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. 2015 Mar 15;121(6):951-9.
doi: 10.1002/cncr.29149. Epub 2014 Dec 2.

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

Areej R El-Jawahri  1 , Lara N Traeger, Kailyn Kuzmuk, Justin R Eusebio, Harry B Vandusen, Jennifer A Shin, Tanya Keenan, Emily R Gallagher, Joseph A Greer, William F Pirl, Vicki A Jackson, Karen K Ballen, Thomas R Spitzer, Timothy A Graubert, Steven L McAfee, Bimalangshu R Dey, Yi-Bin A Chen, Jennifer S Temel
Affiliations

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

Areej R El-Jawahri et al. Cancer. .

Abstract

Background: We conducted a study to investigate the impact of hospitalization for hematopoietic stem cell transplantation (HCT) on the quality of life (QOL) and mood of patients and family caregivers (FC).

Methods: We conducted a longitudinal study of patients who were hospitalized for HCT and their FC. We assessed QOL (using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation) and mood (using the Hospital Anxiety and Depression Scale) at baseline (6 days before HCT), day +1, and day +8 of HCT. We administered the Medical Outcomes Study Health Survey Short Form-36 to examine FC QOL (Physical Component Scale and Mental Component Scale). To identify predictors of changes in QOL, we used multivariable linear mixed models.

Results: We enrolled 97% of eligible patients undergoing autologous (30 patients), myeloablative (30 patients), or reduced intensity (30 patients) allogeneic HCT. Patients' QOL markedly declined (mean Functional Assessment of Cancer Therapy-Bone Marrow Transplantation score, 109.6 to 96.0; P<.0001) throughout hospitalization. The percentage of patients with depression (Hospital Anxiety and Depression Scale-Depression score of >7) more than doubled from baseline to day +8 (15.6% to 37.8%; P<.0001), whereas the percentage of patients with anxiety remained stable (22.2%; P = .8). These results remained consistent when data were stratified by HCT type. Baseline depression (β, -2.24; F, 42.2 [P<.0001]) and anxiety (β, -0.63; F, 4.4 [P =.03]) were found to independently predict worse QOL throughout hospitalization. FC QOL declined during the patient's hospitalization (physical component scale: 83.1 to 79.6 [P =.03] and mental component scale: 71.6 to 67.4 [P =.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.

Keywords: depression; family caregivers; mood; quality of life (QOL); stem cell transplantation.

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Figures

Figure 1
Figure 1. Common Symptoms during HCT Hospitalization
Figure 1A = Insomnia, Figure 1B = Nausea, Figure 1C = Bowel Trouble, Figure 1D = Pain.
See this image and copyright information in PMC

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