Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.
Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Psychooncology. 2021 Jun;30(6):936-945. doi: 10.1002/pon.5680. Epub 2021 Mar 31.
Caregiving for hematopoietic stem cell transplant (HSCT) patients is associated with significant physical and psychological sequelae. While psychosocial interventions may reduce caregiver burden, knowledge regarding which caregivers may benefit the most from such interventions is limited. The purpose of this secondary analysis was to examine whether HSCT caregivers' peritransplant sleep moderated the effect of a psychosocial intervention on depression and anxiety posttransplant.
Participants included 135 caregivers (mean age = 54.23) who participated in randomized controlled trial and were assigned to receive either 8 weeks of Psychoeducation, Paced Respiration, and Relaxation (PEPRR) or treatment as usual (TAU). Sleep, depression, and anxiety were assessed using the Pittsburg Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the State-Trait Anxiety Inventory, respectively. Caregiver symptoms were assessed at baseline (e.g., peritransplant period) and 6-month posttransplant.
Baseline sleep quality (∆R = 0.04, p = 0.002), sleep efficiency (∆R = 0.03, p = 0.02), and sleep onset latency (∆R = 0.07, p < 0.001) independently moderated the effect of group assignment on depression outcomes at the 6-month follow-up. Specifically, caregivers with poor sleep at baseline who received PEPRR reported significantly lower depression scores at follow-up compared to caregivers with poor sleep who received TAU. By contrast, only sleep quality (∆R = 0.02, p = 0.01) and sleep onset latency (∆R = 0.02, p = 0.005) moderated the effect of the group assignment on anxiety.
Psychosocial interventions for HSCT caregivers may buffer against psychological morbidity, particularly among caregivers with poor sleep quality.
造血干细胞移植（HSCT）患者的护理工作会给护理人员带来显著的身心影响。虽然心理社会干预可能会减轻护理人员的负担，但对于哪些护理人员可能最受益于这些干预措施的了解有限。本二次分析的目的是研究 HSCT 护理人员移植期间的睡眠质量是否会调节心理社会干预对移植后抑郁和焦虑的影响。
本研究共纳入 135 名护理人员（平均年龄 54.23 岁），他们参加了一项随机对照试验，并被随机分配接受 8 周的心理教育、呼吸调节和放松（PEPRR）或常规治疗（TAU）。使用匹兹堡睡眠质量指数、流行病学研究中心抑郁量表和状态特质焦虑量表分别评估睡眠、抑郁和焦虑。护理人员的症状在基线（如移植期）和移植后 6 个月进行评估。
基线睡眠质量（∆R=0.04，p=0.002）、睡眠效率（∆R=0.03，p=0.02）和睡眠潜伏期（∆R=0.07，p<0.001）独立调节了组分配对 6 个月随访时抑郁结果的影响。具体而言，基线睡眠质量差的接受 PEPRR 的护理人员在随访时报告的抑郁评分明显低于接受 TAU 的护理人员。相比之下，只有睡眠质量（∆R=0.02，p=0.01）和睡眠潜伏期（∆R=0.02，p=0.005）调节了组分配对焦虑的影响。
HSCT 护理人员的心理社会干预可能会缓冲心理发病率，特别是对睡眠质量差的护理人员。
