Social support and survival: mixed methods study of blood and lymphoid cancer patients after transplant

Abstract

Background: Social support is linked with well-being, health, and survival, and one underlying pathway could be support for critical patient self-care. A recent review (Beattie, Lebel, & Tay, 2013) of caregiver support and survival in allogeneic hemotopoietic cell transplant (allo HCT) found few existing studies. Given the need to adher to a complex self-care regimen when patients transfer from the hospital home, the availability of a caregiver is important to study after transplant. This study aims to understand the link between social support from a dedicated caregiver to survival in blood and lymphoid cancer patients after transplant. Methods: We present data from a retrospective study of patient charts for allo HCT recipients between 2009 and 2013 (N = 253; age M = 49.5 years; 40% female; 36% ethnic minority; 86% had a family caregiver) and from a prospective multi-method study (N = 33). Findings: Caregiver presence was tied to higher probability for survival post-allogeneic transplant in the retrospective study (56% vs. 37%). The multi-method study identified concrete caregiver support strategies facilitating survival during this harsh treatment (e.g., practical support for taking numerous medications on a timed schedule, following dietary guidelines, ensuring adequate hydration, monitoring for signs of infection, and attending frequent hospital visits; emotional support: encouragement and calming presence, meaning in life). Few patients were able to perform self-care alone. Discussion: Improved adherence to complex self-care is one explanatory pathway for the support-survival link.