Relationships among symptoms, psychosocial factors, and health-related quality of life in hematopoietic stem cell transplant survivors.
Relationships among symptoms, psychosocial factors, and health-related quality of life in hematopoietic stem cell transplant survivors.
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造血干细胞移植幸存者的症状，社会心理因素和与健康相关的生活质量之间的关系。
DOI：
10.1007/s00520-014-2420-z
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发表时间：
2015-03
影响因子：
3.1
通讯作者：
Wingard, John
中科院分区：
文献类型：
--
作者：
Kenzik, Kelly;Huang, I-Chan;Rizzo, J. Douglas;Shenkman, Elizabeth;Wingard, John
关键词：
评估抑郁症状对造血干细胞移植幸存者（HSCT）躯体症状和健康相关生活质量（HRQOL）之间关系的中介作用;并测试除躯体和心理症状外，可能影响HRQOL的心理社会因素的概念模型。这是一项次要数据分析，使用了从国际血液和骨髓移植研究中心确定的在40家北美医疗中心接受治疗的HSCT幸存者受试者（N=662）。通过邮寄调查、电话采访和医疗记录收集数据。我们使用结构方程模型来检验抑郁症状在躯体症状与HRQOL关系中的中介作用。我们还测试了从身体症状到HRQOL的综合途径，增加了其他心理社会因素，包括乐观，应对和社会约束。在抑郁症状中介分析中，躯体症状对躯体HRQOL的直接影响（B=-0.98，p<0.001）强于抑郁症状（B=0.23，p>0.05）。抑郁症状与精神HRQOL相关，并介导躯体症状与精神HRQOL之间的关系。在综合路径分析中，身体症状仍然是与身体HRQOL相关的最重要因素。相比之下，抑郁症状对精神HRQOL有直接影响（B=-0.76，p<0.001），并且是一个重要的中介因素。心理社会因素与精神HRQOL直接相关，并通过抑郁症状与精神HRQOL间接相关。躯体症状与躯体HRQOL的相关性最强，而抑郁症状和心理社会因素对心理HRQOL的影响大于躯体HRQOL。针对身体/心理症状和心理社会因素的干预措施可能会改善HSCT幸存者的HRQOL。
To evaluate the mediating effect of depressive symptoms on the relationship between physical symptoms and health-related quality of life (HRQOL) in hematopoietic stem cell transplant survivors (HSCT); and to test a conceptual model of psychosocial factors, in addition to physical and psychological symptoms, that might contribute to HRQOL. This is a secondary data analysis using subjects (N=662) identified from the Center for International Blood and Marrow Transplant Research for HSCT survivors who were treated in 40 North American Medical Centers. Data were collected through mailed surveys, phone interviews, and medical records. We used structural equation modeling to test the mediating role of depressive symptoms on the relationship of physical symptoms with HRQOL. We also tested comprehensive pathways from physical symptoms to HRQOL by adding other psychosocial factors including optimism, coping, and social constraints. In the depressive symptom mediation analyses, physical symptoms had a stronger direct effect on physical HRQOL (b=−0.98, p<0.001) than depressive symptoms (b=0.23, p>0.05). Depressive symptoms were associated with mental HRQOL and mediated the relationship between physical symptoms and mental HRQOL. In the comprehensive pathway analyses, physical symptoms remained the most significant factor to be associated with physical HRQOL. In contrast, depressive symptoms had a direct effect (b=−0.76, p<0.001) on mental HRQOL and were a significant mediator. Psychosocial factors were directly associated with mental HRQOL and indirectly associated with mental HRQOL through depressive symptoms. Physical symptoms are most strongly associated with physical HRQOL; while depressive symptoms and psychosocial factors impact mental HRQOL more than physical HRQOL. Interventions targeting physical/psychological symptoms and psychosocial factors may improve HRQOL of HSCT survivors.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
Bentler, Peter M.
影响因子：
45.3
作者：
Andrykowski, MAA;Bishop, MM;Wingard, JR
通讯作者：
Wingard, JR
影响因子：
3.6
作者：
Friedman, Lois C.;Kalidas, Mamta;Liscum, Kathleen R.
通讯作者：
Liscum, Kathleen R.
影响因子：
2.1
作者：
Hochhausen, Nicole;Altmaier, Elizabeth M.;Henslee-Downey, Jean
通讯作者：
Henslee-Downey, Jean
影响因子：
3.2
作者：
Mosher CE;Lepore SJ;Wu L;Austin J;Valdimarsdottir H;Rowley S;Isola L;Redd WH;Rini C
通讯作者：
Rini C