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A mixed methods analysis of perceived cognitive impairment in hematopoietic stem cell transplant survivors

Published online by Cambridge University Press:  21 September 2018

Lisa M. Wu*
Affiliation:
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Nadia Kuprian
Affiliation:
Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, New York, United States
Krista Herbert
Affiliation:
Department of Psychology, Rowan University, Glassboro, New Jersey, United States
Ali Amidi
Affiliation:
Unit for Psychooncology and Health Psychology, Department of Psychology, Aarhus University, Aarhus, Denmark Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
Jane Austin
Affiliation:
Department of Psychology, William Paterson University, Wayne, New Jersey, United States
Heiddis Valdimarsdottir
Affiliation:
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, United States Department of Psychology, Reykjavik University, Reykjavik, Iceland
Christine Rini
Affiliation:
John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, United States
*
Author for correspondence: Lisa M. Wu, Ph.D., Northwestern University Feinberg School of Medicine, 633 North St. Clair, 19th Floor, Chicago, IL 60611. E-mail: lisa.wu1@northwestern.edu

Abstract

Objective

Hematopoietic stem cell transplant (HSCT) survivors may show evidence of objective cognitive impairment; however, perceived cognitive problems and their impact on quality of life are less well-understood. The purpose of this study was to explore HSCT survivors’ perceptions of cognitive impairment and its effect on daily life functioning.

Method

Sixty-nine autologous and allogeneic HSCT survivors nine months to three years posttransplant experiencing mild survivorship problems completed a brief structured interview regarding perceived cognitive impairment since transplant. Data were coded and content analyzed. The frequency of participants reporting cognitive problems by domain and associations between reports of cognitive problems and age, depressed mood, anxiety, and health-related quality of life were examined.

Result

Overall, 49 of the 69 participants (71%) reported cognitive impairments after transplant: 38 in memory (55%), 29 in attention and concentration (42%), and smaller numbers in other domains. There were no significant differences in problems reported by transplant type. Of the 50 participants who worked before transplant, 19 (38%) did not return to work following transplant, with 12 citing cognitive and health problems as being the reason. There were significant associations between reports of cognitive impairment and younger age (p = 0.02), depressed mood (p = 0.02), anxiety (p = 0.002), and health-related quality of life (p = 0.008).

Significance of results

A large proportion of survivors reported cognitive impairment following HSCT that impaired daily life functioning. Perceived cognitive impairment was associated with younger age, greater distress and reduced health-related quality of life.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2018 

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