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Self‐efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well‐being after hematopoietic stem cell transplant
Author(s) -
Wu Lisa M.,
Austin Jane,
Hamilton Jada G.,
Valdimarsdottir Heiddis,
Isola Luis,
Rowley Scott,
Warbet Rachel,
Winkel Gary,
Redd William H.,
Rini Christine
Publication year - 2012
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.2012
Subject(s) - cognition , stem cell , hematopoietic stem cell , psychology , hematopoietic stem cell transplantation , cognitive skill , haematopoiesis , self efficacy , clinical psychology , psychotherapist , psychiatry , biology , genetics
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. Copyright © 2011 John Wiley & Sons, Ltd.