A novel positive psychology approach may help improve stress, fatigue, physical function, and quality of life in patients with hematologic malignancies who undergo hematopoietic stem cell transplantation, according to a new study published by Amonoo et al in JNCCN–Journal of the National Comprehensive Cancer Network.
Study Methods and Results
In the pilot study, researchers randomly assigned 70 hematopoietic stem cell transplantation recipients to receive either a 9-week, phone-delivered, positive psychology program called the Positive Affect for the Transplantation of Hematopoietic Stem Cells (PATH) intervention—with exercises focused on gratitude, personal strengths, and meaning—or standard care between August 2021 and August 2022. They noted that the PATH intervention was specifically tailored to the needs of this patient population and was initiated about 100 days following hematopoietic stem cell transplantation.
“Having 9 out of 10 [patients] complete all the sessions is great. We designed PATH with the needs of [hematopoietic stem cell transplantation] survivors in mind,” emphasized lead study author Hermioni L. Amonoo, MD, MPP, MPH, of the Brigham and Women’s Hospital and Dana-Farber Cancer Institute. “First, [the intervention] is accessible to patients, as they can learn the skills and engage with the intervention over phone from wherever they are—eliminating the need to travel to the cancer center. Second, the weekly exercises can be completed by patients at their convenience using the PATH manual, which guides patients on how to use the exercises and skills. This means that the actual phone sessions only last 15 [to] 20 minutes, in contrast to other well-established psychotherapies like cognitive behavioral therapy—which typically last 60 [to] 90 minutes per session. Third, we carefully curated the intervention sessions based on which activities patients can safely engage in while their immune system recovers following the transplant. [U]nlike in other medical populations, we did not include exercises that focus on community service [and] might unnecessarily expose patients to risks,” she continued.
The researchers found that the PATH intervention was feasible and well received. For instance, 94% of the patients in the PATH intervention group completed at least 6 of their sessions, and 91% of them completed all nine of their sessions. These patients also reported that they found the sessions easy and helpful. The researchers indicated that the PATH intervention had positive effects on patient-reported outcomes immediately after completion and again at week 18.
Conclusions
“Cancer care providers should consider the potential benefits of psychosocial resources and interventions like PATH that focus on enriching positive emotions to bolster their patients’ well-being. While the active identification and treatment of psychological distress, like anxiety, in patients with cancer are crucial, encouraging patients to engage in simple, structured, and systematic exercises aimed at fostering positive thoughts and emotions, such as gratitude, has the potential to enhance well-being as well,” Dr. Amonoo suggested.
“This positive psychology intervention highlights the importance of not only screening for distress but the promise of creating mechanisms that enhance well-being and reduce distress in our patients,” underscored Jessica Vanderlan, PhD, Manager of the Siteman Psychology Service and a licensed clinical psychologist at the Siteman Cancer Center at Barnes-Jewish Hospital and the Washington University School of Medicine as well as Vice Chair of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Distress Management, who was not involved in the study. “Development of clinical interventions that are brief … and delivered by phone could greatly improve patient access to care. This type of accessibility is important in an oncology population, especially in acute recovery periods with many competing demands and physical symptoms,” she concluded.
Disclosure: For full disclosures of the study authors, visit jnccn.org.
