Introduction
Methods
Procedure and participants
Characteristics | n (%) | M (SD), range |
---|---|---|
Demographic
| ||
Male | 127 (55.5) | |
Employment: yes | 82 (35.8) | |
Marital status: married/partnership | 195 (85.2) | |
Subjective economic status | ||
Above average | 27 (11.8) | |
Average | 183 (79.9) | |
Below average | 19 (8.3) | |
Age (years) | 47.83 (13.45), 19–68 | |
Education (years) | 14.13 (3.25), 6–28 | |
Clinical
| ||
Primary diagnosis | ||
Leukemias and other myeloid neoplasms | 42 (18.3) | |
Lymphomas | 105 (45.9) | |
Multiple myeloma | 73 (31.9) | |
Other cancer types (solid tumor, other) | 9 (3.9) | |
Medical comorbidities | ||
None | 114 (48.1) | |
1 | 66 (27.8) | |
2 | 31 (13.1) | |
3 or more | 18 (11.0) | |
Type of transplant | ||
Autologous (autoHSCT) | 168 (73.4) | |
Allogeneic (alloHSCT) | 61 (26.6) | |
Myeloablative conditioning | 219 (95.6) | |
Time since diagnosis (months) | 21.48 (24.83), 3–180 | |
Medical comorbidities | .94 (1.26), 0–7 | |
Days from HSCT to discharge | 18.61 (9.26), 10–91 | |
AutoHSCT recipients | 14.45 (3.50), 10–33 | |
AlloHSCT recipients | 30.05 (10.47), 17–91 |
Measures
Daily physical symptoms
Daily symptom-related coping strategies
Daily PA and NA
1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | 9. | 10. | |
---|---|---|---|---|---|---|---|---|---|---|
1. Physical symptoms | − .30*** | .32*** | .07*** | .12*** | .06*** | .04** | − .06*** | − .04** | − .03* | |
2. Positive affect | − .44*** | − .12*** | − .14*** | .04** | .01 | .20*** | .23*** | .11*** | ||
3. Negative affect | .18*** | .20*** | − .05** | .17*** | − .04** | − .09*** | − .02 | |||
4. Brooding | .62*** | .21*** | .26*** | .17*** | .03** | .24*** | ||||
5. Reflection | .24*** | .25*** | .20*** | .05*** | .28*** | |||||
6. Co-rumination | .22*** | .29*** | .13*** | .19*** | ||||||
7. Venting | .34*** | .17*** | .32*** | |||||||
8. Positive Reframing | .33*** | .33*** | ||||||||
9. Acceptance | .28*** | |||||||||
10. Active Coping |
Mean | 3.63 | 14.68 | 9.82 | 2.86 | 3.22 | 3.74 | 3.63 | 3.95 | 5.45 | 4.24 |
SD
| 2.83 | 4.72 | 3.59 | 1.34 | 1.46 | 1.88 | 1.36 | 1.73 | 1.61 | 1.66 |
ICC | .74 | .63 | .55 | .62 | .59 | .68 | .57 | .61 | .61 | .62 |
Within-level ω | .94 | .90 | .96 | .90 | .98 | .55 | .95 | .63 | .93 | |
Between-level ω | .87 | .87 | .56 | .56 | .56 | .56 | .56 | .56 | .56 |
Statistical analysis
Results
Preliminary analyses
Within-subject mediation analyses: coping as a mediator
Predictor | → Mediator → | Outcome | B (SE) | Average effect [95% CI] | |||
---|---|---|---|---|---|---|---|
a path | b path | c′ path | Total effect | Indirect effect | |||
∆Physical Symptoms | ∆Brooding | ∆Positive Affect | .04 (.01)** | − .21 (.07)** | − .50 (.05)*** | − .52 [− .60; − .45] | − .02 [− .04; − .003] |
∆Reflection | .06 (.02)*** | − .23 (.06)*** | − .47 (.04)*** | − .52 [− .59; − .44] | − .05 [− .07; − .02] | ||
∆Co-rumination | .02 (.02) | .11 (.05)* | − .53 (.05)*** | − .53 [− .60; − .45] | .00 [− .02; .02] | ||
∆Venting | .02 (.02) | − .11 (.06)* | − .49 (.04)*** | − .52 [− .60; − .45] | − .04 [− .05; − .02] | ||
∆Positive Reframing | − .04 (.02)** | .29 (.05)*** | − .50 (.05)*** | − .53 [− .60; − .45] | − .02 [− .04; − .01] | ||
∆Acceptance | − .04 (.02)* | .28 (.05)*** | − .48 (.04)*** | − .52 [− .59; − .45] | − .04 [− .06; − .02] | ||
∆Active Coping | .02 (.02) | .09 (.05) | − .51 (.05)*** | − .52 [− .60; − .45] | − .01 [− .03; .01] | ||
∆Physical Symptoms | ∆Brooding | ∆Negative Affect | .04 (.01)** | .34 (.06)*** | .36 (.04)*** | .39 [.32; .46] | .02 [.004; .05] |
∆Reflection | .06 (.02)*** | .34 (.05)*** | .35 (.04)*** | .39 [.32; .46] | .04 [.02; .06] | ||
∆Co-rumination | .02 (.02) | − .004 (.04) | .38 (.04)*** | .38 [.31; .45] | .001 [− .01; .02] | ||
∆Venting | .02 (.02) | .29 (.05)*** | .37 (.04)*** | .39 [.32; .46] | .02 [.002; .04] | ||
