Self-efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well-being after hematopoietic stem cell transplant
Article first published online: 8 JUL 2011
Copyright © 2011 John Wiley & Sons, Ltd.
Volume 21, Issue 11, pages 1175–1184, November 2012
How to Cite
Wu, L. M., Austin, J., Hamilton, J. G., Valdimarsdottir, H., Isola, L., Rowley, S., Warbet, R., Winkel, G., Redd, W. H. and Rini, C. (2012), Self-efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well-being after hematopoietic stem cell transplant. Psycho-Oncology, 21: 1175–1184. doi: 10.1002/pon.2012
- Issue published online: 5 NOV 2012
- Article first published online: 8 JUL 2011
- Manuscript Accepted: 25 MAY 2011
- Manuscript Revised: 24 MAY 2011
- Manuscript Received: 9 FEB 2011
- American Cancer Society. Grant Number: #RSGPB-07-285-01-CPPB
- National Cancer Institute. Grant Number: #2R25CA081137-11A1)
- cognitive functioning;
- quality of life;
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.
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.
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.
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.