Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona.
Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington.
Transplant Cell Ther. 2022 Jun;28(6):333.e1-333.e7. doi: 10.1016/j.jtct.2022.03.008. Epub 2022 Mar 12.
The medical and psychological sequelae of hematopoietic cell transplantation (HCT) are well established, but less is known about the impact on intimate relationships. We sought to describe the prevalence of relationship distress among married HCT survivors and to identify factors associated with relationship distress. The study was cross-sectional. HCT survivors treated at a National Cancer Institute-designated cancer center completed a survey that included measures of psychological and relationship distress (Revised Dyadic Adjustment Scale [RDAS]), demographic, and medical factors. A total of 1047 respondents reported being married and completed the RDAS. Sample characteristics were a mean age of 58 years (range, 22 to 83 years), a mean interval post-HCT of 12.3 years (range, <1 to 43 years), 42% female, and 89% non-Hispanic white. RDAS total adjustment scores were comparable to published community sample values. Nineteen percent of the respondents were classified as relationship-distressed. Three factors were associated with greater odds of relationship distress: cancer and treatment distress (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.09 to 2.31); depression (OR, 1.44; 95% CI, 1.17 to 1.76), and time post-transplantation (OR, 1.03; 95% CI, 1.01 to 1.04). These findings were qualified by sex-stratified analyses. Depression was associated with relationship distress among females; the other 2 variables were associated with relationship distress among males. Our results paint an overall picture of positive long-term marital functioning among HCT survivors, with a subset reporting relationship distress. Screening is warranted to identify survivors at risk for relationship distress and to inform targeted intervention.
造血细胞移植（HCT）的医学和心理后遗症是明确的，但对其对亲密关系的影响知之甚少。我们旨在描述已婚 HCT 幸存者中关系困扰的流行程度，并确定与关系困扰相关的因素。该研究为横断面研究。在国家癌症研究所指定的癌症中心接受治疗的 HCT 幸存者完成了一项调查，其中包括心理和关系困扰（修订后的对偶调整量表[RDAS]）、人口统计学和医疗因素的测量。共有 1047 名报告已婚并完成 RDAS 的受访者。样本特征为平均年龄 58 岁（范围，22 至 83 岁），HCT 后平均间隔 12.3 年（范围，<1 至 43 年），42%为女性，89%为非西班牙裔白人。RDAS 总调整评分与已发表的社区样本值相当。19%的受访者被归类为关系困扰。三个因素与更高的关系困扰几率相关：癌症和治疗困扰（优势比[OR]，1.59；95%置信区间[CI]，1.09 至 2.31）；抑郁（OR，1.44；95% CI，1.17 至 1.76），以及移植后时间（OR，1.03；95% CI，1.01 至 1.04）。这些发现通过性别分层分析进行了限定。抑郁与女性的关系困扰相关；其他两个变量与男性的关系困扰相关。我们的研究结果描绘了 HCT 幸存者长期积极的婚姻功能总体情况，其中一部分报告了关系困扰。需要进行筛查以识别有发生关系困扰风险的幸存者，并为有针对性的干预提供信息。
