Are psychosocial factors associated with quality of life in patients with haematological cancer? A critical review of the literature

Abstract

Haematological cancers differ from other cancers mainly with regard to treatment strategies: surgery is used for diagnostic purposes but rarely for treatment, whereas chemotherapy is of central importance and, in some cases, cures patients. This article reviews studies that examine the relationships between psychosocial factors and quality of life (QoL) in haematological cancer patients. A review of the literature was conducted from the databases 'PsycInfo', 'Medline' and 'Science Direct' using the keywords 'lymphoma', 'leukaemia', 'myeloma', 'quality of life', 'psychosocial factors', 'coping', 'social support', 'personality', 'anxiety,' 'depression', 'locus of control' and 'alexithymia'. Fourteen studies were analysed. One study found positive relationships between sense of coherence and health-related QoL, whereas another showed a positive link between self-esteem and QoL. Another study suggested that a high external health locus of control was related to a better QoL. Fighting spirit had a positive impact on QoL for two studies, and helplessness-hopelessness was positively related to emotional distress in one study. Two studies indicated the relationships between emotional distress and QoL. Satisfaction with information about disease determined emotional distress in another study. Social support, general health perceptions, global meaning or spirituality were found to improve QoL in four other reports. Literature about the relationships between psychosocial factors and QoL is lacking. Sense of coherence, self-esteem and health locus of control, coping strategies, social support, global meaning or emotional distress are associated with QoL. Results concerning coping and social support should be interpreted with caution because of level II evidence in studies.