Skip to main content
Log in

Resilience in patients after allogeneic stem cell transplantation

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  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):2192

    Google Scholar 

  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 20:615–622

    Article  PubMed Central  PubMed  Google Scholar 

  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 48:11–21

    Article  CAS  PubMed  Google Scholar 

  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 10:124–130

    Article  CAS  Google Scholar 

  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):2334–2343

    Article  CAS  PubMed  Google Scholar 

  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):1457–1464

    CAS  PubMed  Google Scholar 

  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 126:184–192

    Article  CAS  PubMed  Google Scholar 

  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 47:473–482

    Article  CAS  PubMed  Google Scholar 

  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):2335–2343

    Article  CAS  PubMed  Google Scholar 

  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 20:1907–1917

    Article  PubMed  Google Scholar 

  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 29:341–351

    Article  CAS  PubMed  Google Scholar 

  12. Baker F, Zabora J, Polland A, Wingard J (1999) Reintegration after bone marrow transplantation. Cancer Pract 7(4):190–197

    Article  CAS  PubMed  Google Scholar 

  13. Sherman RS, Cooke E, Grant M (2005) Dialogue among survivors of hematopoietic cell transplantation: support-group themes. J Psychosoc Oncol 23:1–24

    Article  PubMed  Google Scholar 

  14. Rutter M (1995) Psychosocial adversity: risk, resilience and recovery. South Afr J Child Adolesc Psychiatry 7(2):75–88

    Google Scholar 

  15. Wagnild GM, Young HM (1993) Development and psychometric evaluation of the Resilience Scale. J Nurs Meas 1(2):165–178

    CAS  PubMed  Google Scholar 

  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 21:999–1006

    Article  CAS  Google Scholar 

  17. Brix C, Schleußner CH, Füller J, Rörig B, Strauß B (2009) Fatigue und deren Determinanten in der Radioonkologie. Psychother Psychosom Med Psychol 59:42–49

    Article  PubMed  Google Scholar 

  18. Leppert K, Gunzelmann T, Schumacher J, Strauß B, Brähler E (2005) Resilienz als protektives Persönlichkeitsmerkmal im Alter. Psychother Psychosom Med Psychol 55:365–369

    Article  PubMed  Google Scholar 

  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 5:484–495

    Article  Google Scholar 

  20. Aspinwall LG, MacNamara A (2005) Taking positive changes seriously: toward a positive psychology of cancer survivorship and resilience. Cancer 104:2549–2556

    Article  PubMed  Google Scholar 

  21. Bandura A (1997) Self-efficacy: the exercise of control. W.H. Freeman, New York

    Google Scholar 

  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 35–37

    Google Scholar 

  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):365–376

    Article  CAS  PubMed  Google Scholar 

  24. Leppert K (2003) RS-Resilienzskala. In: Brähler E, Schumacher J, Strauß B (eds) Diagnostische Verfahren in der Psychotherapie. Hogrefe, Göttingen, pp 295–298

    Google Scholar 

  25. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  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):143–152

    Google Scholar 

  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 53:16–39

    Google Scholar 

  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 2013

    PubMed  Google Scholar 

  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):1155–1167

    Article  PubMed  Google Scholar 

  30. Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S (2007) Social support and resilience to stress. Psychiatry 4(5):35–40

    PubMed  Google Scholar 

  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):445–453

    Article  PubMed  Google Scholar 

  32. Hinz A, Schwarz R (2001) Angst und Depression in der Allgemeinbevölkerung. Eine Normierungsstudie zur Hospital Anxiety and Depression Scale. Psychotherapie, Psychosomatik. Med Psychol 51:193–200

    CAS  Google Scholar 

  33. Hinz A, Schumacher J, Albani C, Schmid G, Brähler E (2006) Bevölkerungs-repräsentative Normierung der Skala zur Allgemeinen Selbstwirksamkeitserwartung. Diagnostica 52:26–32

    Article  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrea Schumacher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schumacher, A., Sauerland, C., Silling, G. et al. Resilience in patients after allogeneic stem cell transplantation. Support Care Cancer 22, 487–493 (2014). https://doi.org/10.1007/s00520-013-2001-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-013-2001-6

Keywords

Navigation