Advertisement

Supportive Care in Cancer

, Volume 22, Issue 2, pp 487–493 | Cite as

Resilience in patients after allogeneic stem cell transplantation

  • Andrea SchumacherEmail author
  • Cristina Sauerland
  • Gerda Silling
  • Wolfgang E. Berdel
  • Matthias Stelljes
Original Article

Abstract

Purpose

After undergoing allogeneic stem cell transplantation (alloSCT), patients adapt in very different ways to their taxing situation. Some patients cope very well; others almost seem to fail. Psychosocial variables are important factors for successful reintegration. Besides quality of life, resilience may help to understand the variance in individual differences in adaptation after alloSCT.

Methods

A pilot study at the University Hospital Muenster, Germany, assessed resilience in patients after alloSCT. The sample included 75 patients (leukemia, lymphoma, myeloma, aplastic anemia) aged 20–76 years. The instruments Resilience Scale RS-25, Hospital Anxiety and Depression Scale, General Self-efficacy Scale, and EORTC QLQ-C30 were used.

Results

Resilience is positively correlated with quality of life (Spearman’s rho 0.587) and social functioning (0.472), negatively with anxiety (−0.491) and depression (−0.577). Dividing the sample at the median resilience score of 144 reveals that high-resilience patients report less anxiety (p = 0.008) and depression (p < 0.001); higher physical (p = 0.041), emotional (p = 0.030), and social functioning (p = 0.003); and a better quality of life (p < 0.001) than low-resilience patients. No effects on resilience were found for age, gender, and primary disease entity. The high correlation of resilience and self-efficacy (r = 0.698) shows the strong relationship between the two concepts. Our results indicate a potential influence of the time span from alloSCT on patients’ resilience.

Conclusions

Resilience should be considered as a protective psychosocial factor for patients after alloSCT. A high degree of resilience can help patients to adapt to their situation and to resume their everyday life.

Keywords

Resilience Quality of life Stem cell transplantation Protective psychosocial factors 

Notes

Acknowledgments

We wish to thank Annika Nilius and Susanne Schwanke for their contribution to this study with their doctoral theses. We would also like to thank the participants for the time they took to fill out the questionnaires.

Conflict of interest

The authors declare that they have no conflict of interest to report.

