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Published in: Supportive Care in Cancer 4/2019

01-04-2019 | Original Article

Fatigue predicts impaired social adjustment in survivors of allogeneic hematopoietic cell transplantation (HCT)

Authors: Jumin Park, Leslie Wehrlen, Sandra A. Mitchell, Li Yang, Margaret F. Bevans

Published in: Supportive Care in Cancer | Issue 4/2019

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Abstract

Purpose

The aim of this study is to examine social adjustment to illness and to identify factors related to social adjustment in allogeneic hematopoietic cell transplantation (HCT) survivors.

Methods

Cross-sectional data were drawn from a longitudinal study of patients ≥ 3 years after their first HCT. The five subscales of the Psychosocial Adjustment to Illness Scale (PAIS) that reflect social adjustment, specifically vocational environment (VE); domestic environment (DE); sexual relationships (SEX); extended family relationships (ER); and social environment (SE) were examined in this analysis. Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) measured cancer-related fatigue.

Results

Subjects (N = 171) were a median of 5.19 years from HCT (range 3–16). The most impaired dimension of social adjustment was ER with 38% of participants reaching clinically relevant (score ≥ 62) levels of social maladjustment. Unmarried and unemployed participants had lower levels of social adjustment in VE (p < .001 and p < .001, respectively) and DE (p = .004 and p = .006, respectively). Survivors with some college had poorer SEX adjustment than those with less or more education (p < .005). Hispanics reported lower adjustment with respect to ER adjustment (p = .002). Participants with higher fatigue had poorer adjustment in all five dimensions (p < .001).

Conclusions

Although the majority of survivors are well adjusted, subgroups may experience significant poor social adjustment. Specifically, survivors with fatigue are at risk to experience lower levels of social adjustment. Development of effective rehabilitation strategies to improve affected areas of social health is warranted, and all HCT survivors should be screened periodically for social maladjustment and provided with resources and referrals.
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Metadata
Title
Fatigue predicts impaired social adjustment in survivors of allogeneic hematopoietic cell transplantation (HCT)
Authors
Jumin Park
Leslie Wehrlen
Sandra A. Mitchell
Li Yang
Margaret F. Bevans
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4411-y

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