Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Brookline, Massachusetts.
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
Biol Blood Marrow Transplant. 2019 Jan;25(1):e5-e16. doi: 10.1016/j.bbmt.2018.09.030. Epub 2018 Oct 8.
Positive psychological constructs (eg, optimism, positive affect) have been independently associated with superior health outcomes across many medical populations. However, there has been little synthesis of the literature examining these associations among patients with hematologic malignancies receiving hematopoietic stem cell transplantation (HSCT). To address this gap we completed a systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, of studies examining relationships between positive psychological constructs and health-related outcomes (eg, psychiatric symptoms, function, health-related quality of life [HRQoL], or treatment compliance) after HSCT. Eighteen eligible studies (N = 4201; 47% women; mean age, 47.1) were identified. Optimism (n = 12 studies) was the most frequently studied positive construct and HRQoL (examined in n = 11 studies) the most common outcome. All 17 studies with quantitative analyses found a significant (P < .05) association between a positive psychological construct and a health outcome; most but not all controlled for 1 or more relevant covariates. Among patients with hematologic malignancies who receive HSCT, positive psychological constructs appear to be associated with improved HRQoL and other health outcomes. Further work is warranted to more comprehensively understand the independent effects of positive psychological constructs on a variety of health outcomes and to develop interventions to promote well-being that are adapted to the needs of this population.
积极的心理结构(例如乐观、积极情绪)已被独立证明与许多医学人群的健康结果有关。然而,对于接受造血干细胞移植(HSCT)的血液恶性肿瘤患者,这些关联的文献研究很少有综合。为了解决这一差距,我们按照系统评价和荟萃分析的首选报告项目指南,完成了一项系统评价,研究了积极心理结构与健康相关结果(例如精神病症状、功能、健康相关生活质量[HRQoL]或治疗依从性)之间的关系。确定了 18 项符合条件的研究(N=4201;47%为女性;平均年龄为 47.1)。乐观(n=12 项研究)是研究最多的积极结构,HRQoL(在 n=11 项研究中进行了研究)是最常见的结果。所有进行定量分析的 17 项研究都发现积极心理结构与健康结果之间存在显著关联(P<0.05);大多数(但不是全部)都控制了 1 个或多个相关协变量。在接受 HSCT 的血液恶性肿瘤患者中,积极的心理结构似乎与改善的 HRQoL 和其他健康结果有关。有必要进一步研究,以更全面地了解积极心理结构对各种健康结果的独立影响,并开发适应这一人群需求的促进幸福感的干预措施。