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Positive and negative psychosocial sequelae of bone marrow transplantation: Implications for quality of life assessment

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Abstract

Life-threatening disease can trigger positive effects such as greater appreciation for life and enhanced interpersonal relationships. Little research has examined these salutary effects or their association with quality of life (QOL). Adult bone marrow transplantation (BMT) survivors (n=90) were interviewed regarding psychosocial sequelae of BMT and completed indices of QOL and psychological adjustment. Thematic analysis was used to code interview responses into discrete categories of negative and positive sequelae. Multiple regression analyses indicated POSTOTAL scores were inversely associated with time post-BMT and positively associated with negative prognostic factors at BMT. Scores on indices of QOL and psychological adjustment were significantly correlated with reports of negative post-BMT sequelae but unrelated to positive sequelae. It was concluded that life-threatening disease can trigger positive sequelae that can contribute to QOL. However, standard QOL indices may not measure this positive QOL dimension, thus yielding a potentially incomplete picture of current QOL.

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References

  • Affleck, G., Tennen, H., Croog, S., and Levine, S. (1987). Causal attribution, perceived benefits, and morbidity after a heart attack: An 8-year study.J. Consult. Clin. Psychol. 55: 29–35.

    PubMed  Google Scholar 

  • Andrykowski, M. A. (1994). Psychosocial factors in bone marrow transplantation: A review and recommendations for research.Bone Marrow Transplant. 13: 357–375.

    PubMed  Google Scholar 

  • Andrykowski, M. A., and Henslee-Downey, P. J. (1990). Emotional adjustment in adult survivors of allogeneic bone marrow transplantation (BMT): Beyond the “honeymoon effect”.Psychosom. Med. 52: 239 (abstr.).

    Google Scholar 

  • Andrykowski, M. A., Altmaier, E. M., Barnett, R. L., Otis, M. L., Gingrich R., and Henslee-Downey, P. J. (1990). Quality of life in adult survivors of allogeneic bone marrow transplantation: Correlates and comparison with matched renal transplant recipients.Transplantation 50: 399–406.

    PubMed  Google Scholar 

  • Andrykowski, M. A., Brady, M. J., and Hunt, J. W. (1993). Positive psychosocial adjustment in potential bone marrow transplant recipients: Cancer as a psychosocial transition.Psycho Oncology 2: 261–276.

    Google Scholar 

  • Andrykowski, M. A., Brady, M. J., Greiner, C. B., Altmaier, E. M., Burish, T. G., Antin, J. H., Gingrich, R., McGarigle, C., and Henslee-Downey, P. J. (1995a). “Returning to normal” following bone marrow transplantation: Outcomes, expectations, and informed consent.Bone Marrow Transplant. 15: 573–581.

    PubMed  Google Scholar 

  • Andrykowski, M. A., Greiner, C. B., Altmaier, E. M., Burish, T. G., Antin, J. H., Gingrich, R., McGarigle, C., and Henslee-Downey, P. J. (1995b). Quality of life following bone marrow transplantation: Findings from a multicentre study.Br. J. Cancer 71: 1322–1329.

    PubMed  Google Scholar 

  • Armitage, J. O. (1994). Bone marrow transplantation.N. Engl. J. Med. 330: 827–838.

    PubMed  Google Scholar 

  • Beatty, P. G. (1992). Results of allogeneic bone marrow transplantation with unrelated or mismatched donors.Semin. Oncol. 19(3; Suppl. 7): 13–19.

    Google Scholar 

  • Belec, R. H. (1992). Quality of life: Perceptions of long-term survivors of bone marrow transplantation.Oncol. Nurs. Forum 19: 31–37.

    PubMed  Google Scholar 

  • Bergner, M., Bobbitt, R. A., Carter, W. B., and Gilson, B. S. (1981). The Sickness Impact Profile: Development and final revision of a health status measure.Med. Care 19: 787–805.

    PubMed  Google Scholar 

  • Brickman, P., Coates, D., and Janoff-Bulman, R. (1978). Lottery winners and accident victims: Is happiness relative?J. Personal. Social Psychol. 36: 917–927.

    Google Scholar 

  • Cacioppo, J. T., and Berntson, G. G. (1994). Relationship between attitudes and evaluative space: A critical review with emphasis on the separability of positive and negative substrates.Psychol. Bull. 115: 401–423.

    Google Scholar 

  • Calhoun, L. G., and Tedeschi, R. G. (1990). Positive aspects of critical life problems: Recollections of grief.Omega 20: 265–272.

