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Effect of family cohesion on symptom distress during hematopoietic stem cell transplantation

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Abstract

Purpose

Family may play an important role in hematopoietic stem cell transplantation (HSCT) recovery; however, little is known about the effect of family functioning on an individual’s health. The purpose of this study was to examine the effect of family cohesion (family functioning) on the trajectory of HSCT recipients’ symptom distress (symptom frequency and symptom bother) before, during, and after HSCT.

Methods

Secondary analysis was conducted using data collected from178 individuals who underwent HSCT. Longitudinal parallel process (LPP) modeling was used to examine how family cohesion and HSCT-associated symptoms (symptom frequency and symptom bother) change over time, and how these longitudinal changes relate to each other.

Results

The trajectory of family cohesion predicted the trajectories of HSCT-associated symptom frequency and bother. HSCT recipients who experienced higher family cohesion at baseline (T1) showed lower symptom frequency (p < .01) as well as symptom bother (p < .01) at T1. This trajectory analysis also showed that HSCT recipients who had improved family cohesion over time reported decrease in symptom frequency (p < .01) as well as bother (p < .01) over time.

Conclusion

Findings indicate that higher family cohesion predicts decrease in symptom distress over the HSCT trajectory. Interventions aimed at enhancing family cohesion have the potential to lower HSCT recipients’ symptom distress. Further research is needed to understand the critical role of family cohesion and family functioning and their relationship with HSCT symptom distress prevention, early detection, and risk stratification.

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Data availability

Data will be provided to the publisher after they obtain a material transfer agreement from the Indiana University School of Nursing.

Code availability

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References

  1. Wildes TM, Stirewalt DL, Medeiros B, Hurria A (2014) Hematopoietic stem cell transplantation for hematologic malignancies in older adults: geriatric principles in the transplant clinic. J Natl Compr Canc Netw 12(1):128–136. https://doi.org/10.6004/jnccn.2014.0010

    Article  PubMed  PubMed Central  Google Scholar 

  2. Resnick IB, Shapira MY, Slavin S (2005) Nonmyeloablative stem cell transplantation and cell therapy for malignant and non-malignant diseases. Transpl Immunol 14(3–4):207–219. https://doi.org/10.1016/j.trim.2005.03.009

    Article  CAS  PubMed  Google Scholar 

  3. Gooley TAP, Chien JWMD, Pergam SAMDMPH, Hingorani SMDMPH, Sorror MLMD, Boeckh MMD, ..., McDonald GBMD (2010) Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med 363(22): 2091-2101. https://doi.org/10.1056/NEJMoa1004383

  4. Bevans MF, Mitchell SA, Marden S (2008) The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT). Support Care Cancer 16(11):1243–1254. https://doi.org/10.1007/s00520-008-0420-6

    Article  PubMed  PubMed Central  Google Scholar 

  5. Fife BL, Huster GA, Cornetta KG, Kennedy VN, Akard LP, Broun ER (2000) Longitudinal study of adaptation to the stress of bone marrow transplantation. J Clin Oncol 18(7):1539–1549. https://doi.org/10.1200/jco.2000.18.7.1539

    Article  CAS  PubMed  Google Scholar 

  6. Sannes TS, Simoneau TL, Mikulich-Gilbertson SK, Natvig CL, Brewer BW, Kilbourn K, Laudenslager ML (2019) Distress and quality of life in patient and caregiver dyads facing stem cell transplant: identifying overlap and unique contributions. Support Care Cancer 27(6):2329–2337. https://doi.org/10.1007/s00520-018-4496-3

    Article  PubMed  Google Scholar 

  7. Mosher CE, Redd WH, Rini CM, Burkhalter JE, DuHamel KN (2009) Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology 18(2):113–127. https://doi.org/10.1002/pon.1399

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tichelli A, Labopin M, Rovó A, Badoglio M, Arat M, van Lint MT, ..., Socié G (2013) Increase of suicide and accidental death after hematopoietic stem cell transplantation: a cohort study on behalf of the Late Effects Working Party of the European Group for Blood and Marrow Transplantation (EBMT). Cancer 119(11): 2012-2021. https://doi.org/10.1002/cncr.27987

