Cancer-and-treatment-specific distress and its impact on posttraumatic stress in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT)
Cancer-and-treatment-specific distress and its impact on posttraumatic stress in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT)
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DOI：
10.1002/pon.4295
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发表时间：
2017-08-01
期刊：
影响因子：
3.6
通讯作者：
Mehnert, Anja
中科院分区：
文献类型：
--
作者：
Kuba, Katharina;Esser, Peter;Mehnert, Anja
背景资料：在这项前瞻性多中心研究中，我们调查了癌症和治疗特异性痛苦（CTXD）及其对异基因造血干细胞移植（HSCT）患者创伤后应激障碍（PTSD）症状的影响。方法：患者在HSCT前（T0，N = 239），3（T1，N = 150），12个月（T2，N = 102）后咨询。结果：随机截距模型显示，CTXD总分在HSCT前（T0）最高，T1（γ = -.18，95%CI [-.26/-.09]）和T2（γ = -.10，95%CI [-.20/-.00]）降低。不确定性、家庭压力和健康负担被认为是HSCT期间最令人痛苦的因素。从T0到T1，不确定性和家庭压力降低（γ = -.30，95% CI [-.42/-.17]; = -.10，95% CI [-.20/-.00]），从T1到T2，健康负担降低（γ = -.21，95% CI [-.36/.05]）。与男性相比，女性更可能报告不确定性（γ = 0.38，95% CI [0.19/0.58]）、家庭紧张（γ = 0.38，95% CI [0.19/0.58]）和对外表和性行为的担忧（γ = 0.31，95% CI [0.14/0.47]）。不确定（γ = 0.18，95% CI [0.12/0.24]），外观和性取向（γ = 0.09，95% CI [0.01/0.16]），和健康负担（gamma = .21，95%CI [.14/.27]）在3个评估点上成为PTSD精神病学的预测因子。我们的数据提供了关于HSCT期间CTXD 6个维度的过程及其对PTSD病理学影响的第一个证据。具体而言，结果强调的主要负担的不确定性预HSCT和不确定性和关注的外观和性PTSD创伤学的影响。
Background: In this prospective multicenter study, we investigated cancer-and-treatment-specific distress (CTXD) and its impact on symptoms of posttraumatic stress disorder (PTSD) in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).Methods: Patients were consulted before (T0, N = 239), 3 (T1, N = 150), and 12months (T2, N = 102) after HSCT. Medical (eg, diagnosis and pretreatment) and demographic information, CTXD and PTSD (PCL-C) were assessed.Results: Random intercept models revealed that the sum score of CTXD was highest pre-HSCT (T0), decreased by T1 (gamma = -.18, 95% CI [-.26/-.09]), and by T2 (gamma = -.10, 95% CI [-.20/-.00]). Uncertainty, family strain, and health burden were rated most distressing during HSCT. Uncertainty and family strain decreased from T0 to T1 (gamma = -.30, 95% CI [-.42/-.17]; = -.10, 95% CI [-.20/-.00]) and health burden from T1 to T2 (gamma = -.21, 95% CI [-.36/.05]). Women were more likely to report uncertainty (gamma = .38, 95% CI [.19/.58]), family strain (gamma = .38, 95% CI [.19/.58]), and concerns regarding appearance and sexuality (gamma = .31, 95% CI [.14/.47]) than men. Uncertainty (gamma = .18, 95% CI [.12/.24]), appearance and sexuality (gamma = .09, 95% CI [.01/.16]), and health burden (gamma = .21, 95% CI [.14/.27]) emerged as predictors of PTSD symptomatology across the 3 assessment points.Conclusions: Our data provide first evidence regarding the course of 6 dimensions of CTXD during HSCT and their impact on PTSD symptomatology. Specifically, results emphasize the major burden of uncertainty pre-HSCT and the impact of uncertainty and concerns regarding appearance and sexuality on PTSD symptomatology.