    Google Scholar 

  • Cantril, H. (1965).The Patterns of Human Concern, Rutgers University Press. New Brunswick, NJ.

    Google Scholar 

  • Cella, D. F., and Tross, S. (1986). Psychological adjustment to survival from Hodgkin's disease.J. Consult. Clin. Psychol. 54: 616–622.

    PubMed  Google Scholar 

  • Collins, R. L., Taylor, S. E., and Skokan, L. A. (1990). A better world or a shattered vision? Changes in life perspectives following victimization.Social Cognit. 8: 263–285.

    Google Scholar 

  • Curbow, B., Legro, M. W., Baker, F., Wingard, J. R., and Somerfield, M. R. (1993a). Loss and recovery themes of long-term survivors of bone marrow transplants.J. Psychosoc. Oncol. 10: 1–20.

    Google Scholar 

  • Curbow, B., Somerfield, M., Baker, F., Wingard, J., and Legro, M. (1993b). Personal changes, dispositional optimism and psychological adjustment to an aggressive cancer treatment.J. Behav. Med. 16: 423–443.

    PubMed  Google Scholar 

  • Danoff, B., Kramer, S., Irwin, P., and Gottlieb, A. (1983). Assessment of the quality of life in long-term survivors after definitive radiotherapy.Am. J. Clin. Oncol. 6: 339–345.

    PubMed  Google Scholar 

  • Dapkus, M. A. (1985). A thematic analysis of the experience of time.J. Personal. Soc. Psychol. 49: 408–419.

    Google Scholar 

  • Derogatis, L. R. (1986). The psychosocial adjustment to illness scale (PAIS).J. Psychosom. Res. 30: 77–91.

    PubMed  Google Scholar 

  • Dobkin, P. L., and Morrow, G. R. (1985). Long-term side effects in patients who have been treated successfully for cancer.J. Psychosoc. Oncol. 3(4): 23–51.

    Google Scholar 

  • Ferrell, B., Grant, M., Schmidt, G. M., Rhiner, M., Whitehead, C., Fonbuena, P., and Forman, S. J. (1992a). The meaning of quality of life for bone marrow transplant survivors. 1. The impact of bone marrow transplant on quality of life.Cancer Nurs. 15: 153–160.

    PubMed  Google Scholar 

  • Ferrell, B., Grant, M., Schmidt, G. M., Rhiner, M., Whitehead, C., Fonbuena, P., and Forman, S. J. (1992b). The meaning of quality of life for bone marrow transplant survivors. 2. Improving quality of life for bone marrow transplant survivors.Cancer Nurs. 15: 247–253.

    PubMed  Google Scholar 

  • Festinger, L. (1957).A Theory of Cognitive Dissonance, Stanford University Press, Stanford, CA.

    Google Scholar 

  • Freund, B. L., and Siegel, K. (1986). Problems in transition following bone marrow transplantation.Am. J. Orthopsychiat. 56: 244–252.

    PubMed  Google Scholar 

  • Glanz, K., and Lerman, C. (1992). Psychosocial impact of breast cancer: A critical review.Ann. Behav. Med. 14: 204–212.

    Google Scholar 

  • Goldberg, R. J. (1988). Psychiatric aspects of psychosocial distress in cancer patients.J. Psychosoc. Oncol. 6: 139–163.

    Google Scholar 

  • Irvine, D., Brown, B., Brooks, D., Roberts, J., and Browne, G. (1991). Psychosocial adjustment in women with breast cancer.Cancer 67: 1097–1117.

    PubMed  Google Scholar 

  • Kennedy, B. J., Tellegen, A., Kennedy, S., and Havernick, N. (1976). Psychological response of patients cured of advanced cancer.Cancer 38: 2184–2191.

    PubMed  Google Scholar 

  • Kessler, B. G. (1987). Bereavement and personal growth.J. Hum. Psychol. 27: 228–247.

    Google Scholar 

  • Laerum, E., Johnsen, N., Smith, P., and Larsen, S. (1988). Myocardial infarction may induce positive changes in life style and in the quality of life.Scand. J. Primary Health Care 6: 67–71.

    Google Scholar 

  • Lehman, D. R., Wortman, C. B., and Williams, A. F. (1987). Long-term effects of losing a spouse or child in a motor vehicle crash.J. Personal Soc. Psychol. 52: 218–231.

