Self-efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well-being after hematopoietic stem cell transplant

Lisa M. Wu*, Jane Austin, Jada G. Hamilton, Heiddis Valdimarsdottir, Luis Isola, Scott Rowley, Rachel Warbet, Gary Winkel, William H. Redd, Christine Rini

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)

Abstract

Objective Cognitive problems are commonly reported by hematopoietic stem cell transplant (HSCT) survivors and are associated with poorer physical and mental well-being. It was hypothesized that adverse effects of subjective cognitive impairment occur because cognitive difficulties reduce survivors' confidence that they can manage HSCT-related symptoms-that is, self-efficacy for symptom management. Methods Hematopoietic stem cell transplant survivors (n = 245), 9 months to 3 years post-HSCT, completed measures of subjective cognitive functioning, self-efficacy for symptom management, and clinically important outcomes: depressed mood, anxiety, and quality of life. Mediation analyses using bootstrapping were conducted to investigate whether effects of subjective cognitive impairment on these outcomes were mediated by self-efficacy for cognitive, emotional (SE-Emotional), social (SE-Social), and physical (SE-Physical) symptom management. Results Self-efficacy mediated relations between subjective cognitive impairment and depressed mood (total indirect effect = -0.0064 and 95% CI -0.0097 to -0.0036), anxiety (total indirect effect = -0.0045, CI -0.0072 to -0.0021), and quality of life (total indirect effect = 0.0952, CI 0.0901 to 0.2642). SE-Emotional was a unique mediator when the outcome was depressed mood and anxiety. SE-Social, SE-Physical, and SE-Emotional were specific mediators when outcome was quality of life. Conclusions Findings support the conclusion that subjective cognitive impairment reduces HSCT survivors' confidence in their ability to manage common post-HSCT symptoms, with implications for physical and mental well-being. Interventions that help enhance survivors' self-efficacy, particularly self-efficacy for the management of emotional symptoms, are likely to benefit HSCT survivors who report subjective cognitive impairment.

Original languageEnglish
Pages (from-to)1175-1184
Number of pages10
JournalPsycho-Oncology
Volume21
Issue number11
DOIs
Publication statusPublished - Nov 2012

Other keywords

  • cancer
  • cognitive functioning
  • distress
  • oncology
  • quality of life
  • self-efficacy

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