Enhanced coping and self‐efficacy in caregivers of stem cell transplant recipients: Identifying mechanisms of a multimodal psychosocial intervention
Autor: | Lara Traeger, Joseph A. Greer, Ashley M. Nelson, Annemarie D. Jagielo, Jennifer S. Temel, Jamie M. Jacobs, Jennifer D'Alotto, Lauren Waldman, Showly Nicholson, Areej El-Jawahri |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male Cancer Research Coping (psychology) Anxiety Psychosocial Intervention Hospital Anxiety and Depression Scale Article law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Quality of life Randomized controlled trial law Adaptation Psychological Humans Medicine 030212 general & internal medicine Aged Aged 80 and over Self-efficacy Depression business.industry Hematopoietic Stem Cell Transplantation Middle Aged Self Efficacy Treatment Outcome Mood Caregivers Oncology 030220 oncology & carcinogenesis Quality of Life Female medicine.symptom business Psychosocial Clinical psychology |
Zdroj: | Cancer |
ISSN: | 1097-0142 0008-543X |
Popis: | BACKGROUND: In a recent trial, a six-session intervention (BMT-CARE) that integrated medical information with cognitive-behavioral strategies improved quality of life (QOL), mood, coping skills, and self-efficacy in family/friend caregivers of hematopoietic stem cell transplantation (HCT) recipients. We examined whether improvements in coping and self-efficacy mediated the intervention effects on QOL and mood. METHODS: From 12/2017 to 4/2019, we enrolled 100 caregivers of HCT recipients in a randomized clinical trial of BMT-CARE versus usual care. Caregivers completed self-report measures of QOL (CareGiver Oncology QOL questionnaire), depression and anxiety symptoms (Hospital Anxiety and Depression Scale), coping skills (Measure of Current Status), and self-efficacy (Cancer Self-Efficacy Scale-Transplant) at enrollment (prior to HCT) and 60 days post-HCT. We used causal mediation regression models to examine whether changes in coping and self-efficacy mediated intervention effects on QOL, as well as depressive and anxiety symptoms. RESULTS: Improvements in 60-day QOL in patients assigned to BMT-CARE were partially mediated by improved coping and self-efficacy (indirect effect=6.93, SE=1.85, 95% CI [3.71, 11.05]). Similarly, reductions in 60-day depression and anxiety symptoms were partially mediated by improved coping and self-efficacy (indirect effect depression=−1.19, SE=0.42, 95% CI [−2.23, −0.53]; indirect effect anxiety=−1.46, SE=0.55, 95% CI [−2.52, −0.43]). Combined improvements in coping and self-efficacy accounted for 67%, 80%, and 39% of the total intervention effect on QOL and depression and anxiety symptoms, respectively. CONCLUSIONS: Coping and self-efficacy are essential components of a brief psychosocial intervention that improves QOL and mood for caregivers of HCT recipients during the acute recovery period. PRECIS: A brief multimodal psychosocial intervention improved quality of life and reduced depression and anxiety symptoms for caregivers of patients undergoing stem cell transplant, compared to a usual care control group. These effects were partially mediated by improvements in coping skills and self-efficacy for caregivers assigned to the intervention. LAY SUMMARY: We previously reported that a six-session program (BMT-CARE), focused on providing medical information, caregiving skills, and self-care and coping strategies, improved quality of life (QOL) and mood of caregivers of hematopoietic stem cell transplantation (HCT) recipients, compared to a group of caregivers who received care as usual. Using statistical models, our findings suggest that learning coping skills and improving self-efficacy were the most essential components of this program that likely led to better QOL and mood for those caregivers. |
Databáze: | OpenAIRE |
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