Effect of Psychosocial Factors on Health Outcomes in Autologous BMT Patients

Abstract

Psychosocial factors have been shown to be indicative of health recovery in cancer populations. However, less is known about Blood and Marrow Transplant (BMT) patients. This paper explores pre-transplant psychosocial factors that may predict poorer health outcomes following autologous transplant (AuBMTs) in patients with hematological malignancies. Participants included 130 cancer patients (51.5% male) who completed a pre-AuBMT evaluation (M = 58.39, SD = 11.71, range = 21 – 80). Data extracted include information regarding measures for distress (DT), problems in daily life (PPL), depressive symptoms (CES-D) and physical and mental health quality of life (PCS-12 and MCS-12). Health outcomes including cancer-related hospital re-admittance, survival rates, and number of medications prescribed within 12 months post-transplant were also extracted. Results indicated that medications were positively correlated to PPL score, r(128) = 0.179, p < 0.05, and to CES-D scores, r(128) = 0.220, p < 0.05, and inversely related to PCS-12 scores, r(128) = -0.293, p < 0.01. ANOVA and Welch ANOVAs indicated insurance status has a significant effect on mortality rate, depression, and physical and health-related quality of life (p<.05). A stepwise multiple linear regression model indicated that approximately 7.9% of the variance of the number of medications used was accounted for by PCS-12. Results suggest that individuals with greater overall problems and depressive symptoms and a poorer physical health quality of life (QOL) were prescribed more medications. Additionally, physical health QOL proved to be a significant predictor for medication use. The impact of insurance status on these outcomes is an area for further exploration. This research supports a relationship between psychosocial variables and health outcomes for BMT patients with a hematological malignancy and may help inform appropriate psychosocial screening and intervention practices for this population.