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Gray TF, Do KM, Amonoo HL, Sullivan L, Kelkar AH, Pirl WF, Hammer MJ, Tulsky JA, El-Jawahri A, Cutler CS, Partridge AH. Family Caregiver Experiences in the Inpatient and Outpatient Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation Settings: A Qualitative Study. Transplant Cell Ther 2024; 30:610.e1-610.e16. [PMID: 37783339 DOI: 10.1016/j.jtct.2023.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/04/2023]
Abstract
Caregivers (ie, family and friends) are essential in providing care and support for patients undergoing hematopoietic cell transplantation (HCT) and throughout their recovery. Traditionally delivered in the hospital, HCT is being increasingly provided in the outpatient setting, potentially heightening the burden on caregivers. Extensive work has examined the inpatient HCT caregiving experience, yet little is known about how caregiver experiences may differ based on whether the HCT was delivered on an inpatient or outpatient basis, particularly during the acute recovery period post-HCT. This study explored the similarities and differences in caregiver experiences in the inpatient and outpatient settings during the early recovery from reduced-intensity conditioning (RIC) allogeneic HCT. We conducted semistructured interviews (n = 15) with caregivers of adults undergoing RIC allogeneic HCT as either an inpatient (n = 7) or an outpatient (n = 8). We recruited caregivers using purposeful criterion sampling, based on the HCT setting, until thematic saturation occurred. Interview recordings were transcribed and coded through thematic analysis using Dedoose v.9.0. The study analysis was guided by the transactional model of stress and coping and the model of adaptation of family caregivers during the acute phase of BMT. Three themes emerged to describe similar experiences for HCT caregivers regardless of setting: (1) caregivers reported feeling like they were a necessary yet invisible part of the care team; (2) caregivers described learning to adapt to changing situations and varying patient needs; and (3) caregivers recounted how the uncertainty following HCT felt like existing between life and death while also maintaining a sense of gratitude and hope for the future. Caregivers also reported distinct experiences based on the transplantation setting and 4 themes emerged: (1) disrupted routines: inpatient caregivers reported disrupted routines when caring for the HCT recipient while simultaneously trying to manage non-caregiving responsibilities at home and work, and outpatient caregivers reported having to establish new routines that included frequent clinic visits with the patient while altering or pausing home and work responsibilities; (2) timing of caregiver involvement: inpatient caregivers felt more involved in care after the patient was discharged from the HCT hospitalization, whereas outpatient caregivers were already providing the majority of care earlier in the post-transplantation period; (3) fear of missing vital information: inpatient caregivers worried about missing vital information about the patient's care and progress if not physically present in the hospital, whereas outpatient caregivers feared overlooking vital information that may warrant contacting the care team as they monitored the patient at home; and (4) perceived adequacy of resources to meet psychosocial and practical needs: inpatient caregivers reported having adequate access to resources (ie, hospital-based services), whereas outpatient caregivers felt they had more limited access and needed to be resourceful in seeking out assistance. Inpatient and outpatient HCT caregivers described both similar and distinct experiences during the acute recovery period post-HCT. Specific interventions should address caregiver psychosocial needs (ie, distress, illness uncertainty, communication, and coping) and practical needs (ie, community resource referral, preparedness for home-based caregiving, and transplantation education) of HCT caregivers based on setting.
