Influence of Coping Style on Symptom Interference Among Adult Recipients of Hematopoietic Stem Cell Transplantation

Joleen C. Schoulte

Jessica A. Lohnberg

Benjamin A. Tallman

Elizabeth M. Altmaier

hematopoietic stem cell transplantation, coping, symptoms
ONF 2011, 38(5), 582-586. DOI: 10.1188/11.ONF.582-586

Purpose/Objectives: To investigate the influence of coping style on interference caused by a variety of common post-treatment symptoms after hematopoietic stem cell transplantation.

Design: Longitudinal; secondary analysis of data from the original study that examined health-related quality-of-life variables (e.g., depression, well-being) in adult patients treated with conventional bone marrow transplantation or depleted T-cell bone marrow transplantation.

Setting: Fifteen university medical centers in the United States.

Sample: 105 adult recipients of hematopoietic stem cell transplantation.

Methods: Patients were assessed via telephone-based interviews for coping style at baseline and for symptom interference in daily living six months post-treatment.

Main Research Variables: Coping style and symptom interference.

Findings: Neither age nor gender predicted symptom interference, with the exception of chronic graft-versus-host disease, where older patients experienced more interference at six months, and breathing symptoms, for which women experienced more interference than men at six months. Avoidant coping style at baseline predicted increased interference from symptoms, but emotion-focused and instrumental coping styles did not predict decreased interference.

Conclusions: A generalized avoidant coping style before treatment increased interference from common cancer symptoms six months after hematopoietic stem cell transplantation.

Implications for Nursing: An intervention to teach alternate coping strategies should be implemented prior to treatment and tested for prevention of symptom-related life interference.

Jump to a section


    Aarstad, A. K., Aarstad, H. J., Bru, E., & Olofsson, J. (2005). Psychological coping style versus disease extent, tumour treatment and quality of life in successfully treated head and neck squamous cell carcinoma patients. Clinical Otolaryngology, 30, 530-538.
    Altmaier, E. M., Ewell, M., McQuellon, R., Geller, N., Carter, S. L., Henslee-Downey, J., … Gingrich, R. (2006). The effect of unrelated donor marrow transplantation on health-related quality of life: A report of the unrelated donor marrow transplantation trial (T-cell depletion trial). Biology of Blood and Marrow Transplantation, 12, 648-655.
    Bevans, M., Castro, K., Prince, P., Shelburne, N., Prachenko, O., Loscalzo, M., … Zabora, J. (2010). An individualized dyadic problem-solving education intervention for patients and family caregivers during allogeneic hematopoietic stem cell transplantation: A feasibility study. Cancer Nursing, 33, E24-E32.
    Billings, A. G., & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4, 139-157.
    Broers, S., Kaptein, A. A., Le Cessie, S., Fibbe, W., & Hengeveld, M. W. (2000). Psychological functioning and quality of life following bone marrow transplantation: A 3-year follow-up study. Journal of Psychosomatic Research, 48, 11-21.
    Bush, N. E., Donaldson, G. W., Haberman, M. H., Dacanay, R., & Sullivan, K. M. (2000). Conditional and unconditional estimation of multidimensional quality of life after hematopoietic stem cell transplantation: A longitudinal follow-up of 415 patients. Biology of Blood and Marrow Transplantation, 6, 576-591.
    Carver, C. S. (1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100.
    Costanzo, E. S., Lutgendorf, S. K., Rothrock, N. E., & Anderson, B. (2006). Coping and quality of life among women extensively treated for gynecologic cancer. Psycho-Oncology, 15, 132-142.
    Devine, D., Parker, P. A., Fouladi, R. T., & Cohen, L. (2003). The association between social support, intrusive thoughts, avoidance, and adjustment following an experimental cancer treatment. Psycho-Oncology, 12, 453-462.
    Edman, L., Larsen, J., Hägglund, H., & Gardulf, A. (2001). Health-related quality of life, symptom distress and sense of coherence in adult survivors of allogeneic stem-cell transplantation. European Journal of Cancer Care, 10, 124-130.
    Fife, B. L., Huster, G. A., Cornetta, K. G., Kennedy, V. N., Akard, L. P., & Broun, E. R. (2000). Longitudinal study of adaptation to the stress of bone marrow transplantation. Journal of Clinical Oncology, 18, 1539-1549.
    Folkman, S., & Moskowitz, J. T. (2004). Coping: Pitfalls and promise. Annual Review of Psychology, 55, 745-774.
    Gaston-Johansson, F., & Foxall, M. (1996). Psychological correlates of quality of life across the autologous bone marrow transplant experience. Cancer Nursing, 19, 170-176.
    Hwang, S. S., Chang, V. T., & Kasimis, B. (2002). Dynamic cancer pain management outcomes: The relationship between pain severity, pain relief, functional interference, satisfaction and global quality of life over time. Journal of Pain and Symptom Management, 23, 190-200.
    Jim, H. S., Andrykowski, M. A., Munster, P. N., & Jacobsen, P. B. (2007). Physical symptoms/side effects during breast cancer treatment predict posttreatment distress. Annals of Behavioral Medicine, 34, 200-208.
    Molassiotis, A., Van Den Akker, O. B., Milligan, D. W., & Goldman, J. M. (1997). Symptom distress, coping style and biological variables as predictors of survival after bone marrow transplantation. Journal of Psychosomatic Research, 42, 275-285.
    Shapiro, J. P., McCue, K., Heyman, E. N., Dey, T., & Haller, H. S. (2010). Coping-related variables associated with individual differences in adjustment to cancer. Journal of Psychosocial Oncology, 28, 1-22.
    Stanton, A. L., Collins, C. A., & Sworowski, L. A. (2001). Adjustment to chronic illness: Theory and research. In A. Baum, T. A. Revenson, & J. E. Singer (Eds.), Handbook of health psychology(pp. 387-403). Mahwah, NJ: Erlbaum.
    Wagner, J. E., Thompson, J. S., Carter, S. L., & Kernan, N. A. (2005). Effect of graft-versus-host disease prophylaxis on 3-year disease-free survival in recipients of unrelated donor bone marrow (T-Cell Depletion Trial): A multi-centre, randomised phase II-III trial. Lancet, 366, 733-741.
    Wang, S. Y., Tsai, C. M., Chen, B. C., Lin, C. H., & Lin, C. C. (2008). Symptom clusters and relationships to symptom interference with daily life in Taiwanese lung cancer patients. Journal of Pain and Symptom Management, 35, 258-266.
    Ware, J. E. (1994). SF-36® physical and mental health summary scales: A user's manual. Boston, MA: The Health Institute.
    Wells, K. J., Booth-Jones, M., & Jacobsen, P. B. (2009). Do coping and social support predict depression and anxiety in patients undergoing hematopoietic stem cell transplantation? Journal of Psychosocial Oncology, 27, 297-315.