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移植候选人的心理社会评估量表(PACT)与异基因造血干细胞移植后的生存。

Psychosocial Assessment of Candidates for Transplantation scale (PACT) and survival after allogeneic hematopoietic stem cell transplantation.

机构信息

Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, Japan.

Department of Haematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, Japan.

出版信息

Bone Marrow Transplant. 2019 Jul;54(7):1013-1021. doi: 10.1038/s41409-018-0371-6. Epub 2018 Oct 23.

Abstract

Recent findings suggest that patient pre-transplant psychosocial risk factors predict survival after hematopoietic stem cell transplant (HSCT) and importance of comprehensive psychosocial assessment during pre-transplant period is increasingly acknowledged. Psychosocial screening process, however, has not been standardized across transplant centers and its predictive value has not yet been confirmed. An observational cohort study was conducted to explore the relationships between psychosocial variables, assessed with the Psychosocial Assessment of Candidates for Transplantation (PACT) scale, and post-transplant overall survival (OS) of patients with hematologic malignancies who received allogeneic HSCT as treatment. Overall, 119 patient medical records were reviewed to determine the PACT score. After controlling for clinical and demographic covariates, lower PACT scores in the domain of compliance with medications and medical advice were significantly associated with poorer OS (HR = 1.75, P = 0.03). Lower PACT ratings in the subscales of personality and psychopathology (HR = 1.35, P = 0.08), lifestyle factors (HR = 1.43, P = 0.08), and relevant disease knowledge and receptiveness to education (HR = 1.32, P = 0.08) tended to be associated with shorter OS. These findings suggested the association between pre-transplant psychosocial factors using PACT and post-transplant OS in patients receiving allogeneic HSCT.

摘要

最近的研究结果表明,患者移植前的心理社会风险因素可以预测造血干细胞移植(HSCT)后的生存率,因此在移植前期间进行全面的心理社会评估越来越受到重视。然而,移植中心之间并未标准化心理社会筛查过程,其预测价值也尚未得到证实。本观察性队列研究旨在探讨心理社会变量与移植候选者心理评估(PACT)量表评估之间的关系,这些变量与接受异基因 HSCT 治疗的血液恶性肿瘤患者的移植后总体生存率(OS)有关。总体而言,共回顾了 119 名患者的病历以确定 PACT 评分。在控制了临床和人口统计学协变量后,药物和医疗建议依从性领域的较低 PACT 评分与较差的 OS 显著相关(HR=1.75,P=0.03)。在个性和精神病理学(HR=1.35,P=0.08)、生活方式因素(HR=1.43,P=0.08)、相关疾病知识和对教育的接受程度(HR=1.32,P=0.08)等子量表中,较低的 PACT 评分也与较短的 OS 相关。这些发现表明,使用 PACT 评估移植前心理社会因素与接受异基因 HSCT 的患者移植后 OS 之间存在关联。

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