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Affiliation(s)
- Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer, Boston, Massachusetts; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
| | - Khuyen M Do
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hermioni L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lauren Sullivan
- Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Amar H Kelkar
- Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - William F Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Marilyn J Hammer
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer, Boston, Massachusetts
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Areej El-Jawahri
- Harvard Medical School, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Divison of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Corey S Cutler
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ann H Partridge
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Spirituality in the care of patients with cancer: What is the psychiatrist's role? Palliat Support Care 2023; 21:173-175. [PMID: 35776064 DOI: 10.1017/s1478951521001930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Andersen L, McHugh M, Ulrich CM, Meghani SH, Deng J. A systematic review of coping skill interventions to reduce anxiety and depressive symptoms among adults with hematologic malignancies. Eur J Oncol Nurs 2022; 61:102224. [PMID: 36375304 PMCID: PMC9714520 DOI: 10.1016/j.ejon.2022.102224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/08/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with hematologic malignancies experience anxiety and depressive symptoms from diagnosis through survivorship. The aim of this systematic review is to determine if coping skill interventions can reduce anxiety and depressive symptoms for persons with hematologic cancer. METHODS Databases including PubMed, Embase, CINAHL, APA PyschInfo, Scopus, and Cochrane were searched in June of 2021 for coping skill interventional studies with adult patients with hematologic cancer and outcomes of anxiety and depressive symptoms. Search terms, definitions, and inclusion/exclusion criteria were guided by the Transactional Model of Stress and Coping, and quality appraisal utilized the Johns Hopkins Evidence Based Practice Appraisal tool. The study was registered in PROSPERO under "CRD42021262967." RESULTS Eleven studies met inclusion criteria with ten studies evaluating anxiety symptoms and nine studies evaluating depressive symptoms. Of ten studies with 449 participants evaluating anxiety, five studies showed significant reduction (p < 0.05), three found small to moderate effect size reductions not reaching statistical significance (p > 0.05), and only two showed no reduction in anxiety symptoms. Of nine studies with 429 participants evaluating depressive symptoms, three had significant reductions (p < 0.05), three reported small to moderate effect size reductions not reaching statistical significance (p > 0.05), and three found no effect on depressive symptoms. Coping interventions that were problem-focused as opposed to emotion-focused were most effective for both anxiety and depressive symptoms. CONCLUSION This systematic review finds evidence that problem-focused coping interventions reduce anxiety symptoms among patients with hematologic malignancies, with mixed evidence for reduction of depressive symptoms. Nurses and other clinicians caring for patients with hematologic cancers may employ coping skill interventions as a potential way to mitigate anxiety and depressive symptoms. PROSPERO REGISTRATION ID CRD42021262967.
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Affiliation(s)
- Lucy Andersen
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA.
| | - Molly McHugh
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA
| | - Connie M Ulrich
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA
| | - Salimah H Meghani
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA
| | - Jie Deng
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
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Manettas AI, Tsaklis P, Kohlbrenner D, Mokkink LB. A Scoping Review on Outcomes and Outcome Measurement Instruments in Rehabilitative Interventions for Patients with Haematological Malignancies Treated with Allogeneic Stem Cell Transplantation. Curr Oncol 2022; 29:4998-5025. [PMID: 35877257 PMCID: PMC9322392 DOI: 10.3390/curroncol29070397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
Rationale: Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with increased treatment-related mortality, loss of physical vitality, and impaired quality of life. Future research will investigate the effects of multidisciplinary rehabilitative interventions in alleviating these problems. Nevertheless, published studies in this field show considerable heterogeneity in selected outcomes and the outcome measurement instruments used. The purpose of this scoping review is to provide an overview of the outcomes and outcome measurement instruments used in studies examining the effects of rehabilitative interventions for patients treated with allogeneic HSCT. Methods: We conducted a scoping review that included randomized controlled trials, pilot studies, and feasibility studies published up to 28 February 2022. Results: We included n = 39 studies, in which n = 84 different outcomes were used 227 times and n = 125 different instruments were used for the measurements. Conclusions: Research in the field of rehabilitation for patients with haematological malignancies treated with allogeneic HSCT is hampered by the excess outcomes used, the inconsistent outcome terminology, and the inconsistent use of measurement instruments in terms of setting and timing. Researchers in this field should reach a consensus with regard to the use of a common terminology for the outcomes of interest and a homogeneity when selecting measurement instruments and measurement timing methods.
