Psychological adjustment of patients with chronic leukemia

Abstract

Psychosocial sequelae of chronic myelocytic leukemia survivors treated with standard care, chemotherapy or no chemotherapy (SC) (N = 19), or chemotherapy followed by a bone marrow transplant (BMT) (N = 21) were investigated in patients who were at least one year post diagnosis. The Brief Symptom Inventory, Death Anxiety Questionnaire, Impact of Events Scale, Psychological Adjustment to Illness Scale, Derogatis Sexual Functioning Inventory, Karnofsky Performance Index, and two face valid medical questionnaires were utilized. The questionnaires were completed during the survivors' clinic visit or at a time convenient for them.;The hypotheses were: that patients treated with a BMT would report lower psychological adjustment than patients treated with SC; as time since diagnosis increased, psychological distress would decrease in the BMT group and increase in the SC group; in both treatment groups, as age at testing increased, psychosexual distress would decrease; and as age at testing increased, psychological adjustment would increase. Results indicated that: (1) between the two treatment groups, there were not statistically significant differences for psychological adjustment and psychological distress; (2) for the SC group, correlations between time since diagnosis and psychological distress were not statistically significant; for the BMT group, only death anxiety was statistically significant; and (3) none of the correlations between age and psychological outcome were statistically significant. Although gender differences on outcome measures were not included in the hypotheses, there was a significant main effect for gender on psychological distress (p {dollar}<{dollar}.001). Women reported more distress than men on all of the measures of psychological distress. On psychological adjustment, women (BMT) reported poorer adjustment than men (BMT).;To summarize, MANOVA indicated that between the two treatment groups, there were no statistically significant differences on psychological distress or adjustment. Therefore, it may be appropriate for researchers to combine cancer treatment groups. However, there were statistically significant differences between the two gender groups on two measures of psychological distress, Impact of Events Scale and Psychological Distress. Future research, such as the investigation of potential predictors of psychological distress, psychological adjustment, and psychosexual functioning, should be investigated. Furthermore, since responses to the impact of cancer are not universal, future within group analyses need to be done to identify at risk individuals. Identification of at risk individuals will lead to appropriate planning of cost efficient interventions.