  9. Fife BL, Von Ah DM, Spath ML, Weaver MT, Yang Z, Stump T, Farag S (2017) Preliminary efficacy of a brief family intervention to prevent declining quality of life secondary to parental bone marrow transplantation. Bone Marrow Transplant 52(2):285–291. https://doi.org/10.1038/bmt.2016.267

    Article  CAS  PubMed  Google Scholar 

  10. Fife BL, Monahan PO, Abonour R, Wood LL, Stump TE (2009) Adaptation of family caregivers during the acute phase of adult BMT. Bone Marrow Transplant 43(12):959–966. https://doi.org/10.1038/bmt.2008.405

    Article  CAS  PubMed  Google Scholar 

  11. Packman W, Weber S, Wallace J, Bugescu N (2010) Psychological effects of hematopoietic SCT on pediatric patients, siblings and parents: a review. Bone Marrow Transplant 45(7):1134–1146. https://doi.org/10.1038/bmt.2010.74

    Article  CAS  PubMed  Google Scholar 

  12. Lewandowski AS, Palermo TM, Stinson J, Handley S, Chambers CT (2010) Systematic review of family functioning in families of children and adolescents with chronic pain. J Pain 11(11):1027–1038. https://doi.org/10.1016/j.jpain.2010.04.005

    Article  PubMed  PubMed Central  Google Scholar 

  13. Epstein NB, Baldwin LM, Bishop DS (1983) The McMaster family assessment device. J Marital Fam Ther 9(2):171–180. https://doi.org/10.1111/j.1752-0606.1983.tb01497.x

    Article  Google Scholar 

  14. Alderfer MA, Fiese BH, Gold JI, Cutuli JJ, Holmbeck GN, Goldbeck L, ..., Patterson J (2008) Evidence-based assessment in pediatric psychology: family measures. J Pediatr Psychol 33(9):1046–1061; discussion 1062–1044. https://doi.org/10.1093/jpepsy/jsm083

  15. Bronfenbrenner U (1977) Toward an experimental ecology of human development. Am Psychol 32(7):513–531. https://doi.org/10.1037/0003-066X.32.7.513

    Article  Google Scholar 

  16. Dunbar SB, Clark PC, Quinn C, Gary RA, Kaslow NJ (2008) Family influences on heart failure self-care and outcomes. J Cardiovasc Nurs 23(3):258–265. https://doi.org/10.1097/01.JCN.0000305093.20012.b8

    Article  PubMed  PubMed Central  Google Scholar 

  17. Holmes CS, Yu Z, Frentz J (1999) Chronic and discrete stress as predictors of children’s adjustment. J Consult Clin Psychol 67(3):411–419. https://doi.org/10.1037//0022-006x.67.3.411

    Article  CAS  PubMed  Google Scholar 

  18. Jobe-Shields L, Alderfer MA, Barrera M, Vannatta K, Currier JM, Phipps S (2009) Parental depression and family environment predict distress in children before stem cell transplantation. J Dev Behav Pediatr 30(2):140–146. https://doi.org/10.1097/DBP.0b013e3181976a59

    Article  PubMed  PubMed Central  Google Scholar 

  19. Phipps S, Mulhern RK (1995) Family cohesion and expressiveness promote resilience to the stress of pediatric bone marrow transplant: a preliminary report. J Dev Behav Pediatr 16(4):257–263. Retrieved from http://europepmc.org/abstract/MED/7593661. Accessed 20 April 2021

  20. Rivera FI, Guarnaccia PJ, Mulvaney-Day N, Lin JY, Torres M, Alegria M (2008) Family cohesion and its relationship to psychological distress among Latino groups. Hisp J Behav Sci 30(3):357–378. https://doi.org/10.1177/0739986308318713

    Article  PubMed  PubMed Central  Google Scholar 

  21. Spath ML, Fife BL, Monahan PO, Decker CL, Austin JK, Abonour R, Wood LL (2013) Children’s emotional adaptation to parental BMT. Bone Marrow Transplant 48(1):135–140. https://doi.org/10.1038/bmt.2012.93

    Article  CAS  PubMed  Google Scholar 

  22. Sousa KH, Kwok O-M, Schmiege SJ, West SG (2013) A longitudinal approach to understanding the relationship between symptom status and QOL. West J Nurs Res 36(6):732–747. https://doi.org/10.1177/0193945913510980