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Affiliation(s)
- Anastasios I. Manettas
- Department of Physiotherapy and Occupational Therapy, University Hospital Zurich, 8091 Zurich, Switzerland;
- Biomechanics and Ergonomics, ErgoMech Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Panagiotis Tsaklis
- Biomechanics and Ergonomics, ErgoMech Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
- Department of Molecular Medicine and Surgery, Growth and Metabolism, Karolinska Institute, 17176 Stockholm, Sweden
- Correspondence:
| | - Dario Kohlbrenner
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland;
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Lidwine B. Mokkink
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007MB Amsterdam, The Netherlands;
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Shi Y, Wu Z, Wang H, Kong W, Zhuansun X. The Influence of Family-Oriented Enabling Psychological Nursing on Posttraumatic Stress and Fear of Recurrence in Patients with Cervical Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:6720287. [PMID: 35783518 PMCID: PMC9249470 DOI: 10.1155/2022/6720287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
Objective. The incidence of cervical cancer is high, which seriously threatens the life and health of women. At present, there were few studies on the application of family-oriented enabling psychological nursing in patients with cervical cancer. So, the purpose of this study was to explore the effect of family-oriented enabling psychological nursing on posttraumatic stress and fear of recurrence in patients with cervical cancer. The clinical data of 236 patients with cervical cancer treated in our hospital from January 2020 to December 2021 was retrospectively analyzed. According to different nursing methods, they were assigned to convention group (105 cases accepted the conventional nursing) and psychology group (131 cases accepted the family-oriented enabling psychological nursing). The PTSD Checklist-Civilian Version (PCL-C) scores, Fear of Progression Questionnaire-Short Form (FoP-Q-SF) scores, Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) scores, and satisfaction rates of the two groups were compared. It turned out that the PCL-C score, FoP-Q-SF score, and CARES-SF score decreased in the psychology group and the convention group (P < 0.05) and the decreases of those three scores were more obvious in the psychology group. In comparison with the convention group, the nursing satisfaction rate of psychology group was higher (96.18% vs. 76.19%, P < 0.05). It could be concluded that family-oriented enabling psychological nursing had definite clinical application value in patients with cervical cancer, which could alleviate the symptoms of posttraumatic stress disorder and reduce the fear of recurrence, stabilize the perioperative psychological state, facilitate treatment, and improve the quality of life and satisfaction rate of patients and was worthy of promotion and application.
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Affiliation(s)
- Yue Shi
- Department of Gynecology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210003, Jiangsu, China
| | - Zhongye Wu
- Department of Gynecology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210003, Jiangsu, China
| | - Hong Wang
- Department of Gynecology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210003, Jiangsu, China
| | - Wufan Kong
- Department of Gynecology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210003, Jiangsu, China
| | - Xiaowan Zhuansun
- Department of Gynecology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210003, Jiangsu, China
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Amonoo HL, El-Jawahri A, Deary EC, Traeger LN, Cutler CS, Antin JA, Huffman JC, Lee SJ. Yin and Yang of Psychological Health in the Cancer Experience: Does Positive Psychology Have a Role? J Clin Oncol 2022; 40:2402-2407. [PMID: 35377731 PMCID: PMC9467675 DOI: 10.1200/jco.21.02507] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Hermioni L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Areej El-Jawahri
- Harvard Medical School, Boston, MA.,Mass General Cancer Center, Massachusetts General Hospital, Boston, MA
| | - Emma C Deary
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
| | - Lara N Traeger
- Harvard Medical School, Boston, MA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Corey S Cutler
- Harvard Medical School, Boston, MA.,Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - Joseph A Antin
- Harvard Medical School, Boston, MA.,Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - Jeff C Huffman
- Harvard Medical School, Boston, MA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Stephanie J Lee
- Division of Medical Oncology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
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Banerjee R, Huang CY, Dunn L, Knoche J, Ryan C, Brassil K, Jackson L, Patel D, Lo M, Arora S, Wong SW, Wolf J, Martin Iii T, Dhruva A, Shah N. Digital Life Coaching during Stem Cell Transplantation: A Pilot Feasibility Study. JMIR Form Res 2022; 6:e33701. [PMID: 35039279 PMCID: PMC8933800 DOI: 10.2196/33701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND For patients with multiple myeloma receiving high-dose chemotherapy followed by autologous stem cell transplantation (SCT), acute life disruptions and symptom burden may lead to worsened quality of life (QOL) and increased emotional distress. Digital life coaching (DLC), whereby trained coaches deliver personalized wellbeing-related support via phone calls and text messages, has been shown to improve QOL among SCT survivors. However, DLC has not been investigated during the acute peri-SCT period which is generally characterized by symptomatic exacerbations and 2-week hospitalizations. OBJECTIVE We launched a single-arm pilot study to investigate the feasibility of patient engagement with DLC during this intensive period. METHODS We approached English-speaking adult patients with multiple myeloma undergoing autologous SCT at our center. Enrolled patients received 16 weeks of virtual access to a life coach beginning at Day -5 before SCT. Coaches used structured frameworks to help patients identify and overcome personal barriers to wellbeing. Patients chose the coaching topics and preferred communication styles. Our primary endpoint was ongoing DLC engagement, defined as bidirectional conversations occurring at least once every four weeks during the study period. Secondary endpoints were electronic patient-reported outcome (ePRO) assessments of QOL, distress, and sleep disturbances. Our study was registered as clinicaltrials.gov identifier NCT04432818. RESULTS Of 20 screened patients, 17 patients chose to enroll and 15 underwent SCT as planned. Of these 15 patients (median age 65, range 50-81), 73% (n = 11) demonstrated ongoing DLC engagement. The median frequency of bidirectional conversations during the 3-month study period was once per 6.2 days (range: 3.9-28). During index hospitalizations with median lengths of stay 16 days (range 14-31), the median frequency of conversations was once per 5.3 days (range 2.7-15). ePRO assessments (94% adherence) demonstrated an expected QOL nadir during the second week following SCT. The prevalence of elevated distress was highest immediately before and after SCT, with 69% of patients exhibiting elevated distress at Day -5 and at Day +2. CONCLUSIONS DLC may be feasible for older patients during intensive hospital-based cancer treatments such as autologous stem cell transplantation for multiple myeloma. Limitations of our study include small sample size, selection bias among enrolled patients, and heterogeneity in DLC usage. Based on the positive results of this pilot study, a larger phase 2 randomized study of DLC during SCT is under way to investigate its efficacy with regard to patient wellbeing. CLINICALTRIAL Our study was registered as clinicaltrials.gov identifier NCT04432818.
