Andrykowski M A, Brady M J, Greiner C B, Altmaier E M, Burish T G, Antin J H, Gingrich R, McGarigle C, Henslee-Downey P J
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington 40536-0086, USA.
Bone Marrow Transplant. 1995 Apr;15(4):573-81.
The psychosocial impact of bone marrow transplantation (BMT) was investigated in 172 disease-free adult BMT survivors drawn from five different BMT treatment centers. Respondents were a mean of 43.5 months after BMT. Both questionnaire and interview assessments were utilized. Survivors' perceptions of whether they had 'returned to normal' following BMT, recollections of pre-BMT expectations for returning to normal and current psychological distress were assessed. The results indicated that only a minority of respondents considered themselves to have 'returned to normal' following BMT. Reports of less than normal physical, cognitive, occupational, sexual and/or interpersonal functioning were common. In contrast, few patients reported pre-BMT expectations for such. Discordance between pre-BMT expectations for returning to normal and current functional status was associated with greater current psychological distress. Finally, despite the presence of any functional deficits and despite any discordance between pre-BMT expectations and current functional status, survivors' evaluations of their decision to pursue BMT were generally quite positive. Results are discussed in terms of their implications for: (1) the process of obtaining informed consent for BMT, and (2) clinical strategies for enhancing post-BMT psychological adjustment.
对来自五个不同骨髓移植治疗中心的172名无病成年骨髓移植幸存者的心理社会影响进行了调查。受访者在骨髓移植后平均43.5个月。采用了问卷调查和访谈评估。评估了幸存者对骨髓移植后是否“恢复正常”的看法、骨髓移植前对恢复正常的期望回忆以及当前的心理困扰。结果表明，只有少数受访者认为自己在骨髓移植后“恢复正常”。身体、认知、职业、性和/或人际功能低于正常水平的报告很常见。相比之下，很少有患者报告骨髓移植前有这样的期望。骨髓移植前恢复正常的期望与当前功能状态之间的不一致与当前更大的心理困扰相关。最后，尽管存在任何功能缺陷，尽管骨髓移植前的期望与当前功能状态之间存在任何不一致，但幸存者对接受骨髓移植决定的评价总体上相当积极。从以下方面讨论了结果的意义：(1) 获得骨髓移植知情同意的过程，以及 (2) 增强骨髓移植后心理调适的临床策略。
