Brigham and Women's Hospital, Boston, Massachusetts.
Dana-Farber Cancer Institute, Boston, Massachusetts.
Cancer. 2021 Apr 15;127(8):1260-1265. doi: 10.1002/cncr.33455. Epub 2021 Feb 17.
Social support is crucial for successful recovery after hematopoietic stem cell transplantation (HSCT) and has the potential to affect patient quality of life (QOL) and health outcomes. However, there are limited data on the relationship between a patient's perception of his or her social support and these outcomes.
The authors conducted a secondary analysis of 250 autologous and allogeneic HSCT recipients enrolled in 2 supportive care trials at Massachusetts General Hospital from April 2011 through February 2016. They assessed social support as a patient's perception of his or her social well-being via the social well-being subscale of the Functional Assessment of Cancer Therapy. The authors used multivariate regression analyses to examine the relationship between pretransplant social well-being and QOL (Functional Assessment of Cancer Therapy-Treatment Outcome Index), psychological distress (Hospital Anxiety and Depression Scale), posttraumatic stress disorder [PTSD] symptoms (PTSD Checklist), fatigue (Functional Assessment of Cancer Therapy-Fatigue), and health care utilization (hospitalizations and days alive and out of the hospital) 6 months after HSCT.
Participants were on average 56.4 years old (SD, 13.3 years); 44% (n = 110) and 56% (n = 140) received autologous and allogeneic HSCT, respectively. Greater pre-HSCT social well-being was associated with higher QOL (B = 0.10; 95% CI, 0.06-0.13; P < .001), lower psychological distress (B = -0.21; 95% CI, -0.29 to -0.12; P < .001), and lower PTSD symptoms (B = -0.12; 95% CI, -0.19 to -0.06; P < .001). Pre-HSCT social well-being was not significantly associated with fatigue or health care utilization 6 months after HSCT.
Patients with higher pre-HSCT perceptions of their social support reported better QOL and lower psychological distress 6 months after HSCT. These findings underscore the potential for social support as a modifiable target for future supportive care interventions to improve the QOL and care of HSCT recipients.
社会支持对于造血干细胞移植（HSCT）后的成功康复至关重要，并且有可能影响患者的生活质量（QOL）和健康结果。然而，关于患者对其社会支持的看法与这些结果之间的关系的数据有限。
作者对 2011 年 4 月至 2016 年 2 月期间在马萨诸塞州综合医院参加 2 项支持性护理试验的 250 名自体和同种异体 HSCT 受者进行了二次分析。他们通过癌症治疗功能评估的社会福祉子量表评估社会支持，作为患者对其社会福祉的感知。作者使用多元回归分析来检验移植前社会福祉与 QOL（癌症治疗功能评估-治疗结局指数）、心理困扰（医院焦虑和抑郁量表）、创伤后应激障碍（PTSD）症状（PTSD 检查表）、疲劳（癌症治疗功能评估-疲劳）以及 HSCT 后 6 个月的医疗保健利用率（住院和出院天数）之间的关系。
参与者的平均年龄为 56.4 岁（标准差，13.3 岁）；分别有 44%（n=110）和 56%（n=140）接受了自体和同种异体 HSCT。较高的 HSCT 前社会福祉与较高的 QOL 相关（B=0.10；95%置信区间，0.06-0.13；P<.001）、较低的心理困扰（B=-0.21；95%置信区间，-0.29 至-0.12；P<.001）和较低的 PTSD 症状（B=-0.12；95%置信区间，-0.19 至-0.06；P<.001）。HSCT 后 6 个月，HSCT 前的社会福祉与疲劳或医疗保健利用率无显著相关性。
HSCT 前对社会支持的看法较高的患者报告说，HSCT 后 6 个月的 QOL 更高，心理困扰更低。这些发现强调了社会支持作为未来支持性护理干预的一个可改变目标的潜力，以改善 HSCT 受者的 QOL 和护理。
