Positive Psychological Well-Being in Hematopoietic Stem Cell Transplantation Survivors

Abstract

Positive thoughts and emotions contribute to overall psychological health in diverse medical populations, including patients undergoing HSCT. However, few studies have described positive psychological well-being (eg, optimism, gratitude, flourishing) in patients undergoing HSCT using well-established, validated patient-reported outcome measures. We conducted cross-sectional secondary analyses of baseline data in 156 patients at 100 days post-HSCT enrolled in a randomized controlled trial of a psychological intervention (ClinicalTrials.gov identifier NCT05147311) and a prospective study assessing medication adherence at a tertiary care academic cancer center from September 2021 to December 2022. We used descriptive statistics to outline participant reports of positive psychological well-being (PPWB) using validated measures for optimism, gratitude, positive affect, life satisfaction, and flourishing. The participants had a mean age of 57.4 ± 13.1 years, and 51% were male (n = 79). Many, but not all, participants reported high levels of PPWB (ie, optimism, gratitude, positive affect, life satisfaction, and flourishing), defined as agreement with items on a given PPWB measure. For example, for optimism, 29% of participants did not agree that "overall, I expect more good things to happen to me than bad." Aside from life satisfaction, mean PPWB scores were higher in the HSCT population than in other illness populations. Although many patients with hematologic malignancies undergoing HSCT report high levels of PPWB, a substantial minority of patients reported low PPWB (i.e., no agreement with items on a given PPWB measure). Because PPWB is associated with important clinical outcomes in medical populations, further research should determine whether an intervention to promote PPWB can improve quality of life in HSCT recipients.

Keywords: Flourishing; Gratitude; Hematopoietic stem cell transplantation; Life Satisfaction; Optimism; Positive Affect; Positive psychological well-being; Positive psychology; Psycho-oncology; Well-being.

Figure 1.

Optimism from Life Orientation Test-Revised Questionnaire (N=154) This figure provides a distribution of participants report of optimism via their responses to the Life Orientation Test-Revised (LOT-R) Questionnaire, a validated measure for dispositional optimism. The four distractor questions were not included.

Figure 2.

Gratitude from Gratitude Questionnaire-6 (N=150) This figure provides a distribution of participants report of gratitude via their responses to the Gratitude Questionnaire-6 (GQ-6), a validated measure for dispositional gratitude.

Figure 3.

Positive Affect from the Positive Affect Scale (N=154) This figure provides a distribution of participants report of positive affect via their responses to the Positive Affective Scale (PANAS), a validated measure for trait positive affect.

Figure 4.

Life Satisfaction from Satisfaction with Life Scale (N=149) This figure provides a distribution of participants report of life satisfaction via their responses to the Satisfaction with Life Scale (SWLS), a validated measure for dispositional life satisfaction.

Figure 5.

Flourishing from the Flourishing Scale (N=150) This figure provides a distribution of participants report of flourishing via their responses to the Flourishing scale, a validated measure for trait flourishing.

Figure 6:

HSCT Positive Psychology Measure Means Compared to Other Samples This figure shows a descriptive comparison of mean scores of positive psychological well-being constructs of patients undergoing HSCT and that of other chronic medical populations.