ABSTRACT
The aim of this study was to determine the associations between health locus of control (LoC), causal attributions and coping in tumour patients prior to autologous peripheral blood stem cell transplantation. Patients completed the Questionnaire of Health Related Control Expectancies, the Questionnaire of Personal Illness Causes (QPIC), and the Freiburg Questionnaire of Coping with Illness. A total of 126 patients (45% women; 54% suffering from a multiple myeloma, 29% from non-Hodgkin lymphomas, and 17% from other malignancies) participated in the study. Cluster analysis yielded four LoC clusters: 'fatalistic external', 'powerful others', 'yeah-sayer' and 'double external'. Self-blaming QPIC items were positively correlated with depressive coping, and 'fate or destiny' attributions with religious coping (P<0.001). The highest scores were found for 'active coping' in the LoC clusters 'powerful others' and 'yeah-sayer'. External LoC and an active coping style prevail before undergoing autologous peripheral blood stem cell transplantation, whereas the depressive coping is less frequent, associated with self-blaming causal attributions. Health beliefs include causal and control attributions, which can improve or impair the patient's adjustment. A mixture between internal and external attributions seems to be most adaptive.
Subject(s)
Adaptation, Psychological , Attitude to Health , Neoplasms/therapy , Peripheral Blood Stem Cell Transplantation/psychology , Depressive Disorder/etiology , Female , Humans , Internal-External Control , Male , Middle Aged , Neoplasms/psychology , Personality Inventory , Self Concept , Surveys and Questionnaires/statistics & numerical dataABSTRACT
PURPOSE: Previous research discussed the predictive value of psychosocial variables along with biomedical predictors for survival; such as affective functioning and quality of life. The present study addresses the following research question: does perceived social support prior to PSBCT have an impact on post-transplant survival? SUBJECTS AND METHODS: Ninety-nine patients suffering from Multiple Myeloma (n=55), Non-Hodgkin Lymphoma (n=33), and other malignancies (n=11) completed the Illness Specific Scales of Social Support (ISSS) before undergoing PBSCT. ISSS is comprised of the subscales 'positive social support' and 'problematic social support', e.g. criticising, victimising, or avoiding interactions. RESULTS: The mean score in the subscale 'positive social support' was 3.2 (S.D. 0.54; range 0 until 4), in the subscale 'negative social support' 0.94 (S.D. 0.53). There was no association between positive interactions and survival following PBSCT. Conversely, those patients perceiving problematic social support, showed a correspondence with poor survival following PBSCT (RR=3.649; p=0.015; Cox-regression analysis). The following variables were controlled: Karnofsky Performance Status, interferon treatment, depression and participation in psychotherapy. CONCLUSION: Differentiating between positive and problematic interactions prior to PBSCT helps to recognise detrimental forms of social support. Future research should investigate the clinical implications and help tailor psychotherapeutic intervention.
Subject(s)
Hematopoietic Stem Cell Transplantation/psychology , Lymphoma, Non-Hodgkin/psychology , Multiple Myeloma/psychology , Neoplasms/psychology , Sick Role , Social Support , Survival/psychology , Adult , Aged , Conflict, Psychological , Depression/diagnosis , Depression/psychology , Female , Hematopoietic Stem Cell Transplantation/mortality , Humans , Interferons/therapeutic use , Interpersonal Relations , Karnofsky Performance Status , Longitudinal Studies , Lymphoma, Non-Hodgkin/mortality , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Multiple Myeloma/mortality , Multiple Myeloma/therapy , Neoplasms/mortality , Neoplasms/therapy , Personality Inventory , Prospective Studies , Psychoanalytic Therapy , Psychotherapy, Brief , Self Concept , Statistics as TopicABSTRACT
BACKGROUND: Most quality-of-life (QoL) studies in autologous Peripheral Blood Stem Cell Transplantation (PBSCT) are descriptive and concentrate on symptom severity and functional deficits. The aim of this study is to compare individual QoL (iQoL) with health-related QoL (hrQoL) and functional status of patients before high-dosed therapy/PBSCT. PATIENTS AND METHODS: Multiple Myeloma, non-Hodgkin's Lymphoma and other tumor patients were asked to complete the following measures before high-dosed therapy/PBSCT: the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-life Questionnaire Core 30 (QLQ-C30), and the Schedule for the Evaluation of Individual QoL-Direct Weighting (SEIQoL-DW), a patient-generated instrument which allows the patients to nominate the five most important domains (cues) for their present QoL. The SEIQoL-DW assessment generates: (1) a global QoL score (SEIQoL-INDEX), calculated as Sigma(levelsxweights); (2) the current overall QoL, rated on a visual analogue scale (VAS). Additional measures included demographic data, clinical disease status of remission and Karnofsky's index. RESULTS: Seventy-nine patients completed both types of questionnaires. The QoL domains nominated by the patients were assigned to groups (aggregated cues), the most frequent of which were family (89%), hobbies/pastimes (74%), health (physical, including mobility) (70%), profession/occupation (51%), social life/friends (47%) and marriage/partnership (33%). There was no correlation between the SEIQoL-DW total scores and the EORTC QLQ-C30 scale or the Karnofsky index. CONCLUSION: Individual QoL as assessed by the SEIQoL-DW is unrelated to standard health-status measures such as the EORTC QLQ-C30 or the Karnofsky index. Patient-perceived iQoL in PBSCT seems to depend largely on areas others than health and physical functioning, with the family playing a prominent role.
