Category: Health Psychology / Behavioral Medicine - Adult

PS5- #B41 - Effects of a Cognitive-Behavioral Assessment Before a Stem Cell Transplantation on Requirement of Psychiatric Care During a Hospital Stay

Friday, Nov 17
1:30 PM – 2:30 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Hispanic American/ Latinx | Assessment | Health Psychology

Over half of patients with hematologic malignancies who are treated with hematopoietic stem cell transplantation (HSCT) report clinically significant psychological symptoms during the HCST hospital stay. Guidelines for quality oncology care have increasingly included psychological assessment prior to HSCT, however there is a lack of clarity on necessary assessment components. AIM: To evaluate the effect of adding a cognitive behavioral self-report assessment to psychosocial clinical interviews prior to HSCT on psychiatric treatment utilization during the hospital stay. METHOD: Quasi-experimental study comparing requirement of psychiatric care in two groups: (a) HSCT patients in 2016 who completed a semi-structure clinical interview and self-report measures of anxiety and depression symptoms (HADS), psychological distress (DT), coping (SPSI-R), adjustment to cancer (MAC) and quality of life (EORTC QLQ) prior to HSCT. (b) Historical matched control patients in 2014 who completed a clinical none structure interview only. Clinical interviews in both groups were administered by the psycho-oncology department and included referrals to follow-up care as needed. Additionally, all patients were evaluated by psychiatric department prior to HSCT, so each patient had the psycho-oncology and psychiatric positive valuation to receive the HSCT. Requirement psychiatric care was defined with three components: (a) psychiatric consultation (the decision was responsibility of the medical doctor or the principal nurse) for moderate to high psychological symptoms like anxiety, depression or insomnia that were interfering with the treatment, (b) the number of psychiatric visits during the hospital stay and (c) the needed of pharmacological treatment. RESULTS: 64 patients were included in the study, including 33 intervention patients (12 allogeneic HCST and 21 autologous HCST; mean age=41 years [SD=14]; 54.5% male, 63.6% married) and 31 historical control patients (11 allogeneic HSCT and 20 autologous HSCT; mean age=43 years [SD=13]; 54.8% male; 58.1% married). Lower proportions of intervention patients required psychiatric consultation (21.2% vs. 54.8%; x2=7.71, p < .01) or pharmacological treatment before HSCT (18.2% vs. 51.6%; x2=7.92, p < .01) or during the hosptial stay (24.2% vs 61.3%; x2=9.00, p < .01) in comparison to historical control patients. Intervention patients also had fewer psychiatry visitis during the hospital stay (0.79 vs 3.06). CONCLUSION: Lower requirement of psychiatric care in intervention patients could be partially explained because it involves a greater awareness of the part of patients to recognize symptoms and clinicians can identify patient’s resources, strengths and weaknesses.

Liliana MEY LEN.. Rivera-Fong

Ph D. Student
Universidad Nacional Autónoma de México / Instituto Nacional de Cancerología
Mexico, City, Mexico

Angélica Riveros Rosas

Full time professor / Health Psychology Investigator
Universidad Nacional Autónoma de México, Distrito Federal, Mexico

Corina Benjet

Epidemiology Investigator
Instituto Nacional de Psiquiatría, Distrito Federal, Mexico

Rebeca Robles García

Health Psychology Investigator
Instituto Nacional de Psiquiatría, Distrito Federal, Mexico

Lara Traeger

Clinical Psychology / Medical Professor
Harvard Medical School / Massachussetts General Hospital, Distrito Federal, Mexico

Brenda Lizeth Acosta-Maldonado

Hematologist
Instituto Nacional de Cancerología, Distrito Federal, Mexico

Luis Manuel Valero Saldaña

Hematologist
Instituto Nacional de Cancerología, Distrito Federal, Mexico

Silvia Rivas-Vera

Hematologist
Instituto Nacional de Cancerología, Distrito Federal, Mexico

Daniel Briones Villegas

Master Student
Universidad Nacional Autónoma de México, Distrito Federal, Mexico

José Luis Aguilar Ponce

Medical Oncologist
Instituto Nacional de Cancerología, Distrito Federal, Mexico