Psychosocial adjustment of patients and caregivers prior to allogeneic bone marrow transplantation

Abstract

Summary:There are many studies that examine the psychosocial adjustment of survivors of bone marrow transplantation (BMT). On the other hand, there are relatively few studies that examine the psychosocial adjustment of patients prior to BMT, and even fewer that focus on the psychosocial adjustment of the patient's caregiver. The purpose of the present study was to assess performance status and psychosocial adjustment to illness, mood and stress response of patients and caregivers prior to admission for allogeneic BMT. Forty patients and their 39 caregivers were assessed using standardized measures. One-fourth of the patients reported clinical levels of psychosocial maladjustment on the Psychosocial Adjustment to Illness Scale and had greater adjustment problems than BMT survivors. Approximately onethird (35%) and one-quarter (23%) of the patients reported significant symptoms of intrusive and avoidance stress responses, respectively on the Impact of Events Scale. Caregivers reported more impairments in family relationships than patients, but overall reported similar distress to that of patients. Information about the pre-BMT process appears to be critical to understanding the psychosocial impact that BMT can have on patients and their caregivers. Bone Marrow Transplantation (2001) 27, 1181-1188.

Adaptation of family caregivers during the acute phase of adult BMT

“…Adaptation of the caregiver is important not only for his/her own well-being but also for family relationships that have been found to be important determinants of the recipient's physical and emotional recovery. [7][8][9] This is not surprising, given the interdependence within this partner relationship where one individual's cognition, emotion and behavior affects the cognition, emotion and behavior of the other. [10][11][12] Caregiving in the crisis of life-threatening illness includes major role changes.…”

“…Siston et al 9 conducted a study of 40 recipients and 39 of their caregivers before allogeneic transplantation using standardized questionnaires at this single time point. The overall level of distress of caregivers equaled that of the recipients, whereas caregivers experienced even greater difficulty with family relationships.…”

Psychosocial adjustment and quality of life among multiple myeloma patients undergoing evaluation for autologous stem cell transplantation

“…Moreover, in many studies, the time frame for assessment has centered on the intermediate 19 or, more typically, the long-term post transplant period, 15,16,[20][21][22][23] with fewer studies examining the critical interval before transplantation. Levels of distress and psychosocial morbidity appear to be especially high during this period, 18,24,25 which warrants increased attention from investigators to help guide clinical services, inform patients about what to expect, and establish baselines to assess subsequent changes.…”

“…Much of the QOL literature involving patients with other types of malignancies has focused on allogeneic as opposed to autologous transplants, [14][15][16][17][18] which are less commonly used for myeloma patients. Moreover, in many studies, the time frame for assessment has centered on the intermediate 19 or, more typically, the long-term post transplant period, 15,16,[20][21][22][23] with fewer studies examining the critical interval before transplantation.…”

Long-term follow-up of informal caregivers after allo-SCT: a systematic review

“…24 One of the most common physical symptoms of caregiver strain is fatigue, 21,22,25 which frequently contributes to poor quality of life even after the acute phase of transplant is complete. 26 All of the above symptoms experienced by caregivers of HSCT patients likely contribute to several psychosocial aberrations that have been demonstrated in the literature. First, most caregivers of adult patients are spouses or partners, so it should not be surprising that patients and caregivers experience significant changes to marital dynamics.…”