∆Positive Reframing | − .05 (.02)** | − .08 (.05) | .38 (.04)*** | .39 [.32; .46] | .01 [− .01; .03] | ||
∆Acceptance | − .04 (.02)^ | − .18 (.05)*** | .35 (.04)*** | .38 [.32; .46] | .03 [.02; .05] | ||
∆Active Coping | .02 (.02) | − .02 (.04) | .38 (.04)*** | .39 [.32; .46] | .01 [− .01; .02] |
Reverse-mediation model analyses: affect as a mediator
Mediator/outcome | Model: ∆symptoms–∆coping–∆affect | Model: ∆symptoms–∆affect–∆coping | ||||||
---|---|---|---|---|---|---|---|---|
Log likelihood | AIC | BIC | SSABIC | − 2Log likelihood | AIC | BIC | SSABIC | |
Brooding, NA | − 20,256.24 | 40,538.48 | 40,624.73 | 40,583.43 | − 20,245.40 |
40,516.80
|
40,603.06
|
40,561.75
|
Brooding, PA | − 21,193.23 | 42,412.45 | 42,498.72 | 42,457.41 | − 21,173.09 |
42,372.18
|
42,458.44
|
42,417.13
|
Reflection, NA | − 21,114.02 | 42,254.04 | 42,340.30 | 42,298.99 | − 21,113.11 |
42,252.22
|
42,338.48
|
42,297.17
|
Reflection, PA | − 22,033.53 |
44,093.06
|
44,179.32
|
44,138.01
| − 22,036.25 | 44,098.50 | 44,184.77 | 44,143.46 |
Co-rumination, NA | − 21,898.94 | 43,823.87 | 43,910.12 | 43,868.81 | − 21,896.20 |
43,818.39
|
43,904.64
|
43,863.33
|
Co-rumination, PA | − 22,781.37 | 45,588.73 | 45,674.99 | 45,633.68 | − 22,770.58 |
45,567.16
|
45,653.42
|
45,612.11
|
Venting, NA | − 20,960.28 | 41,946.55 | 42,032.81 | 41,991.50 | − 20,959.85 |
41,945.69
|
42,031.95
|
41,990.64
|
Venting, PA | − 21,912.42 | 43,850.84 | 43,937.11 | 43,895.80 | − 21,909.87 |
43,845.73
|
43,932.00
|
43,890.69
|
Positive Reframing, NA | − 21,672.49 |
43,370.97
|
43,457.21
|
43,415.90
| − 21,675.24 | 43,376.47 | 43,462.72 | 43,421.41 |
Positive Reframing, PA | − 22,554.58 |
45,135.16
|
45,221.42
|
45,180.11
| − 22,560.74 | 45,147.49 | 45,233.74 | 45,192.43 |
Acceptance, NA | − 21,164.94 |
42,355.88
|
42,442.13
|
42,400.82
| − 21,172.94 | 42,371.87 | 42,458.12 | 42,416.81 |
Acceptance, PA | − 22,065.96 | 44,157.93 | 44,244.19 | 44,202.88 | − 22,069.12 |
44,164.24
|
44,250.51
|
44,209.120
|
Active Coping, NA | − 21,422.51 |
42,871.02
|
42,957.27
|
42,915.96
| − 21,418.71 | 42,863.42 | 42,949.66 | 42,908.35 |
Active Coping, PA | − 22,278.77 | 44,583.54 | 44,669.81 | 44,628.50 | − 22,272.40 |
44,570.79
|
44,657.06
|
44,615.75
|
Predictor → Outcome | Mediator | B (SE) | Average effect [95% CI] | |||
---|---|---|---|---|---|---|
a path | b path | c′ path | Total effect | Indirect effect | ||
∆PS → ∆Brooding | ∆NA | .39 (.04)*** | .04 (.01)*** | .02 (.01) | .04 [.02; .07] | .02 [.01; .03] |
∆PA | − .53 (.05)*** | − .02 (.01)** | .03 (.01)* | .04 [.02; .07] | .02 [.01; .03] | |
∆PS → ∆Reflection | ∆NA | .38 (.04)*** | .06 (.01)*** | .03 (.02)* | .06 [.04; .09] | .03 [.02; .04] |
∆PA | − .53 (.05)*** | − .03 (.01)*** | .04 (.02)* | .06 [.03; .08] | .02 [.01; .03] | |
∆PS → ∆Co-rumination | ∆NA | .39 (.04)*** | − .01 (.01) | .03 (.02) | .02 [− .01; .05] | − .01 [− .02; .004] |
∆PA | − .54 (.05)*** | .02 (.01)* | .04 (.02)^ | .02 [− .01; .05] | − .02 [− .03; − .004] | |
∆PS → ∆Venting | ∆NA | .39 (.04)*** | .05 (.01)*** | − .01 (.01) | .02 [− .01; .04] | .02 [.01; .03] |
∆PA | − .53 (.05)*** | − .01 (.01) | .01 (.01) | .02 [− .004; .04] | .01 [− .002; .02] | |
∆PS → ∆Positive Reframing | ∆NA | .39 (.05)*** | − .02 (.01) | − .03 (.02) | − .04 [− .07; − .02] | − .01 [− .02; .00] |
∆PA | − .53 (.05)*** | .04 (.01)*** | − .02 (.02) | − .04 [− .07; − .01] | − .02 [− .03; − .01] | |
∆PS → ∆Acceptance | ∆NA | .38 (.04)*** | − .03 (.01)** | − .02 (.02) | − .03 [− .06; − .01] | − .02 [− .03; − .01] |
∆PA | − .53 (.05)** | .04 (.01)*** | − .01 (.02) | − .03 [− .06; − .01] | − .02 [− .03; − .01] | |
∆PS → ∆Active Coping | ∆NA | .39 (.04)*** | − .001 (.01) | .02 (.02) | .02 [− .001; .05] | .004 [− .001; .01] |
∆PA | − .54 (.05)*** | .02 (.01)** | .03 (.02) | .02 [− .01; .05] | − .01 [− .02; .002] |