Distress, coping and quality of life in patients who underwent a Bone Marrow Transplantation.

Abstract

Bone Marrow Transplantation (BMT) is a therapeutic procedure aimed at curing various forms of malignant haematological forms. It has been progressively applied to other forms of oncological pathologies as well (Bone Marrow Donors Worldwide, 2004). BMT is a very effective therapeutic intervention, but for the patient it is at the same time a very extreme (sometimes even dangerous) one. BMT may have some irreversible consequences on various levels, i. e. biological, psychological and social level. It may involve, for example, loss of fertility or capacity to work, and so on (Lee et al., 2005; Schulz-Kindermann, Hennings, Ramm, Zander & Hasenbring, 2002; van Aghtoven, Vellenga, Fibbe, Kingma, & Uyl-de-Groot, 2001; Jacobsen et al., 1998; Wettergreen, Langius, Björkholm & Björvell, 1997).

The ill person is forced to face an experience that produces a feeling of crisis, whose main manifestations affect his/her personal identity and perception of integrity, since the series of stressful and destabilizing events involved by the illness may deeply endanger one’s self-sense. Therefore a coping process becomes necessary. Seriousness of the diagnosis, strictness of the therapeutic protocol and specific psychological reactions of the ill person are the main objects to which such process is related.
All the recent research works are mainly oriented to psychological distress activated by the effects of the onco-haematological illness and BMT therapy, as well as to the quality of life.
Along the care path of onco-haematological illnesses, the experience of BMT produces a series of changes that require a set in motion of the patient’s coping resources. The main characteristics by which the illness affects a person (on a physical and psychological level) are unified in the notion of distress (Heinonen et al., 2005; Beanlands et al., 2003; Trask et al., 2002). The specific modalities of response to illness, in other words the characterization of the coping process, are studied as further coping reactions, and each one of them seems to be inscribed in a context of personal history and meanings belonging to the ill person (Kirsh, Mcgrew, Dugan & Passik, 2004; Watson et al., 2004; Johnson Vickberg et al., 2001). The modalities of response of the ill persons are so articulated that for each person it is possible to understand how such experience affects his/her personal perception of the quality of life (Redaelli, Stephens, Brandt, Botteman & Pashos, 2004; Schulz-Kindermann et al., 2002; Heinonen et al., 2001; Chiodi et al., 2000).
Even though most of the literature is focused on the patient, there exists also a relational perspective, involving his/her relatives and the care personnel (Futtermann, Wellisch, Zighelboim, Luna-Raines & Weiner, 1996; Zabora, Smith, Baker, Wingard & Curbow, 1992; Singer, Donnelly &Messerschmidt, 1990; Patenaude & Rappeport, 1984).
The present work develops by focusing on the most recent research works dealing with the triad “distress, coping and quality of life (QOL)” in relation to the ill person.