    Article  PubMed  Google Scholar 

  23. Cheong J, Mackinnon DP, Khoo ST (2003) Investigation of mediational processes using parallel process latent growth curve modeling. Struct Equ Modeling 10(2):238. https://doi.org/10.1207/s15328007sem1002_5

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hefner J, Kapp M, Drebinger K, Dannenmann A, Einsele H, Grigoleit GU, ..., Mielke S (2014) High prevalence of distress in patients after allogeneic hematopoietic SCT: fear of progression is associated with a younger age. Bone Marrow Transplant 49(4): 581-584. https://doi.org/10.1038/bmt.2013.228

  25. Popplewell LL, Forman SJ (2002) Is there an upper age limit for bone marrow transplantation? Bone Marrow Transplant 29(4):277–284. https://doi.org/10.1038/sj.bmt.1703382

    Article  CAS  PubMed  Google Scholar 

  26. Hu L, t., & Bentler, P. M, (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 6(1):1–55. https://doi.org/10.1080/10705519909540118

    Article  Google Scholar 

  27. Little RJA, Rubin DB (2002) Statistical analysis with missing data (2nd Ed.). Hooken, NJ

  28. Anyan F, Hjemdal O (2018) Stress of home life and gender role socializations, family cohesion, and symptoms of anxiety and depression. Women Health 58(5):548–564. https://doi.org/10.1080/03630242.2017.1316343

    Article  PubMed  Google Scholar 

  29. Lim J-W, Shon E-J (2018) The dyadic effects of family cohesion and communication on health-related quality of life: the moderating role of sex. Cancer Nurs 41(2):156–165. https://doi.org/10.1097/NCC.0000000000000468

    Article  PubMed  PubMed Central  Google Scholar 

  30. Keitner GI, Ryan CE, Miller IW, Kohn R, Bishop DS, Epstein NB (1995) Role of the family in recovery and major depression. Am J Psychiatry 152(7):1002–1008. https://doi.org/10.1176/ajp.152.7.1002

    Article  CAS  PubMed  Google Scholar 

  31. Goodyer IM, Herbert J, Tamplin A, Secher SM, Pearson J (1997) Short-term outcome of major depression: II. Life events, family dysfunction, and friendship difficulties as predictors of persistent disorder. J Am Acad Child Adolesc Psychiatry 36(4):474–480. https://doi.org/10.1097/00004583-199704000-00009

    Article  CAS  PubMed  Google Scholar 

  32. Jafari H, Jannati Y, Nesheli HM Hassanpour S (2017) Effects of nonpharmacologial interventions on reducing fatigue after hematopoietic stem cell transplantation. J Res Med Sci 20(13). https://doi.org/10.4103/1735-1995

  33. Rediy S, Tefera, B (2020) A family-based behavioral intervention to enhance family communication and family cohesion among siblings in polygamous family

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Acknowledgements

The authors thank the participating families for sharing their experiences with us. We would also like to thank Dr. Betsy Fife (PI) on the American Cancer Society grant that made this work possible.

Funding

A grant from the American Cancer Society (RSGPB-05–012-01-CPPB) supported this research. The content in this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center-James, 406 W 10th Ave., Columbus, OH, 43210, USA

    Yesol Yang

  2. Duke University School of Nursing, 307 Trent Drive, Durham, NC, 27710, USA

    Wei Pan

  3. Indiana University Simon Cancer Center, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN, 46202, USA

    Sherif S. Farag

  4. The Ohio State University College of Nursing, 1585 Neil Ave, Columbus, OH, 43210, USA

    Diane Von Ah

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  1. Yesol Yang
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  2. Wei Pan
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  4. Diane Von Ah
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All authors were involved in writing.

Corresponding author

Correspondence to Diane Von Ah.

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Ethics approval

This study was approved by the Committee on Human Research at the Indiana University School of Nursing.

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All of the patients signed a written informed consent prior to study participation.

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All of the authors read the final version of the paper and approved its submission for publication.

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The authors declare no competing interests.

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Yang, Y., Pan, W., Farag, S.S. et al. Effect of family cohesion on symptom distress during hematopoietic stem cell transplantation. Support Care Cancer 30, 1731–1737 (2022). https://doi.org/10.1007/s00520-021-06593-z

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  • DOI: https://doi.org/10.1007/s00520-021-06593-z

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