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Affiliation(s)
- Rahul Banerjee
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Chiung-Yu Huang
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, US
| | - Lisa Dunn
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Jennifer Knoche
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Chloe Ryan
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | | | | | | | - Mimi Lo
- Division of Hematology/Oncology, Department of Pharmacy, University of California San Francisco, San Francisco, US
| | - Shagun Arora
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Sandy Wai Wong
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Jeffrey Wolf
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Thomas Martin Iii
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Anand Dhruva
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
| | - Nina Shah
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, 400 Parnassus Avenue, San Francisco, US
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8
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Amonoo HL, El-Jawahri A, Celano CM, Brown LA, Harnedy LE, Longley RM, Onyeaka HK, Healy BC, Cutler CS, Pirl WF, Lee SJ, Huffman JC. A positive psychology intervention to promote health outcomes in hematopoietic stem cell transplantation: the PATH proof-of-concept trial. Bone Marrow Transplant 2021; 56:2276-2279. [PMID: 33879852 PMCID: PMC8416696 DOI: 10.1038/s41409-021-01296-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/17/2021] [Accepted: 03/31/2021] [Indexed: 02/05/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) recipients often experience deficits in positive psychological well-being (PPWB) due to intensive treatment and follow-up care. Positive psychology interventions (PPIs) that promote PPWB via deliberate and systematic exercises (e.g., writing a gratitude letter) have consistently improved PPWB in medical populations, yet have never been studied in early HSCT recovery. In this single-arm, proof-of-concept study, we assessed the feasibility and acceptability of a novel eight-session, telephone-delivered PPI in early HSCT recovery. A priori, we defined feasibility as >50% of eligible patients enrolling in the study and >50% of participants completing 5/8 sessions, and acceptability as mean ease and utility scores of weekly participant ratings of PP exercises as 7/10. Of 45 eligible patients, 25 (55.6%) enrolled, 20 (80%) completed baseline assessments, 15 (75%) started the intervention, and 12 (60%) completed the intervention and follow-up assessments. The intervention was feasible (55.6% of eligible participants enrolled; 60% of baseline assessment completers finished 5/8 sessions) and led to very small-to-medium effect-size improvements in patient-reported outcomes. A novel, eight-week, telephone-delivered PPI was feasible and acceptable in allogeneic HSCT recipients. Larger, randomized studies are needed to examine the efficacy of PPIs for improving outcomes in this population.
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Affiliation(s)
- Hermioni L. Amonoo
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA,Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Areej El-Jawahri
- Harvard Medical School, Boston, MA, USA,Mass General Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher M. Celano
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Lydia A. Brown
- Healthscope Hospitals, VIC, Australia,La Trobe University, VIC, Australia,University of Melbourne, VIC, Australia
| | - Lauren E Harnedy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Regina M. Longley
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Henry K. Onyeaka
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Brian C. Healy
- Harvard Medical School, Boston, MA, USA,Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Corey S. Cutler
- Harvard Medical School, Boston, MA, USA,Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA, USA
| | - William F. Pirl
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Stephanie J. Lee
- Division of Medical Oncology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
| | - Jeff C. Huffman
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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