Optimistic expectations and survival after hematopoietic stem cell transplantation
Optimistic expectations and survival after hematopoietic stem cell transplantation
复制标题
DOI：
10.1016/s1083-8791(03)00103-4
复制
发表时间：
2003-06-01
影响因子：
4.3
通讯作者：
Weeks, JC
中科院分区：
文献类型：
--
作者：
Lee, SJ;Loberiza, FR;Weeks, JC
假设乐观的态度在面对危及生命的疾病时是有益的。然而，对治疗成功的高期望与医疗结果的实际关系是有争议的。通过对1996年7月至1999年11月登记的313名自体和异体造血干细胞移植患者的前瞻性队列研究，我们测试了移植前患者报告的期望是否与手术后的生存和生活质量相关。在移植前，对移植过程期望较高的患者精神和情绪功能较好，但与期望较低的患者身体状况和医疗状况相似。在移植后的前2个月，乐观预期与更好的生存率相关（92% v 84%；死亡率相对风险0.45,95%可信区间0.22-0.92；P= 0.03），控制了其他身心特征。然而，移植后6个月，最初期望较高和较低的患者的生存和生活质量没有区别。我们的数据表明，更乐观的预期与造血干细胞移植后的早期生存之间存在关联，但这种关联在移植后6个月不存在。(C) 2003年美国血液和骨髓移植学会。
An optimistic attitude is hypothesized to be beneficial when facing a life-threatening medical condition. However, the actual relationship of high expectations for treatment success and medical outcome is controversial. Using a prospective cohort of 313 autologous and allogeneic hematopoietic stem cell transplant patients enrolled July 1996 through November 1999, we tested whether patient-reported expectations before transplantation were associated with survival and quality of life following the procedure. Before transplantation, patients with higher expectations that the transplant procedure would go well had better mental and emotional functioning, but similar physical status and medical condition to patients with less optimistic expectations. In the first 2 months after transplantation, optimistic expectations were associated with better survival (92% v 84%; relative risk for mortality 0.45, 95% confidence interval 0.22-0.92; P=.03) controlling for other physical and mental characteristics. However, by 6 months posttransplantation, survival and quality of life were indistinguishable between patients with initially higher and lower expectations. Our data suggest an association between more optimistic expectations and early survival following hematopoietic stem cell transplantation, but this association is not present by 6 months posttransplantation. (C) 2003 American Society for Blood and Marrow Transplantation.