| Objective: To investigate the pre-transplantation psychological distress of allogeneic Hematopoietic Stem Cell Transplantation(allo-HSCT)patients with acute myelogenous leukemia(AML)and the main problems that cause psychological distress in patients.Factors related to patients' psychological distress,and follow-up comparison of patients with significant psychological distress and no significant psychological distress.Methods:(1)Investigation of psychological distress: According to the inclusion criteria,a total of 144 adult patients with AML undergoing allo-HSCT at the Department of Hematology of the First Affiliated Hospital of Soochow University from September 2016 to December 2017 were continuously investigated.Distress Management Screening Measure(DMSM)was used to complete psychological distress screening one week prior to transplantation,and related risk factors were analyzed by univariate analysis,Logistic regression analysis,and Spearman correlation analysis.(2)Comparison of the prognosis of patients with significant psychological distress and no significant psychological distress: patients with significant psychological distress(DT ? 4)and patients with no significant psychological distress(DT<4)after transplantation were compared by survival analysis.Overall Survival(OS),Disease-Free Survival(DFS),Relapse Rate(RR),and Non-Recurrence Mortality(NRM).Results: 1.The incidence of psychological pain: DT scores mainly concentrated between 2-7 points,with an average of(4.22±2.241)points.Thedetection rate of significant psychological distress before allo-HSCT in AML patients was 57.6%.2.Univariate analysis: Work status(with or without work),pre-transplant disease status(standard-risk and high-risk groups)and times of transplantation(first-time transplantation and non-first-time transplantation)were significant factors that affected psychological distress,P values were 0.023,0.016,and 0.019,respectively.3.Logistic regression analysis: Working is the protective factor for the risk of psychological distress(P=0.005),while the risk of psychological distress among non-workers is 0.334 times that of workers.Pre-transplant disease status was a risk factor of psychological distress(P=0.013),and the psychological distress of the patients at high-risk was 2.506 times of those at standard-risk.4.Spearman correlation analysis: DT score was positively correlated with transplantation method,r=0.264,P=0.001,that is,the degree of psychological distress was higher among non-homogeneous donors and the degree of psychological distress was lower among relatives and recipients.DT score was positively correlated with whether it was first transplanted,r=0.167,P=0.045,that is,the degree of psychological distress was higher in non-first-time transplanted patients,and the degree of psychological distress was lower in the first-time transplanted patients.5.The top 10 causes of psychological distress were: Worry,economic problems,eating,loneliness,fear,the surrounding environment,fatigue,pain,nausea,and lack of time and energy to care for the elderly and children.Worry,loneliness,and fear are emotional problems.6.Longitudinal follow-up study: There was significant difference in disease free survival(DFS)between the two groups by Kaplan-Meier survival analysis.Conclusions: 1.Psychological distress had a high incidence of allo-HSCT in patients with AML,with significant psychological distress detection rate of 57.6%.2.There was an increased risk of psychologicaldistress in patients without work or high-risk groups;emotional problems were the primary cause of patients' psychological distress before transplantation.3.The degree of distress was positively correlated with the mode of transplantation and whether it was first transplanted.4.Psychological distress before transplantation is related to the prognosis of transplantation. |
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