Original Article
Quality of Life and Mood of Patients and Family Caregivers During Hospitalization for Hematopoietic Stem Cell Transplantation Areej R. El-Jawahri, MD1; Lara N. Traeger, PhD2; Kailyn Kuzmuk, BA2; Justin R. Eusebio, BS2; Harry B. Vandusen, BS2; Jennifer A. Shin, MD1; Tanya Keenan, MD1; Emily R. Gallagher, RN1; Joseph A. Greer, PhD2; William F. Pirl, MD2; Vicki A. Jackson, MD3; Karen K. Ballen, MD1; Thomas R. Spitzer, MD1; Timothy A. Graubert, MD1; Steven L. McAfee, MD1; Bimalangshu R. Dey, MD1; Yi-Bin A. Chen, MD1; and Jennifer S. Temel, MD1
BACKGROUND: We conducted a study to investigate the impact of hospitalization for hematopoietic stem cell transplantation (HCT) on the quality of life (QOL) and mood of patients and family caregivers (FC). METHODS: We conducted a longitudinal study of patients who were hospitalized for HCT and their FC. We assessed QOL (using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation) and mood (using the Hospital Anxiety and Depression Scale) at baseline (6 days before HCT), day 11, and day 18 of HCT. We administered the Medical Outcomes Study Health Survey Short Form-36 to examine FC QOL (Physical Component Scale and Mental Component Scale). To identify predictors of changes in QOL, we used multivariable linear mixed models. RESULTS: We enrolled 97% of eligible patients undergoing autologous (30 patients), myeloablative (30 patients), or reduced intensity (30 patients) allogeneic HCT. Patients’ QOL markedly declined (mean Functional Assessment of Cancer Therapy-Bone Marrow Transplantation score, 109.6 to 96.0; P7) more than doubled from baseline to day 18 (15.6% to 37.8%; P7) and major or other depressive syndromes (PHQ-9). For the PHQ-9, a major or other depressive syndrome is diagnosed if a patient reports at least 2 of the 9 symptoms of depression, with 1 of the symptoms being anhedonia or depressed mood.20 We used nonlinear mixed-effects models with binomial distribution adjusting for age and comorbidities to examine the changes in these dichotomous outcomes over time. To identify potential predictors of QOL (TOI), we first tested unadjusted associations between the following baseline variables of interest and QOL scores over time: age, sex, diagnosis, HCT-CI, relationship status, education, income, social well-being, emotional well-being, HADS-Depression, and HADS-Anxiety. Variables that were associated with QOL at a P value
Quality of Life and Mood of Patients and Family Caregivers During Hospitalization for Hematopoietic Stem Cell Transplantation Areej R. El-Jawahri, MD1; Lara N. Traeger, PhD2; Kailyn Kuzmuk, BA2; Justin R. Eusebio, BS2; Harry B. Vandusen, BS2; Jennifer A. Shin, MD1; Tanya Keenan, MD1; Emily R. Gallagher, RN1; Joseph A. Greer, PhD2; William F. Pirl, MD2; Vicki A. Jackson, MD3; Karen K. Ballen, MD1; Thomas R. Spitzer, MD1; Timothy A. Graubert, MD1; Steven L. McAfee, MD1; Bimalangshu R. Dey, MD1; Yi-Bin A. Chen, MD1; and Jennifer S. Temel, MD1
BACKGROUND: We conducted a study to investigate the impact of hospitalization for hematopoietic stem cell transplantation (HCT) on the quality of life (QOL) and mood of patients and family caregivers (FC). METHODS: We conducted a longitudinal study of patients who were hospitalized for HCT and their FC. We assessed QOL (using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation) and mood (using the Hospital Anxiety and Depression Scale) at baseline (6 days before HCT), day 11, and day 18 of HCT. We administered the Medical Outcomes Study Health Survey Short Form-36 to examine FC QOL (Physical Component Scale and Mental Component Scale). To identify predictors of changes in QOL, we used multivariable linear mixed models. RESULTS: We enrolled 97% of eligible patients undergoing autologous (30 patients), myeloablative (30 patients), or reduced intensity (30 patients) allogeneic HCT. Patients’ QOL markedly declined (mean Functional Assessment of Cancer Therapy-Bone Marrow Transplantation score, 109.6 to 96.0; P7) more than doubled from baseline to day 18 (15.6% to 37.8%; P7) and major or other depressive syndromes (PHQ-9). For the PHQ-9, a major or other depressive syndrome is diagnosed if a patient reports at least 2 of the 9 symptoms of depression, with 1 of the symptoms being anhedonia or depressed mood.20 We used nonlinear mixed-effects models with binomial distribution adjusting for age and comorbidities to examine the changes in these dichotomous outcomes over time. To identify potential predictors of QOL (TOI), we first tested unadjusted associations between the following baseline variables of interest and QOL scores over time: age, sex, diagnosis, HCT-CI, relationship status, education, income, social well-being, emotional well-being, HADS-Depression, and HADS-Anxiety. Variables that were associated with QOL at a P value
