Aims:
In the wide spectrum of cancer therapies, allogeneic hematopoietic stem cell transplantation (HSCT) is a very taxing form of treatment. Accordingly, patients after HSCT are subjected to many physical and emotional stress-factors. Patients adapt in different ways to the situation, some patients almost seem to fail in this challenge. The concepts resilience and self-efficacy may help to understand the individual differences in adaptation after HSCT.
Methods:
The instruments Resilience-Scale (short form), Self-efficacy-Scale (SWE), HADS and EORTC-QLQ were supplemented with a qualitative survey. Out of 89 HSCT-patients (leukemia, lymphoma, myeloma, aplastic anemia), 75 patients took part in the study. 44 patients (59%) were male, 31 female (41%), aged 20-76 years (median 46 years). Time since allo-HSCT ranged from 6 months to 8 years (median: 34 months).
Results:
Resilience is positively correlated with quality of life (QL, Spearman's Rho: .587**) and social functioning (.472**), negatively with anxiety (-.491**) and depression (-.577**). Correlations of resilience with emotional functioning (.253*) and physical functioning (.335**) are weak. Self-efficacy is highly correlated with resilience (.698**) and QL (.453**).
** Sign. at the 0:01 level
* Sign. at the 0:05 level
Patients with a high resilience score (median split at 144) scored higher in physical functioning (p=0,041), emotional functioning (p=0,032) and QL (p=0,000) than patients with a low resilience score.
No effects were found for age, gender or disease entity. Preliminary analysis of the interviews indicates that patients define resilience largely on the basis of self-perception and social environment and attribute themselves a rather strong resilience.
Conclusions:
Further research is needed to understand long-time adaptation after HSCT and to define potential beneficial factors for a successful adaptation. In order to support long-term survivors with their special needs, resilience and self-efficacy should be considered as important protective psychosocial factors.