Share on Facebook
Share on Twitter
Share on LinkedIn
Share by Email
Print
Whether a patient used an approach-oriented or avoidant coping strategy was associated with quality of life (QOL) and psychological distress in those with hematologic malignancies undergoing hematopoietic cell transplantation (HCT). These findings were presented at the ASH Annual Meeting 2023.
Physical and psychological symptoms during hospitalization for HCT can dramatically reduce QOL for patients undergoing the procedure. Yet, studies on the coping strategies that patients used prior to HCT are lacking.
Therefore, researchers conducted a secondary analysis of baseline data from a randomized trial that evaluated supportive care in patients with hematologic malignancies undergoing allogeneic or autologous HCT. The trial enrolled adults aged 18 years and older with hematologic cancers undergoing HCT at 3 tertiary care academic centers.
In this study, researchers sought to characterize pre-HCT coping strategies, identify sociodemographic and clinical factors associated with coping strategy use, and evaluate the association of coping strategy use with pre-HCT QOL and psychological distress.
QOL, psychological symptoms, and coping were assessed prior to HCT using the Functional Assessment of Cancer Therapy – Bone Marrow Transplant, the Hospital Anxiety and Depression Scale and Post Traumatic Stress Disorder (PTSD) – Civilian Version, and the Brief COPE, respectively.
Coping strategies were defined as approach-oriented or avoidant. Characteristics of the approach-oriented strategy were active coping, emotional support, positive reframing, and acceptance. Characteristics of the avoidant strategy were behavioral disengagement, denial, and self-blame.
Median split method was used to categorize high and low use of the coping strategies. Multivariate linear regression was used to measure associations of coping strategy use with QOL and psychological distress.
Of 360 pre-HCT patients, 62.8% were male, 77.2% identified as White, 73.6% were younger than 65, and 52.0% had a college degree or higher education. Approximately half had undergone autologous HCT (179 patients [49.7%]).
Coping strategies used included emotional support (60.8%), acceptance (51.4%), religion (46.7%), reframing (40.3%), active coping (38.3%), self-blame (33.1%), denial (31.4%), and disengagement (11.9%).
Among the patients using approach-oriented coping, approximately one-fourth of patients used 2 (27.1%) or 3 (21.8%) strategies. Of those using avoidant coping, most used 0 (48.6%) or 1 (30.9%) strategy.
Older age (65 years and older; odds ratio [OR], 0.5; P =.01) and higher income (more than $100,000; OR, 0.6; P =.04) were associated with less frequent use of avoidant coping. Female gender (OR, 1.6; P =.03) and disabled employment status (OR, 1.6; P =.04) were associated with increased likelihood of high use of avoidant coping.
High use of approach-oriented coping was associated with better pre-HCT QOL (B, 6.7; P =.001) and lower depression (B, -1.1; P =.001) and anxiety symptoms (B, -0.9; P =.02). High use of avoidant coping was associated with worse pre-HCT QOL (B, -13.3; P <.001) and symptoms of depression (B, 1.9; P <.001), anxiety (B, 3.1; P <.001), and PTSD (B, 8.1; P <.001).
Although no sociodemographic or clinical factors associated with the use of approach-oriented coping, age, gender, employment status were key sociodemographic factors associated with avoidant coping.
“Use of coping strategies was strongly associated with baseline QOL and psychological distress,” the researchers concluded.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Newcomb R, Amonoo HL, Nelson AM, et al. Coping in patients with hematologic malignancies undergoing hematopoietic cell transplantation. Presented at ASH 2023. December 9-12, 2023. San Diego, CA. Abstract 2424.
