Kimberly L Klages1, Marie L Chardon1, Sarah N Drake1, Kasiani C Myers2, Caroline F Morrison3, Ahna L H Pai1,2. 1. Behavioral Medicine and Clinical Psychology & Patient and Family Wellness Center for Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 2. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. 3. University of Cincinnati, College of Nursing Cincinnati, Cincinnati, Ohio, USA.
Abstract
OBJECTIVE: Pediatric hematopoietic stem cell transplant (HCT) is an intensive medical procedure associated with significant late effects, of which pain is a prominent example. While pain is associated with increased depressive symptoms and health-related quality-of-life (HRQoL) impairments in other pediatric chronic illness populations, associations between these variables are not well understood in pediatric HCT. Clarifying these associations may inform clinical interventions to improve health outcomes following pediatric HCT. This study aimed to investigate the relations between pain intensity, depressive symptoms, and HRQoL in survivors of pediatric HCT. METHOD: Fifty-one survivors of pediatric HCT (Mage = 14.3 years, standard deviation [SD] = 4.3; 58.8% male; 80.4% White) completed self-report measures of pain intensity, depressive symptoms, and HRQoL. Demographic and disease information was collected via demographic forms and medical record review. Path analysis was used to examine hypothesized associations between pain intensity, depressive symptoms, and HRQoL. RESULTS: Analyses revealed direct effects of pain intensity on depressive symptoms (estimate [Est.] = .23, p < .001) and HRQoL (Est. = -.2, p = .04), and direct effects of depressive symptoms on HRQoL (Est. = -.68, p < .001). Depressive symptoms also mediated the relationship between pain intensity and HRQoL (Est. = -.16, p = .006). CONCLUSIONS: Greater pain intensity was associated directly with increased depressive symptoms and indirectly with HRQoL through depressive symptoms. Results of this study suggest that multitargeted cognitive behavioral interventions that address pain and depressive symptoms may improve HRQoL ratings in survivors of pediatric HCT.
OBJECTIVE: Pediatric hematopoietic stem cell transplant (HCT) is an intensive medical procedure associated with significant late effects, of which pain is a prominent example. While pain is associated with increased depressive symptoms and health-related quality-of-life (HRQoL) impairments in other pediatric chronic illness populations, associations between these variables are not well understood in pediatric HCT. Clarifying these associations may inform clinical interventions to improve health outcomes following pediatric HCT. This study aimed to investigate the relations between pain intensity, depressive symptoms, and HRQoL in survivors of pediatric HCT. METHOD: Fifty-one survivors of pediatric HCT (Mage = 14.3 years, standard deviation [SD] = 4.3; 58.8% male; 80.4% White) completed self-report measures of pain intensity, depressive symptoms, and HRQoL. Demographic and disease information was collected via demographic forms and medical record review. Path analysis was used to examine hypothesized associations between pain intensity, depressive symptoms, and HRQoL. RESULTS: Analyses revealed direct effects of pain intensity on depressive symptoms (estimate [Est.] = .23, p < .001) and HRQoL (Est. = -.2, p = .04), and direct effects of depressive symptoms on HRQoL (Est. = -.68, p < .001). Depressive symptoms also mediated the relationship between pain intensity and HRQoL (Est. = -.16, p = .006). CONCLUSIONS: Greater pain intensity was associated directly with increased depressive symptoms and indirectly with HRQoL through depressive symptoms. Results of this study suggest that multitargeted cognitive behavioral interventions that address pain and depressive symptoms may improve HRQoL ratings in survivors of pediatric HCT.
Authors: Qian Lu; Kevin R Krull; Wendy Leisenring; Jason E Owen; Toana Kawashima; Jennie C I Tsao; Bradley Zebrack; Ann Mertens; Gregory T Armstrong; Marilyn Stovall; Leslie L Robison; Lonnie K Zeltzer Journal: Pain Date: 2011-09-09 Impact factor: 6.961
Authors: Cornelius B Groenewald; Emily F Law; Emma Fisher; Sarah E Beals-Erickson; Tonya M Palermo Journal: J Pain Date: 2018-08-09 Impact factor: 5.820
Authors: Gisela Michel; Cornelia E Rebholz; Nicolas X von der Weid; Eva Bergstraesser; Claudia E Kuehni Journal: J Clin Oncol Date: 2010-03-01 Impact factor: 44.544
Authors: Claire E Wakefield; Jordana McLoone; Belinda Goodenough; Kate Lenthen; David R Cairns; Richard J Cohn Journal: J Pediatr Psychol Date: 2009-07-03
Authors: Matthew J Bitsko; Debra Cohen; Robyn Dillon; Jeanne Harvey; Kevin Krull; James L Klosky Journal: Pediatr Blood Cancer Date: 2015-10-21 Impact factor: 3.167