Cross-sectional study of patient-reported neurobehavioral problems following hematopoietic stem cell transplant and health-related quality of life

Wu, Lisa M.; Austin, Jane E.; Valdimarsdottir, Heiðdís; Isola, Luis; Rowley, Scott D.; Diefenbach, Michael A.; Cammarata, Meredith; Redd, William H.; Rini, Christine

doi:10.1002/pon.3554

Cited by 7 publications

(5 citation statements)

References 36 publications

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“…Only recently has the existence of such symptoms been reported in cancer patients by our team (Wu et al, 2014). In the present study, the neurobehavioral symptoms of emotional lability and impulsivity (both aspects of disinhibition) were reported by significantly more ADT than nADT patients.…”

Section: Discussionmentioning

confidence: 99%

Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: A mixed methods study

Tanenbaum

Dijkers

et al. 2016

Social Science & Medicine

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BACKGROUND Few studies have investigated prostate cancer patients’ experiences of cognitive functioning or neurobehavioral symptoms (i.e., behavioral changes associated with neurological dysfunction) following androgen deprivation therapy (ADT). METHODS Semi-structured interviews conducted from the US by phone and in-person were used to explore and characterize the: 1) experience of cognitive and neurobehavioral functioning in non-metastatic prostate cancer patients undergoing ADT (n=19) compared with patients who had not undergone ADT (n=20); 2) perceived causes of cognitive and neurobehavioral symptoms; 3) impact of these symptoms on quality of life; and 4) strategies used to cope with or compensate for these symptoms. Neuropsychological performance was assessed to characterize the sample. RESULTS Overall, ADT patients experienced marginally more cognitive problems than non-ADT (nADT) patients even though there were no significant differences between groups in neuropsychological performance. ADT patients also experienced more declines in prospective memory and multi-tasking than nADT patients. Significant proportions of participants in both groups also experienced retrospective memory, attention and concentration, and information processing difficulties. With respect to neurobehavioral symptoms, more ADT patients experienced emotional lability and impulsivity (both aspects of disinhibition) than nADT patients. Among the causes to which participants attributed declines, both groups attributed them primarily to aging. A majority of ADT patients also attributed declines to ADT. For both groups, increased cognitive and neurobehavioral symptoms negatively impacted quality of life, and most participants developed strategies to ameliorate these problems. CONCLUSION ADT patients are more vulnerable to experiencing specific cognitive and neurobehavioral symptoms than nADT patients. This study highlights the importance of capturing: a) cognitive symptoms not easily detected using neuropsychological tests; b) neurobehavioral symptoms that can be confused with psychological symptoms, and c) causal beliefs that may affect how people cope with these symptoms. Effective interventions are needed to assist prostate cancer patients in managing these symptoms.

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Section: Discussionmentioning

confidence: 99%

Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: A mixed methods study

Tanenbaum

Dijkers

et al. 2016

Social Science & Medicine

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“…Some neurobehavioral problems, particularly apathy, were observed in patients after HCT. 33 Although cognitive impairments are evident for a subset of patients before HCT, results from a meta-analysis suggest that cognition does not significantly change after HCT. 34 What Is the Impact of Cancer on Cognition?…”

Section: Report From the 2012 Icctf Paris Meetingmentioning

confidence: 99%

Impact of Cancer and Its Treatments on Cognitive Function: Advances in Research From the Paris International Cognition and Cancer Task Force Symposium and Update Since 2012

Joly

Giffard

Rigal³

et al. 2015

Journal of Pain and Symptom Management

141

107

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“…Our study revealed that the participants' experiences of both cognitive impairment and especially the endless sense of fatigue played a major role for NMA‐HSCT patients because these experiences influence and challenge the entire process of adapting to changes. Other studies have found that below average cognitive performance is common after allogeneic stem cell transplant (Scherwath et al, ; Wu et al, ). The extent and severity of the problem have, however, not been clarified (Harder et al, ; Wu et al, ).…”

Section: Discussionmentioning

confidence: 93%

“…The extent and severity of the problem have, however, not been clarified (Harder et al, ; Wu et al, ). Subjective cognitive impairment reduces HSCT patients’ confidence in their ability to manage common post‐transplant symptoms (Wu et al, ) and health‐related quality of life (Wu et al, ). Patients who report cognitive impairment are likely to benefit from interventions that enhance their confidence in the management of emotional symptoms (Wu et al, ).…”

Section: Discussionmentioning

confidence: 99%

Patients´ experiences and perspectives of challenges and needs related to nonmyeloablative stem cell transplantation: Involving patients in developing a targeted rehabilitation programme

Lindman

Petersen

Olesen

et al. 2019

Journal of Clinical Nursing

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Aims and objectives:To explore patients' experiences and perspectives of their challenges and needs regarding their return to everyday life after allogeneic nonmyeloablative haematopoietic stem cell transplantation (NMA-HSCT).Background: NMA-HSCT can cure patients with malignant blood diseases, but during the following years, the majority of patients suffer from serious side effects and complications. Hence, it is a major challenge for patients treated with NMA-HSCT to rehabilitate, maintain physical and psychosocial functioning and return to a life in restored balance. Design:The design was qualitative using the interpretive description methodology, and the theoretical framework symbolic interactionism inspired the interview guide and analysis.Methods: Between April to May 2017, five focus group interviews were conducted with 15 outpatients in a haematological ward in Denmark. The patients were treated with NMA-HSCT 8-30 months prior to the interviews. The study adheres to the Consolidated Criteria for Reporting Qualitative Research guidelines. Results:The impaired functioning was the overarching theme and seemed to be the trigger entailing rehabilitation needs related to the following main themes: realising decline, adapting to changes, the meaning of motivation and reliance on relations.These findings seemed to affect and influence the patients' struggle for a return to an everyday life like before being diagnosed or just before undergoing NMA-HSCT. Conclusion:This study adds to our understanding of important elements to consider when developing a targeted rehabilitation programme. Relevance to clinical practice: Based on our findings, the rehabilitation programme should encompass: extensive variation regarding how to address the impaired functioning through individualised approaches, multimodal interventions, interventions through several months with varying intensity, an interdisciplinary team approach supporting motivation and visualisation of every progress by tangible goal setting, communication regarding hope and support, extended supportive care for patients | 1261 LINDMAN et AL. analysis and interpretation of data, (2) drafting of article or critical revision for important intellectual content, (3) final approval of the version to be submitted. O RCI D Astrid Lindman https://orcid.org/0000-0002-5893-4581 Annemette Krintel Petersen https://orcid. org/0000-0002-4185-9001 Charlotte Handberg https://orcid.org/0000-0002-1378-2449 S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Lindman A, Krintel Petersen A, Olesen G, Handberg C. Patients´ experiences and perspectives of challenges and needs related to nonmyeloablative stem cell transplantation: Involving patients in developing a targeted rehabilitation programme.

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Cross-sectional study of patient-reported neurobehavioral problems following hematopoietic stem cell transplant and health-related quality of life

Cited by 7 publications

References 36 publications

Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: A mixed methods study

Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: A mixed methods study

Impact of Cancer and Its Treatments on Cognitive Function: Advances in Research From the Paris International Cognition and Cancer Task Force Symposium and Update Since 2012

Patients´ experiences and perspectives of challenges and needs related to nonmyeloablative stem cell transplantation: Involving patients in developing a targeted rehabilitation programme

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