    Google Scholar 

  • Lesko, L. M. (1989). Bone marrow transplantation. In Holland, J. C., and Rowland, J. H. (eds.),Handbook of Psycho-oncology: Psychological Care of the Patient with Cancer, Oxford University Press, New York, pp. 163–173.

    Google Scholar 

  • Longman, A. J., and Graham, K. Y. (1986). Living with melanoma: Content analysis of interviews.Oncol. Nurs. Forum 13: 58–64.

    PubMed  Google Scholar 

  • Maher, E. L. (1982). Anomic aspects of recovery from cancer.Social Sci. Med. 16: 907–912.

    Google Scholar 

  • McNair, P. M., Lorr, M., and Droppelman, L. (1981).POMS Manual (2nd ed.), Educational and Industrial Testing Service, San Diego.

    Google Scholar 

  • Moch, S. D. (1990). Health within the experience of breast cancer.J. Adv. Nurs. 15: 1426–1435.

    PubMed  Google Scholar 

  • Parkes, C. M. (1971). Psycho-social transitions: A field for study.Social Sci. Med. 5: 101–115.

    Google Scholar 

  • Ringden, O., Horowitz, M. M., Gale, R. P., Biggs, J. C., Gagewski, J., Rimm, A. A., Speck, B., Veumstone, J. A., de Witte, T., and Bortin, M. M. (1993). Outcome after allogeneic bone marrow transplant for leukemia in older adults.JAMA 270: 57–60.

    PubMed  Google Scholar 

  • Rosenberg, M. (1965).Society and the Adolescent Self-Image, Princeton University Press, Princeton, NJ.

    Google Scholar 

  • Schipper, H., Clinch, J., McMurray, A., and Levitt, M. (1984). Measuring the quality of life of cancer patients: The Functional Living Index—Cancer development and validation.J. Clin. Oncol. 2: 472–483.

    PubMed  Google Scholar 

  • Steeves, R. H. (1992). Patients who have undergone bone marrow transplantation: Their quest for meaning.Oncol. Nurs. Forum 19: 899–905.

    PubMed  Google Scholar 

  • Sullivan, K. M., and Storb, R. (1989). Bone marrow transplantation and graft-versus-host disease. In Brent, L., and Sells, R. A. (eds.),Organ Transplantation: Current Clinical and Immunological Concepts. Bailliere-Tindall, London, pp. 91–118.

    Google Scholar 

  • Syrjala, K. L., Cummings, C., and Donaldson, G. W. (1992). Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: A controlled clinical trial.Pain 48: 137–146.

    PubMed  Google Scholar 

  • Taylor, S. E. (1983). Adjustment to threatening events: A theory of cognitive adaptation.Am. Psychol. 38: 1161–1173.

    Google Scholar 

  • Tempelaar, R., de Haes, J. C. J. M., de Ruiter, J. H., Bakker, D., Van den Heuvel, W. J. A., and Van Nieuwenhuijzen, M. G. (1989). The social experiences of cancer patients under treatment: A comparative study.Social Sci. Med. 29: 635–642.

    Google Scholar 

  • Van Eys, J. (1987). Living beyond cure: Transcending survival.Am. J. Pediat. Hematol./Oncol. 9: 114–118.

    Google Scholar 

  • Watson, D., and Tellegen, A. (1985). Toward a consensual structure of mood.Psychol. Bull. 98: 219–235.

    PubMed  Google Scholar 

  • Watson, D., Clark, L. A., and Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect.J. Personal. Soc. Psychol. 54: 1063–1070.

    Google Scholar 

  • Welch-McCaffrey, D., Hoffman, J., Leigh, S. A., Loescher, L. J., and Meyskens, F. L. (1989). Surviving adult cancers. 2. Psychosocial implications.Ann. Intern. Med. 111: 517–524.

    PubMed  Google Scholar 

  • Zemore, R., Rinholm, J., Shepel, L., and Richards, M. (1989). Some social and emotional consequences of breast cancer and mastectomy: A content analysis of 87 interviews.J. Psychosoc. Oncol. 7: 33–45.

    Google Scholar 

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  1. Department of Behavioral Science, University of Kentucky College of Medicine, 40536, Lexington, Kentucky

    Kathleen Fromm, Michael A. Andrykowski & Jean Hunt

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  1. Kathleen Fromm
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  2. Michael A. Andrykowski
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Fromm, K., Andrykowski, M.A. & Hunt, J. Positive and negative psychosocial sequelae of bone marrow transplantation: Implications for quality of life assessment. J Behav Med 19, 221–240 (1996). https://doi.org/10.1007/BF01857767

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