A109
Psychological adjustment and coping style in patients undergoing BMT/SCT: a prospective longitudinal study
Josja Eggen, David Horne, Charles Craddock
University of Birmingham, Birmingham, UK
Background
Patients undergoing Stem Cell Transplantation (SCT) experience considerable distress. This prospective longitudinal study aimed to: (1)evaluate the development of psychological distress prior to SCT and up to 120-days post-treatment; and (2) examine pre-treatment demographic, medical and psychosocial factors to predict post-treatment psychological adjustment.
Method
Sixty-two patients undergoing allogenic or autologous SCT completed questionnaires at 4 time points: hospital admission, 2 days prior to discharge, 1 week post discharge, and 120 days post-transplant. Adjustment was assessed using the Hospital Anxiety and Depression Scale (HADS) and mood disturbance score on the Profile of Mood States scale (POMS). Predictor variables were demographic, medical and pre-treatment psychosocial factors, including illness perceptions and informational coping style.
Results
Depression and anxiety were highest prior to discharge, but diminished during follow-up, although depressive symptoms remained elevated. Pre-treatment factors best predicting post-treatment positive adjustment were lower distress at admission (p<.01), blunting coping style (p<.05), attributions of psychological factors as a cause of illness (p<.01). Logistic regression revealed depression and anxiety before treatment were the best predictors of clinical depression (odds ratio=5.0) and anxiety (odds ratio =5.6) at 120 days after treatment, predicting 79% and 86% of cases, respectively.
Conclusion
Pre-SCT levels of anxiety, depression, coping style and attributions of illness causality enable prediction of positive coping and anxiety and depression levels at 120 days post- treatment. This has implications for psychological preparation of patients prior to SCT, based on individuals’ coping styles and beliefs about illness causality.