References

  1. 1.
    Grulke N, Bailer H, Juchems A, Heitz V, Caspari-Oberegelsbacher H, Domann U, Prudlo U, Kraus S, Larbig W, Kaechele H (2003) Psychosocial interventions for patients undergoing allogenic stem cell transplantation: results of a controlled clinical trial. Psychooncology 12(4):2192Google Scholar
  2. 2.
    Bevans M, Wehrlen L, Prachenko O, Soeken K, Zabora J, Wallen G (2011) Distress screening in allogeneic hematopoietic stem cell (HSCT) caregivers and patients. Psychooncology 20:615–622PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Broers S, Kaptein AA, Le Cessie S, Fibbe W, Hengeveld MW (2000) Psychological functioning and quality of life following bone marrow transplantation: a 3-year follow-up study. J Psychosom Res 48:11–21PubMedCrossRefGoogle Scholar
  4. 4.
    Edman L, Larsen J, Hagglund H, Gardulf A (2001) Health-related quality of life, symptom distress and sense of coherence in adult survivors of allogeneic stem-cell transplantation. Eur J Cancer Care 10:124–130CrossRefGoogle Scholar
  5. 5.
    Kiss TL, Abdolell M, Jamal N, Minden MD, Lipton JH, Messner HA (2002) Long-term medical outcomes and quality-of-life assessment of patients with chronic myeloid leukemia followed at least 10 years after allogeneic bone marrow transplantation. J Clin Oncol 20(9):2334–2343PubMedCrossRefGoogle Scholar
  6. 6.
    Saleh US, Brockopp DY (2001) Quality of life one year following bone marrow transplantation: psychometric evaluation of the quality of life in bone marrow transplant survivors tool. Oncol Nurs Forum 28(9):1457–1464PubMedGoogle Scholar
  7. 7.
    Duell T, van Lint MT, Ljungman P, Tichelli A, Socié G, Apperley JF, Weiss M, Cohen A, Nekolla E, Kolb HJ (1997) Health and functional status of long-term survivors of bone marrow transplantation. Ann Intern Med 126:184–192PubMedCrossRefGoogle Scholar
  8. 8.
    Grulke N, Albani C, Bailer H (2012) Quality of life in patients before and after haematopoietic stem cell transplantation measured with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire QLQ-C30. Bone Marrow Transplant 47:473–482PubMedCrossRefGoogle Scholar
  9. 9.
    Syrjala KL, Langer S, Abrams JR, Storer B, Sanders JE, Flowers MED, Martin PJ (2004) Recovery and long-term function after hematopoetic cell transplantation for leukemia or lymphoma. JAMA 291(19):2335–2343PubMedCrossRefGoogle Scholar
  10. 10.
    Prieto JM, Blanch J, Atala J, Carreras E, Rovira M, Cirera E, Gasto C (2002) Psychiatric morbidity and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. J Clin Oncol 20:1907–1917PubMedCrossRefGoogle Scholar
  11. 11.
    Schulz-Kindermann F, Hennings U, Ramm G, Zander AR, Hasenbring M (2002) The role of biomedical and psychosocial factors for the prediction of pain and distress in patients undergoing high-dose therapy and BMT/PBSCT. Bone Marrow Transplant 29:341–351PubMedCrossRefGoogle Scholar
  12. 12.
    Baker F, Zabora J, Polland A, Wingard J (1999) Reintegration after bone marrow transplantation. Cancer Pract 7(4):190–197PubMedCrossRefGoogle Scholar
  13. 13.
    Sherman RS, Cooke E, Grant M (2005) Dialogue among survivors of hematopoietic cell transplantation: support-group themes. J Psychosoc Oncol 23:1–24PubMedCrossRefGoogle Scholar
  14. 14.
    Rutter M (1995) Psychosocial adversity: risk, resilience and recovery. South Afr J Child Adolesc Psychiatry 7(2):75–88Google Scholar
  15. 15.
    Wagnild GM, Young HM (1993) Development and psychometric evaluation of the Resilience Scale. J Nurs Meas 1(2):165–178PubMedGoogle Scholar
  16. 16.
    Braun A, Müller UA, Müller R, Leppert K, Schiel R (2004) Structured treatment and teaching of patients with type 2 diabetes mellitus and impaired cognitive function—the DICOF trial. Diabetes Med 21:999–1006CrossRefGoogle Scholar
  17. 17.
    Brix C, Schleußner CH, Füller J, Rörig B, Strauß B (2009) Fatigue und deren Determinanten in der Radioonkologie. Psychother Psychosom Med Psychol 59:42–49PubMedCrossRefGoogle Scholar
  18. 18.
    Leppert K, Gunzelmann T, Schumacher J, Strauß B, Brähler E (2005) Resilienz als protektives Persönlichkeitsmerkmal im Alter. Psychother Psychosom Med Psychol 55:365–369PubMedCrossRefGoogle Scholar
  19. 19.
    Hou WK, Law CC, Yin J, Fu YT (2010) Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: a growth mixture modeling approach. Health Psychol 5:484–495CrossRefGoogle Scholar
  20. 20.
    Aspinwall LG, MacNamara A (2005) Taking positive changes seriously: toward a positive psychology of cancer survivorship and resilience. Cancer 104:2549–2556PubMedCrossRefGoogle Scholar
  21. 21.
    Bandura A (1997) Self-efficacy: the exercise of control. W.H. Freeman, New YorkGoogle Scholar
  22. 22.
    Schwarzer R, Jerusalem M (1995) Generalized self-efficacy scale. In: Weinman J, Wright S, Johnston M (eds) Measures in health psychology: a user’s portfolio. Causal and control beliefs. NFER-Nelson, Windsor, pp 35–37Google Scholar
  23. 23.
    Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376PubMedCrossRefGoogle Scholar
  24. 24.
    Leppert K (2003) RS-Resilienzskala. In: Brähler E, Schumacher J, Strauß B (eds) Diagnostische Verfahren in der Psychotherapie. Hogrefe, Göttingen, pp 295–298Google Scholar
  25. 25.
    Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370PubMedCrossRefGoogle Scholar
  26. 26.
    Herrmann C, Buss U (1994) Vorstellung und Validierung einer deutschen Version der “Hospital Anxiety and Depression Scale” (HAD-Skala): ein Fragebogen zur Erfassung des psychischen Befindens bei Patienten mit körperlichen Beschwerden. Diagnostica 40(2):143–152Google Scholar
  27. 27.
    Schumacher J, Leppert K, Grunzelmann T, Strauß B, Brähler E (2005) Die Resilienzskala – Ein Fragebogen zur Erfassung der psychischen Widerstandsfähigkeit als Personmerkmal. Z klin Psychol Psychother 53:16–39Google Scholar
  28. 28.
    Hou WK, Lam JHM (2013) Resilience in the year after cancer diagnosis: a cross-lagged panel analysis of the reciprocity between psychological distress and well-being. J Behav Med. doi: 10.1007/s10865-013-9497-6, Published online 20 February 2013PubMedGoogle Scholar
  29. 29.
    Skeath P, Norris S, Katheria V, White J, Baker K, Handel D, Sternberg E, Pollack J, Groninger H, Phillips J, Berger A (2013) The nature of life-transforming changes among cancer survivors. Qual Health Res 23(9):1155–1167PubMedCrossRefGoogle Scholar
  30. 30.
    Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S (2007) Social support and resilience to stress. Psychiatry 4(5):35–40PubMedGoogle Scholar
  31. 31.
    Runkewitz K, Kirchmann H, Strauss B (2006) Anxiety and depression in primary care patients: predictors of symptom severity and developmental correlates. J Psychosom Res 60(5):445–453PubMedCrossRefGoogle Scholar
  32. 32.
    Hinz A, Schwarz R (2001) Angst und Depression in der Allgemeinbevölkerung. Eine Normierungsstudie zur Hospital Anxiety and Depression Scale. Psychotherapie, Psychosomatik. Med Psychol 51:193–200Google Scholar
  33. 33.
    Hinz A, Schumacher J, Albani C, Schmid G, Brähler E (2006) Bevölkerungs-repräsentative Normierung der Skala zur Allgemeinen Selbstwirksamkeitserwartung. Diagnostica 52:26–32CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Andrea Schumacher
    • 1
    Email author
  • Cristina Sauerland
    • 2
  • Gerda Silling
    • 1
  • Wolfgang E. Berdel
    • 1
  • Matthias Stelljes
    • 1
  1. 1.Department of Medicine A/Hematology and OncologyUniversity of MuensterMuensterGermany
  2. 2.Institute of Biostatistics and Clinical ResearchUniversity of MuensterMuensterGermany

Personalised recommendations