Stem Cell Transplantation Patients and Situational Meaning: A Prospective and Longitudinal View

ABSTRACT Background Though there is thorough examination of psychosocial issues in SCT, there are few longitudinal studies examining the meaning SCT patients attribute to their treatment. Objective The object of this study was to examine change in situational appraisal over time, and to explore potential modifiers of that change. Methods A prospective, longitudinal study of 146 autologous and allogeneic stem cell transplant (SCT) patients at Virginia Commonwealth University (VCU) was conducted to measure situational appraisal over time as per the meaning making model of Park and Folkman (1997) utilizing the Illness Perception Questionnaire-Revised (IPQ-R; Moss-Morris et al., 2002). Participants were administered the instrument prior to transplant, at one, three and six months, and at one-year post-transplant. Results Change over time was seen in different diagnoses, donor types, reduced intensity and standard pre-transplant preparative regimens, and between the two major ethnic groups (Caucasian and African American) studied. Many of the patient subgroups had statistically significant findings in measures of illness attribution. Conclusion The appraisals SCT patients made of their situation in treatment revealed a complex process of appraisal affected by illness, treatment and patient characteristics including disease type, donor type, race, and pre-transplant regimen.