Grant R03CA130725

Training Patients and Partners for HSCT: A Novel Coping Skills Intervention

unreadable] DESCRIPTION (provided by applicant): Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment of hematological malignancies and related disorders with more than 40,000 transplants conducted each year. HSCT patients endure immediate physical side effects of treatment including fatigue, nausea, and pain as well as late effects of treatment including pulmonary, liver, cardiac, and bone complications. In addition, it is estimated that between one-third and one-half of all HSCT patients experience clinically significant levels of psychosocial distress. Underlying the physical and psychosocial stressors of HSCT is much fear and uncertainty regarding the aversive physical side effects of transplant, as well as its long-term efficacy since the threat of relapse or the development of secondary malignancies lingers years after treatment. The uncertainty of transplant places demands on one's coping abilities. Unfortunately, a patient's inability to cope with the stressors of transplant can have deleterious effects on short and long-term psychosocial and physical functioning, as well as survival post-transplant. Partners (or spouses) of HSCT patients experience similar or even greater levels of psychosocial distress than patients; however, their psychosocial needs have, for the most part, been neglected by practitioners and researchers alike. Despite research indicating that patients and their partners experience significant psychosocial distress that peaks during the pre-transplant period and reports calling for psychosocial interventions early in the transplant process to mitigate the aversive side effects of treatment, there clearly remains a need for psychosocial interventions to: 1) be delivered early in the transplant process; 2) include both the patient and their partner; and 3) serve as a prophylactic to psychosocial distress later in the transplant process. This study proposes to address these needs by examining the benefit of a three-session, couple-focused, telephone-delivered Coping Skills Training (CST) intervention designed to teach patients and their partner's effective coping strategies to manage uncertainty and stressful situations that may arise during the transplant process together. Dyads (HSCT recipient and their partner or spouse) will be randomized to one of two treatment conditions: 1) couple-focused CST plus usual care (UC- defined as the care a patient would receive if not enrolled in the study) or 2) UC only. Using a combination of didactic and experiential (e.g. role play, relaxation exercises) approaches, this intervention aims to equip dyads with effective coping skills that they can employ individually or together to manage the stressors of transplant and mitigate the likelihood of psychosocial distress. We will explore functioning of both the patient and their partner across three time points: 1) baseline, after consent to participate in the study, 2) upon hospital admission for transplant; and 3) three- months post-transplant. This study moves the field into a direction to lessoning or even preventing the emotional toll patients and their families undergo during HSCT and other cancer treatments. . Hematopoietic stem cell transplantation (HSCT), although potentially curative, is considered one of the most aggressive cancer treatments marked by much uncertainty regarding the long-term efficacy of treatment and its long-term impact on both the patient and partner. Unfortunately up to one-third of HSCT survivors experience clinically significant levels of distress during and long after the transplant process that not only impacts quality of life, but has been shown to be related to less medication adherence, increases in physical side effects to treatments, and decreased survival. The proposed study aims to mitigate emotional distress in patients and their partners by providing a couple-focused telephone-delivered coping skills training intervention pre-transplant intended to reduce the burden of HSCT and enhance treatment outcomes. [unreadable] [unreadable] [unreadable]