Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

Resilience in cancer survivors after allogeneic hematopoietic stem cell transplantation (#493)

Andrea Schumacher 1 , Cristina Sauerland 2 , Annika Zeglarski 1 , Matthias Stelljes 1 , Wolfgang E Berdel 1
  1. Department Medicine A, University Hospital, Muenster, Germany
  2. Inst. Biostatistics and Clinical Research, University of Muenster, Muenster, Germany

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.

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).

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.

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.