Psychological intervention to alleviate distress in haematopoietic stem cell transplantation: a phase II study

Baliousis, Michail (2016) Psychological intervention to alleviate distress in haematopoietic stem cell transplantation: a phase II study. DClinPsy thesis, University of Nottingham.

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Abstract

Background. Haematopoietic stem cell transplantation (HSCT) is an intensive procedure associated with psychological distress particularly during the first weeks (acute phase). Based on the self-regulatory model of adjustment to illness, a preparatory group intervention was developed aiming at alleviating distress by reducing negative perceptions of HSCT and fostering helpful coping.

Aims. The present study aimed to evaluate the feasibility of delivering the intervention and of conducting a trial to assess its efficacy. It also aimed to explore the applicability of the self-regulatory model in HSCT.

Methods. Participants were adults from consecutive referrals at two transplant centres. Half were randomised to the intervention and half to treatment as usual at each site. Psychological distress, HSCT perceptions, and coping were assessed at baseline (following consent), on transplant day, two weeks, and four weeks after transplantation.

Results. Of 99 eligible patients, 45 consented. Main barriers included inability to consent prior to transplantation, competing priorities, being unwell, and long travel distance. Of 21 participants randomised to intervention, five attended. Main barriers included being unable to attend prior to transplantation and having competing priorities. Groups could not be held sufficiently frequently to enable attendance prior to transplantation, as randomising participants to the control group prevented sufficient accrual at each site. Anxiety peaked two weeks following transplantation but depression increased throughout the acute phase. Intervention effects were small but sample sizes for a full trial appeared feasible. Negative perceptions of HSCT and use of a range of coping styles (including styles considered helpful) predicted higher distress throughout the period.

Conclusions. The findings revealed considerable barriers to delivering a group-based intervention and conducting a trial to assess its effectiveness. This highlighted a need for better integration with routine care and alternative trial procedures. However, the findings illustrated complex psychological needs during the acute phase of HSCT and the role of negative HSCT perceptions and unhelpful coping in underpinning distress.

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: Rennoldson, M.
Das Nair, R.
Dawson, D.
Keywords: Haematopoietic stem cell transplantation, Psychological distress, Helpful coping
Subjects: W Medicine and related subjects (NLM Classification) > WH Hemic and lymphatic system
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 32779
Depositing User: Baliousis, Michael
Date Deposited: 16 Dec 2016 06:40
Last Modified: 12 Oct 2017 20:18
URI: http://eprints.nottingham.ac.uk/id/eprint/32779

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