How Do Coping Strategies Impact Patients Prior to HSCT?

Patients’ coping strategies prior to hematopoietic stem cell transplantation (HSCT) had significant effects on their psychological distress and quality of life (QOL), with approach-oriented coping strategies yielding improved outcomes compared with avoidant coping strategies, concluded an analysis of baseline patient data published in Blood Advances.

“[The] study findings highlight the ongoing need for supportive care providers with expertise in facilitating adaptive coping including social workers, chaplains, psychologists, and palliative care clinicians to be available and involved during early hospitalization,” suggested the authors, led by Richard Newcomb, MD, from the Harvard Medical School in Boston, Massachusetts.

The analysis included 360 patients with hematological malignancies and a mean age of 55.4 years that were admitted to a hospital prior to allogeneic or autologous (49.7%) HSCT.

Participants’ QOL, psychological distress, and coping strategies were assessed via the Functional Assessment of Cancer Therapy—Bone Marrow Transplant, Hospital Anxiety and Depression Scale and PTSD—Civilian Version, and Brief-COPE tools, respectively within 72 hours of admission.

According to the study, 43.5% of patients used approached-oriented coping and 31.3% used avoidant coping. Common examples included emotional support (60.9%), acceptance (51.2%), self-blame (33%), and denial (31.3%). Notably, avoidant coping strategies were less common in patients aged 65 years or older (odds ratio, 0.5; P=.01).

Overall, approach-oriented coping was associated with improvements in baseline QOL (B, 6.7; P=.001), depression (B, -1.1; P=.001), and anxiety (B, -0.9; P=.02) measures, while avoidant coping was associated with reductions in baseline QOL (B, -13.3; P<.001), depression (B, 1.9; P<.001), anxiety (B, 3.1; P<.001), and post-traumatic stress disorder (B, 8.1; P<.001) measures.

“These data support the need for interventions to address coping during [HSCT] hospitalization,” concluded Dr. Newcomb and colleagues.

Reference

Newcomb RA, Amonoo HL, Nelson AM, et al. Coping in patients with hematologic malignancies undergoing hematopoietic cell transplantation. Blood Adv. 2024. doi:10.1182/bloodadvances.2023011081