Cancer‐and‐treatment–specific distress and its impact on posttraumatic stress in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT)

Abstract

Our data provide first evidence regarding the course of 6 dimensions of CTXD during HSCT and their impact on PTSD symptomatology. Specifically, results emphasize the major burden of uncertainty pre-HSCT and the impact of uncertainty and concerns regarding appearance and sexuality on PTSD symptomatology.

Rates and Risk Factors for Post-Traumatic Stress Disorder Symptomatology among Adult Hematopoietic Cell Transplant Recipients and Their Informal Caregivers

“…Due to our large sample size, an absence of significant associations is not due to lack of statistical power. These findings did not align with our hypotheses, 4, 13 and suggests that it may be difficult to predict patients and caregivers at higher risk for PTSD. Instead, all patients and accompanying caregivers could be easily screened for PTSD symptoms and referred if necessary.…”

“…Thus, the lower rate of PTSD in our population may be due to a longer time since transplant compared to previous studies or due to use of different PCL-5 scoring definitions for PTSD. 13 Nevertheless, mixed findings on rates of PTSD over time indicate that screening should occur in all survivors and caregivers regardless of time since HCT. The addition of PTSD screening to survivorship care plans should be considered.…”

“…8 Risk factors for PTSD have included longer length of hospital stay, pain, distress, more negative appraisals of the transplant, and lack of social support. 4, 11–13 Data are mixed regarding associations with age, gender, marital status, transplant type, and history of acute graft versus host disease (GVHD). 3, 4, 6, 7 The presence of comorbidities and disease relapse have not been found to be associated with PTSD.…”

Symptoms of posttraumatic stress disorder among hospitalized patients with cancer

“…For purposeful selection, we included covariates that were associated at a significance level < .10 and any confounders (defined as any variable that changed the parameter estimate of another variable by >20% when removed from the model) in the final model. To examine relationships between continuous PTSD symptoms and patients' physical and psychological symptom burden, we used linear regression models adjusted for potential confounders, including age, sex, marital status, education level, comorbidities (Charlson Comorbidity Index), cancer type, presence of incurable cancer, and time since cancer diagnosis . We also used Fisher's exact test to compare the rates of moderate/severe ESAS symptoms for patients with and without a positive screen for PTSD symptoms.…”

“…We also used Fisher's exact test to compare the rates of moderate/severe ESAS symptoms for patients with and without a positive screen for PTSD symptoms. To investigate the relationships between continuous PTSD symptoms and time to hospital readmission within 90 days, we used Cox proportional hazards regression models adjusted for potential confounders, including age, sex, marital status, education level, comorbidities, cancer type, presence of incurable cancer, time since cancer diagnosis, length of stay during the index hospital admission, PHQ‐4 depression symptoms, PHQ‐4 anxiety symptoms, and ESAS physical symptoms . All reported P values are 2‐sided, with P < .05 considered statistically significant.…”