1 Chaplaincy, Child Life, & Clinical Patient Navigators, Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance , Seattle, Washington.
2 Department of Religion, Health, and Human Values, Rush University Medical Center , Chicago, Illinois.
J Adolesc Young Adult Oncol. 2018 Apr;7(2):210-216. doi: 10.1089/jayao.2017.0069. Epub 2017 Nov 3.
This study describes the prevalence of religious and/or spiritual (R/S) struggle in long-term young adult (YA) survivors following hematopoietic cell transplantation (HCT) as well as existential concerns (EC), social support, and demographic, medical, and emotional correlates of R/S struggle.
Data were collected as part of an annual survey of survivors of HCT aged 18-39 years at survey completion; age at HCT was 1-39 years. Study measures included measures of R/S struggle (defined as any non-zero response on the negative religious coping subscale from Brief RCOPE), quality of life (QOL), and depression. Factors associated with R/S struggle were identified using multivariable logistic regression models.
Fifty-two of the 172 respondents (30%), who ranged from less than a year to 33 years after HCT, had some R/S struggle. In bivariate analysis, depression was associated with R/S struggle. In a multivariable logistic regression model, individuals with greater EC were nearly five times more likely to report R/S struggle. R/S struggle was not associated with age at transplant, time since transplant, gender, race, R/S self-identification, or medical variables.
R/S struggle is common among YA HCT survivors, even many years after HCT. There is a strong correlation between EC and R/S struggle. Given the prevalence of R/S struggle and its associations with EC, survivors should be screened and referred to professionals with expertise in EC and R/S struggle as appropriate. Further study is needed to determine longitudinal trajectory, impact of struggle intensity, causal relationships, and effects of R/S struggle on health, mood, and QOL for YA HCT survivors.
本研究描述了造血细胞移植(HCT)后长期年轻成人(YA)幸存者中宗教和/或精神(R/S)挣扎的流行情况,以及存在问题(EC)、社会支持以及与 R/S 挣扎相关的人口统计学、医学和情感因素。
数据是作为 HCT 后年龄为 18-39 岁的幸存者年度调查的一部分收集的;HCT 时的年龄为 1-39 岁。研究措施包括 R/S 挣扎(定义为从简短 RCOPE 的负面宗教应对子量表上的任何非零反应)、生活质量(QOL)和抑郁的测量。使用多变量逻辑回归模型确定与 R/S 挣扎相关的因素。
在 172 名受访者中,有 52 名(30%)在 HCT 后不到一年到 33 年的时间内经历了一些 R/S 挣扎。在单变量分析中,抑郁与 R/S 挣扎有关。在多变量逻辑回归模型中,EC 较高的个体报告 R/S 挣扎的可能性几乎高出五倍。R/S 挣扎与移植时的年龄、移植后的时间、性别、种族、R/S 自我认同或医学变量无关。
R/S 挣扎在 YA HCT 幸存者中很常见,即使在 HCT 多年后也是如此。EC 与 R/S 挣扎之间存在很强的相关性。鉴于 R/S 挣扎的普遍性及其与 EC 的关联,应根据需要对幸存者进行筛查并转介给具有 EC 和 R/S 挣扎专业知识的专业人员。需要进一步研究以确定 YA HCT 幸存者的 R/S 挣扎的纵向轨迹、挣扎强度的影响、因果关系以及 R/S 挣扎对健康、情绪和 QOL 的影响。