Patient and caregiver well-being: Observation of changing dyad over time.

Abstract

89 Background: Allogeneic hematopoietic stem cell transplant (Allo-HSCT) is a particularly stressful time for patient and caregivers alike. As such, well-being within patient-caregivers dyads is highly correlated in previous studies. It is less clear how this dyadic relationship changes over the course of treatment and recovery. Methods: In these secondary analyses of a randomized clinical trial of psychoeducational support (5 time points across 12 months), partial correlations, adjusting for group assignment and age, tested the relationship between individual mental and physical summary scores of patients and caregivers. 117 Allo-HSCT patient and caregivers provided baseline data, with available data used at each subsequent timepoint. Quality of life was measured with the Short-Form Health Survey; divided into mental (MCS) and physical summary (PCS) scores. Results: Patients were primarily men (69.6% male; Mage=49.36; SD=13.04); caregivers were primarily female (78%;Mage=53.26;SD=12.34). Patient and caregivers’ MCS were significantly correlated at baseline (r=.23;p<.05) and 4 weeks after consenting to study participation, (r=.26;p<.01), whereas patients’ PCS scores were significantly correlated with caregivers’ MCS at 3 months (r=.26;p<.05). At 6 months, the relationship between patient PCS and caregiver MCS was no longer significant (p=.51), whereas the relationship between patient and caregiver MCS re-emerged at 6 months (r=.32; p<.05). In evaluating 6 month completers (N=84), the trend between patient-caregivers well-being displayed the same significant pattern at each timepoint. Conclusions: These data replicate significant relationships of mental well-being within patient-caregiver dyads in Allo-HSCT. This relationship shifts over time, in which caregiver mental well-being becomes related to patients’ physical functioning. These data underscore the importance of this dyadic relationship and deserve follow-up statistical approaches (e.g., covariation). Extending these relationships to clinical endpoints remains an area for future investigation. Funding: NIHCA126971(MLL); T32AG044296(TS): DA034604(SMG) and PCORI CE-1304-6208(MLL). Clinical trial information: NCT00833898.