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The effect of pre-transplant pain and chronic disease self-efficacy on quality of life domains in the year following hematopoietic stem cell transplantation

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Abstract

Purpose

Pain is common for hematopoietic stem cell transplant (HSCT) patients and may be experienced pre-transplant, acutely post-transplant, and for months or years following transplant. HSCT patients with persistent pain may be at risk for poor quality of life following transplant; however, the impact of pre-transplant pain on quality of life post-transplant is not well understood. Self-efficacy for chronic disease management is associated with quality of life among cancer patients and may impact quality of life for HSCT patients. The primary aim was to examine the effect of pre-transplant pain and self-efficacy on quality of life domains in the year following transplant.

Methods

One hundred sixty-six HSCT patients completed questionnaires providing information on pain, self-efficacy, and quality of life prior to transplant, at discharge, and 3-, 6-, and 12-months post-transplant as part of a longitudinal, observational study. Linear mixed modeling examined the trajectories of these variables and the effect of pre-transplant pain and self-efficacy on post-transplant quality of life.

Results

Pain and social and emotional quality of life remained stable in the year following transplant while self-efficacy and physical and functional quality of life improved. Pre-transplant pain was significantly related to lower physical well-being post-transplant. Lower pre-transplant self-efficacy was related to lower quality of life across all domains post-transplant.

Conclusion

Above and beyond the effect of pre-transplant pain, self-efficacy for managing chronic disease is important in understanding quality of life following transplant. Identifying patients with pain and/or low self-efficacy pre-transplant may allow for early intervention with self-management strategies.

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Funding

This work was supported in part by the National Institutes of Health (K07CA138767; 5KL2TR001115-03) and internal funding from the Duke Cancer Patient Support Program.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main St., Suite 340, Durham, NC, 27705, USA

    Madeline L. O’Sullivan, Rebecca A. Shelby, Caroline S. Dorfman, Sarah A. Kelleher, Francis J. Keefe & Tamara J. Somers

  2. Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd, Coral Gables, FL, USA

    Hannah M. Fisher

  3. Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, 2400 Pratt St., Suite 9000, Durham, NC, 27710, USA

    Krista A. Rowe Nichols & Anthony D. Sung

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  1. Madeline L. O’Sullivan
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  2. Rebecca A. Shelby
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Correspondence to Tamara J. Somers.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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O’Sullivan, M.L., Shelby, R.A., Dorfman, C.S. et al. The effect of pre-transplant pain and chronic disease self-efficacy on quality of life domains in the year following hematopoietic stem cell transplantation. Support Care Cancer 26, 1243–1252 (2018). https://doi.org/10.1007/s00520-017-3947-6

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