); allogeneic patients (Mean ¼ 13.06, s.d. ¼ 5.36) indicated they were less able to function at work and were less accepting of their illness than autologous patients (Mean ¼ 16.02, s.d. ¼ 6.73). There was a significant main effect for time on nearly all QOL subscales (Po0.05) demonstrating decline during treatment and return to baseline by discharge; only the Social Well-Being scale did not significantly change over time. These results help to understand patients' response to SCT in the earliest stages and ultimately help identify patients at risk who could benefit from therapeutic interventions.

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Non-compliance has received significant attention in medicine, yet few studies have examined its correlates in autologous hematopoietic SCT (AHSCT) patients. This study examined predictors of non-compliance in a sample of 151 AHSCT patients treated in an outpatient setting. Before AHSCT, participants completed a validated measure of mood and retrospective chart reviews were conducted to assess non-compliance during AHSCT, defined as refusal of oral hygiene, prescribed exercise programs, oral nutrition and/or prescribed medications. We found 121 patients (80%) were non-compliant with an aspect of the AHSCT regimen on 1 or more days; mean percentage of noncompliant days was 16.6 (s.d. 15.6). Men were more likely than women to be non-compliant (Po0.05); as were participants with an elevated depression score (Po0.05).Stepwise regression models identified significant predictors of non-compliance: gender, depression, global distress and nausea and vomiting severity (P-values all o0.01). Further analysis revealed that the interaction of the psychological variables with gender was a more robust predictor of noncompliance (Po0.001). For outpatient AHSCT, our findings suggest the need to broaden conceptualizations of risk factors for non-compliance and the importance of assessing patient barriers to compliance to ensure optimal treatment outcome.

Objective to examine the relationships among non-conventional practices, adherence and immune functioning in individuals with HIV. Methods 92 participants completed an interview on non-conventional practices (complementary and alternative medicines (CAM), psychosocial therapies, and religious practice). They also completed the Psychiatric Symptom Index and the AIDS Clinical Trials Group Adherence Follow-up Questionnaire. Medical chart reviews determined CD4 count and viral load. Results Hierarchical logistic regressions revealed religious practice was associated with adherence and CAM was associated with viral load. Conclusion Participation in non-conventional practices in HIV populations may lead to positive health and health behaviors. Clinical implications are discussed.

11018 Background: Participating in end-of-life (EOL) care may lead to physician distress and burnout. Residents rotating on inpatient oncology services often care for patients and families nearing the EOL. There is no standardized resident training for EOL care nor are there standardized methods to assist with resultant emotional distress. Studies have demonstrated that residents on hematology/oncology rotations experience acute empathy decline, which can lead to cynicism and depersonalization, contributing to burnout (McFarland, 2016). Our objective was to prospectively evaluate the impact of a structured debriefing session during a 4-week inpatient oncology rotation on residents' concerns about death and rotation satisfaction. Methods: During week 1, residents completed a 10-item Concerns about Dying (CAD) instrument (Mozer, 2004). During week 3, residents participated in a structured 60-minute debriefing session with a clinical psychologist or licensed social worker specializing in hematology-oncology. During week 4, residents completed the CAD and an end-of-rotation self-assessment. Results: 58 individual residents rotated through inpatient oncology at Loyola University Medical Center from 7/2020 – 1/2022. 15 residents were excluded as they did not complete both the pre and post surveys. Trainees had a lower CAD score at the end of their oncology rotation, indicating a more positive attitude towards death and dying. PGY1s had the greatest decrease in CAD score over 4 weeks. Anxiety (70%), relief (70%), satisfaction/pride (63%) and sadness (58%) were the most common emotions residents felt while providing EOL care. 42/43 (98%) residents were comfortable discussing EOL topics with a licensed counselor and 40/43 (93%) felt the debriefing had a positive impact on their rotation. 38/43 residents (88%) believed the debriefing reduced sentiments of cynicism and dissatisfaction caused by emotional distress related to EOL care. Conclusions: Resident concerns about death decreased during a 4-week inpatient oncology rotation in which a structured debriefing program occurred during week 3. Although the study protocol does not provide causation, it suggests the debriefing allowed residents to reflect on EOL care and enhance their ability to cope with distress. The favorable feedback from this pilot led to a permanent curricular change for the inpatient oncology rotation. Strategies to assess and manage emotional strain among residents providing EOL care remain limited and warrant further investigation.[Table: see text]

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