Sharing and caring: The impact of social support on quality of life and health outcomes in hematopoietic stem cell transplantation

• Published in: Cancer 2021-04, Vol.127 (8), p.1260-1265
• Main Authors: Amonoo, Hermioni L., Johnson, P. Connor, Dhawale, Tejaswini M., Traeger, Lara, Rice, Julia, Lavoie, Mitchell W., Ufere, Nneka N., Longley, Regina M., Harnedy, Lauren E., Clay, Madison A., Topping, Carlisle E. W., DeFilipp, Zachariah, Chen, Yi‐Bin A., El‐Jawahri, Areej
• Format: Article
• Language: English
• Subjects: Autografts; Blood cancer; Cancer; Cancer therapies; Checklist; Clinical trials; Empathy; Fatigue; Female; Health care; health‐related quality of life; hematologic malignancies; hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - psychology; Hematopoietic stem cells; Humans; Male; Mental disorders; Middle Aged; Oncology; Patients; patient‐reported outcomes; Perception; Post traumatic stress disorder; Psychological Distress; Psychological stress; psychological well‐being; Quality of life; Quality of Life - psychology; Regression Analysis; Secondary analysis; Social interactions; Social Support; social well‐being; Socioeconomic Factors; Stem cell transplantation; Stem cells; Stress Disorders, Post-Traumatic - diagnosis; Therapy; Transplantation; Treatment Outcome; Well being
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.33455

Background Social support is crucial for successful recovery after hematopoietic stem cell transplantation (HSCT) and has the potential to affect patient quality of life (QOL) and health outcomes. However, there are limited data on the relationship between a patient's perception of his or her social support and these outcomes. Methods The authors conducted a secondary analysis of 250 autologous and allogeneic HSCT recipients enrolled in 2 supportive care trials at Massachusetts General Hospital from April 2011 through February 2016. They assessed social support as a patient's perception of his or her social well‐being via the social well‐being subscale of the Functional Assessment of Cancer Therapy. The authors used multivariate regression analyses to examine the relationship between pretransplant social well‐being and QOL (Functional Assessment of Cancer Therapy–Treatment Outcome Index), psychological distress (Hospital Anxiety and Depression Scale), posttraumatic stress disorder [PTSD] symptoms (PTSD Checklist), fatigue (Functional Assessment of Cancer Therapy–Fatigue), and health care utilization (hospitalizations and days alive and out of the hospital) 6 months after HSCT. Results Participants were on average 56.4 years old (SD, 13.3 years); 44% (n = 110) and 56% (n = 140) received autologous and allogeneic HSCT, respectively. Greater pre‐HSCT social well‐being was associated with higher QOL (B = 0.10; 95% CI, 0.06‐0.13; P < .001), lower psychological distress (B = –0.21; 95% CI, –0.29 to –0.12; P < .001), and lower PTSD symptoms (B = –0.12; 95% CI, –0.19 to –0.06; P < .001). Pre‐HSCT social well‐being was not significantly associated with fatigue or health care utilization 6 months after HSCT. Conclusions Patients with higher pre‐HSCT perceptions of their social support reported better QOL and lower psychological distress 6 months after HSCT. These findings underscore the potential for social support as a modifiable target for future supportive care interventions to improve the QOL and care of HSCT recipients. Patients' perceptions of social well‐being before hematopoietic stem cell transplantation (HSCT) are associated with important patient‐reported outcomes after HSCT. Supportive oncology interventions for the HSCT population should incorporate techniques that cultivate social well‐being.