Faculty Collaboration Database

Relationships among symptoms, psychosocial factors, and health-related quality of life in hematopoietic stem cell transplant survivors. Support Care Cancer 2015 Mar;23(3):797-807

Date

09/07/2014

Pubmed ID

25193598

Pubmed Central ID

PMC4312505

DOI

10.1007/s00520-014-2420-z

Scopus ID

2-s2.0-84922141798 (requires institutional sign-in at Scopus site)   48 Citations

Abstract

PURPOSE: The study aims to evaluate the mediating effect of depressive symptoms on the relationship between physical symptoms and health-related quality of life (HRQOL) in hematopoietic stem cell transplant (HSCT) survivors and to test a conceptual model of psychosocial factors, in addition to physical and psychological symptoms, that might contribute to HRQOL.

METHODS: This is a secondary data analysis using HSCT survivors (N = 662) identified from the Center for International Blood and Marrow Transplant Research. Data were collected through mail and phone surveys and medical records. We used structural equation modeling to test the mediating role of depressive symptoms on the relationship of physical symptoms with HRQOL. We also tested comprehensive pathways from physical symptoms to HRQOL by adding psychosocial factors (optimism, coping, and social constraints).

RESULTS: In the depressive symptom mediation analyses, physical symptoms had a stronger direct effect on physical HRQOL (b = -0.98, p < 0.001) than depressive symptoms (b = 0.23, p > 0.05). Depressive symptoms were associated with mental HRQOL and mediated the relationship between physical symptoms and mental HRQOL. In comprehensive pathways, physical symptoms remained the most significant factor associated with physical HRQOL. In contrast, depressive symptoms had direct effects (b = -0.76, p < 0.001) on mental HRQOL and were a significant mediator. Psychosocial factors were directly associated with mental HRQOL and indirectly associated with mental HRQOL through depressive symptoms.

CONCLUSION: Physical symptoms are most strongly associated with physical HRQOL, while depressive symptoms and psychosocial factors impact mental HRQOL more than physical HRQOL. Interventions addressing psychosocial factors as well as symptoms may improve the HRQOL of HSCT survivors.

Author List

Kenzik K, Huang IC, Rizzo JD, Shenkman E, Wingard J

Author

J. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adaptation, Psychological
Adolescent
Adult
Aged
Depression
Female
Health Status
Hematopoietic Stem Cell Transplantation
Humans
Male
Mental Health
Middle Aged
Neoplasms
Quality of Life
Survivors
Young Adult