Enhanced coping and self‐efficacy in caregivers of stem cell transplant recipients: Identifying mechanisms of a multimodal psychosocial intervention

Abstract

BACKGROUND: In a recent trial, a 6-session intervention (BMT-CARE) integrating medical information with cognitive-behavioral strategies improved quality of life (QOL), mood, coping skills, and self-efficacy for family/friend caregivers of hematopoietic stem cell transplantation (HCT) recipients. This study examined whether improvements in coping and self-efficacy mediated the intervention effects on QOL and mood. METHODS: From December 2017 to April 2019, 100 caregivers of HCT recipients were enrolled into a randomized clinical trial of BMT-CARE versus usual care. Caregivers completed self-report measures of QOL (CareGiver Oncology Quality of Life questionnaire), depression and anxiety symptoms (Hospital Anxiety and Depression Scale), coping skills (Measure of Current Status), and self-efficacy (Cancer Self-Efficacy Scale-Transplant) at enrollment (before HCT) and 60 days after HCT. Causal mediation regression models were used to examine whether changes in coping and self-efficacy mediated intervention effects on QOL as well as depression and anxiety symptoms. RESULTS: Improvements in 60-day QOL in patients assigned to BMT-CARE were partially mediated by improved coping and self-efficacy (indirect effect, 6.93; SE, 1.85; 95% CI, 3.71-11.05). Similarly, reductions in 60-day depression and anxiety symptoms were partially mediated by improved coping and self-efficacy (indirect effect for depression, −1.19; SE, 0.42; 95% CI, −2.23 to −0.53; indirect effect for anxiety, −1.46; SE, 0.55; 95% CI, −2.52 to −0.43). Combined improvements in coping and selfefficacy accounted for 67%, 80%, and 39% of the total intervention effects on QOL and depression and anxiety symptoms, respectively. CONCLUSIONS: Coping and self-efficacy are essential components of a brief psychosocial intervention that improves QOL and mood for caregivers of HCT recipients during the acute recovery period.

The effectiveness of psychoeducational interventions on caregiver‐oriented outcomes in caregivers of adult cancer patients: A systematic review and meta‐analysis

“…Twenty‐four of the included articles reported RCTs while four studies used a quasi‐experimental design to assess the effect of PEIs on caregiver outcomes 15,34–36 . The majority of the trials were conducted in the United States of America 37–46 with just one trial from France, 47 Nigeria, 36 and Taiwan 35 …”

“…Other interventions were facilitated by social workers, 34,37,44,46,50 psychologists, 15,34,56,58 oncology experts 38 and three studies were facilitated by trained researchers 55,57,60 . The PEIs in 14 of the included trials was guided by a conceptual framework, 35,37,39,41,45,46,50,53,55,60,62,63 the most common being the Transactional Model of Stress and Coping 35,36,46,53 …”

Self-efficacy and positive coping mediate the relationship between social support and resilience in patients undergoing lung cancer treatment: A cross-sectional study

“…Cancer patients with high self-efficacy expectations focus more on the demands of stressful situations and feel more efficacious in their ability in coping with changes and challenges resulting from cancer, which can promote better psychological adjustment and higher levels of resilience (Freire et al, 2020). Studies on cancer patients supported that a higher level of self-efficacy was associated with more self-care behaviours and positive coping strategies, such as relaxation, cognitive restructuring, and assertive communication (Johansson et al, 2018;Chou, 2019;Jacobs et al, 2020). It has been found that as the positive coping strategies increased, psychosocial adjustment also improved, which add to increased resilience (Yu et al, 2022).…”

Preparedness for family caregiving prior to allogeneic hematopoietic stem cell transplantation

“…A newly published study investigated the effectiveness of an individual six-session psychosocial intervention for family caregivers in autologous and allogeneic HSCT care, where improved QoL, self-efficacy, and coping skills reduced caregiving burden, lower anxiety, and depression symptoms in comparison with a group that received standard care were reported (El-Jawahri et al, 2020). Coping and self-efficacy have been shown to be essential components of a brief psychosocial intervention that improves QoL and mood for caregivers of HSCT recipients during the acute recovery period (Jacobs et al, 2020).…”