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Objective Recent research indicates that subjective socioeconomic status (SES) - the perception of one's own SES compared with other people - is an important predictor of cancer-related health outcomes. Subjective SES may function as a psychosocial mechanism by which objective SES affects health, well-being, and, more broadly, quality of life among cancer survivors. This study tested whether the association between objective SES and indicators of quality of life was mediated by subjective SES in a sample of cancer survivors who had undergone hematopoietic stem cell transplantation. Methods Hematopoietic stem cell transplantation survivors ( N = 268) completed measures of objective and subjective SES, along with four measures related to quality of life (depressive symptoms, health-related quality of life, symptoms of generalized distress, and posttraumatic stress disorder symptoms). Results Higher objective SES was associated with greater quality of life across all four measures. Subjective SES mediated the relationship between objective SES and depressive symptoms (total indirect effect b = −0.09, 95% confidence interval [CI] [−0.15, −0.05]), generalized distress (total indirect effect b = −0.08, 95% CI [−0.13, −0.04]), health-related quality of life (total indirect effect b = 0.10, 95% CI [0.06, 0.17]), and posttraumatic stress disorder (total indirect effect b = −0.08, 95% CI [−0.14, −0.04]). Conclusions Findings extend work on subjective SES to cancer and suggest that SES gradients in patient outcomes after cancer may reflect not only material resources but also psychosocial factors related to rank within social hierarchies. Further research may provide insights useful for reducing disparities in this population. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: This article reviews recent literature on adults' quality of life following hematopoietic stem cell transplantation (HSCT). Methods: We identified 22 prospective reports with at least 20 participants at baseline through a search of databases (Medline and PsycInfo) and handsearching of articles published from 2002 to October 2007. If longitudinal data were not available or were scarce for a particular topic or time point, cross-sectional studies were reviewed. Results: Although physical, psychological, and social aspects of quality of life tend to improve during the years following transplantation, a significant proportion of HSCT survivors experience persistent anxiety and depressive symptoms, fatigue, sexual dysfunction, and fertility concerns. Despite ongoing treatment side effects, the majority of HSCT survivors resume their work, school, or household activities. Conclusion: We conclude that theory-driven research with larger samples is needed to identify subgroups of HSCT survivors with adjustment difficulties. Such research would examine survivors' evolving standards and definitions of quality of life to improve the accuracy and meaningfulness of assessment and incorporate biological, psychological, and contextual factors that may contribute to positive adjustment. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The prevalence of psychological distress is higher in cancers with poorer prognoses and speculated as higher in those receiving more aversive treatments. Since hematopoietic stem cell transplant (HSCT) is one of the most taxing cancer treatments to endure and is therefore likely to have more long-term sequelae, this study examined psychological distress symptoms in long-term HSCT survivors who were at least 1 year post-transplant. Participants in this cross-sectional study were recruited from urban medical centers as part of a larger study of HSCT survivors. The sample comprised 236 adults who were on average 3.4 years since transplant. Psychological distress was measured by a commonly used self-report questionnaire, the Brief Symptom Inventory. Clinically elevated psychological distress caseness was present in 43% of long-term HSCT survivors. Elevations were highest on clinical subscales of obsessive-compulsiveness, somatization, and psychoticism. However, item-level analyses revealed that the content of the most frequently reported symptoms included trouble with memory and feelings of loneliness. Results of this study suggest that HSCT survivors may experience memory and existential concerns and that such symptoms may not represent psychiatric sequelae. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Although mothers' fear appraisals about their child's future health and well-being affect their own psychological adjustment to their child's hematopoietic stem cell transplantation (HSCT), little is known about antecedents of maternal fear appraisals. This longitudinal study investigated several potential antecedents of these fear appraisals: maternal optimism, recent negative life events, lifetime history of traumatic events, and medical characteristics of the child's disease and HSCT course. One hundred-forty mothers were interviewed during their child's hospitalization for HSCT and at 3-and 6-months post-HSCT. Structural equation modeling was used to test a model of hypothesized relations. Consistent with predictions, lower optimism and a greater number of negative life events were independently associated with greater maternal fear appraisals. Contrary to expectations, lifetime history of trauma was not associated with maternal fear appraisals. Mothers' fear appraisals during their child's hospitalization were, in turn, associated with their fear appraisals up to 6 months later. These data identify a subset of mothers who may be particularly in need of an intervention to increase optimistic coping strategies, improve coping with negative life events, and reduce fear appraisals to improve their adjustment following their child's HSCT. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: This longitudinal study investigated the course and predictors of benefit finding among 144 mothers of children undergoing hematopoietic stem cell transplantation (HSCT), a severely stressful and life-threatening medical procedure. Purpose: Children's medical risk and mothers' dispositional optimism and sociodemographic resources were examined as predictors of benefit finding. The association between benefit finding and mothers' psychosocial adaptation was also investigated. Methods: Assessments occurred during hospitalization for HSCT (Time 1 [T1]) and 6 months later (Time 2 [T2]). Results: Hierarchical multiple regression analyses revealed that predictors of benefit finding differed systematically across assessments, with optimism and medical risk predicting benefit finding at both time points but sociodemographic resources predicting only T2 benefit finding. Benefit finding did not predict psychosocial adaptation until optimism was considered as a moderator of their relation: T1 benefit finding was positively associated with T2 adaptation only for mothers high in optimism. Conclusions: The need for longitudinal research on posttrauma adaptation and the utility of considering the natural history of the trauma are discussed. [ABSTRACT FROM AUTHOR]