Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation

Abstract

Background To investigate the impact of hospitalization for hematopoietic stem cell transplantation (HCT) on patients’ and family caregivers’ (FC) quality of life (QOL) and mood. Methods We conducted a longitudinal study of patients hospitalized for HCT and their FC. At baseline (6 days pre-HCT), day+1, and day+8 of HCT, we assessed QOL (Functional Assessment of Cancer Therapy-Bone Marrow Transplantation FACT-BMT), and mood (Hospital Anxiety and Depression Scale HADS). We administered the SF-36 to examine FC QOL [physical component scale (PCS), and mental component scale (MCS)]. To identify predictors of QOL changes, we used multivariable linear mixed models. Results We enrolled 97% of eligible patients undergoing autologous (n=30), myeloablative (n=30) or reduced intensity (n=30) allogeneic HCT. Patients’ QOL markedly declined (mean FACT-BMT 109.6 to 96.0, P < 0.0001) throughout hospitalization. The proportion of patients with depression (HADS-Depression> 7) more than doubled from baseline to day+8 (15.6% to 37.8%, P < 0.0001), whereas the proportion of patients with anxiety remained stable (22.2%, P = 0.8). These results remained consistent when data were stratified by HCT type. Baseline depression (β= −2.24, F=42.2, p < 0.0001) and anxiety (β= −0.63, F=4.4, p = 0.03) independently predicted worse QOL throughout hospitalization. FC QOL declined during patient’s hospitalization (PCS: 83.1 to 79.6, P= 0.03, MCS: 71.6 to 67.4, P = 0.04). Conclusions Patients undergoing HCT reported a steep deterioration in QOL and substantially worsening depression during hospitalization. Baseline anxiety and depression predicted worse QOL during hospitalization, underscoring the importance of assessing pre-HCT psychiatric morbidity.

Qualidade De Vida Nos Primeiros Seis Meses Pós-Transplante De Células-Tronco Hematopoéticas

“…However, a reduction is observed over the six months after transplantation in both groups. This result is confirmed by a study 21 carried out in Massachusetts, which showed the symptom of pain as one of the most frequently reported during treatment in both patients undergoing allogeneic and autologous HSCT, with no statistically significant differences between the HSCT types.…”

“…Studies conducted in the Netherlands and the United States with adult patients confirm this result. [19][20][21] Higher education fosters understanding questions related to treatment, especially with regard to the guidelines during hospital stay and after discharge. It is essential that this understanding occurs, making the patient predisposed to developing self-care and active participation in their attempt for succeeding in their therapeutic path and to recover their life activities.…”

Depresión y ansiedad en cuidadores primarios en el Instituto Nacional de Salud del Niño

“…En la población general con trastornos de ansiedad y depresión, el 12,6% ha tenido estudios primarios, 42,8% secundaria y 44% educación superior (13) . Si bien se ha reportado hasta 16% de depresión y 21% de ansiedad en cuidadores primarios de pacientes hematológicos (21) y cifras similares en parálisis cerebral infanti l y asma (6,17,22,23) , no existen datos nacionales ni extranjeros en pacientes hospitalizados, salvo en unidades de prematuros (24,25) . Nuestra investi gación no ha considerado cuidadores de pacientes con una patología específi ca, aunque cerca del 40% fueron neurológicos con postración crónica, como la parálisis cerebral infanti l. Tabla 2.…”

Evaluation of quality of life in individuals with severe chronic motor disability: A major challenge

“…It is now well-known that caregiving negatively impacts the life of the caregiver (67)(68)(69).Caregiving leads to a higher risk of mortality (70) and resulted in a significant and substantial burden, restricted roles and activities, and increased psychosomatic (71), anxious, or depressive symptoms (72), and lower QoL (73).…”