Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Quality of Life

Barriers to mental health service use among hematopoietic SCT survivors

Bone Marrow Transplantation volume 45, pages 570–579 (2010)Cite this article

Abstract

This study examined barriers to mental health service use and the demographic, medical and psychosocial correlates of these barriers among hematopoietic SCT (HSCT) survivors. A sample of 253 HSCT survivors who were 1 to 3 years posttransplant completed measures of demographic, physical, psychological and social characteristics as well as a newly modified measure of barriers to mental health service use. Only 50% of distressed HSCT survivors had received mental health services. An exploratory factor analysis of the barriers to mental health service use scale yielded four factors: scheduling barriers, knowledge barriers, emotional barriers and illness-related barriers. Patients with higher social constraints (perceived problems discussing the illness experience with significant others) reported higher levels of all four types of barriers. General distress and transplant-related posttraumatic stress symptoms were positively associated with emotional, knowledge and illness-related barriers to mental health service use, whereas physical and functional well-being were inversely associated with these barriers. Having more knowledge barriers and more emotional barriers predicted a lower likelihood of receiving mental health services, as did lower levels of education and general distress. Results suggest that a significant number of HSCT survivors may benefit from education about mental health services that is tailored to individual barriers.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Copelan EA . Hematopoietic stem-cell transplantation. N Engl J Med 2006; 354: 1813–1826.

    Article  CAS  PubMed  Google Scholar 

  2. Mosher CE, Redd WH, Rini CM, Burkhalter JE, DuHamel KN . Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology 2009; 18: 113–127.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Rusiewicz A, DuHamel KN, Burkhalter J, Ostroff J, Winkel G, Scigliano E et al. Psychological distress in long-term survivors of hematopoietic stem cell transplantation. Psychooncology 2008; 17: 329–337.

    Article  PubMed  Google Scholar 

  4. DuHamel KN, Ostroff J, Ashman T, Winkel G, Mundy EA, Keane TM et al. Construct validity of the posttraumatic stress disorder checklist in cancer survivors: analyses based on two samples. Psychol Assess 2004; 16: 255–266.

    Article  PubMed  Google Scholar 

  5. Jacobsen PB, Widows MR, Hann DM, Andrykowski MA, Kronish LE, Fields KK . Posttraumatic stress disorder symptoms after bone marrow transplantation for breast cancer. Psychosom Med 1998; 60: 366–371.

    Article  CAS  PubMed  Google Scholar 

  6. Jacobsen PB, Sadler IJ, Booth-Jones M, Soety E, Weitzner MA, Fields KK . Predictors of posttraumatic stress disorder symptomatology following bone marrow transplantation for cancer. J Consult Clin Psychol 2002; 70: 235–240.

    Article  PubMed  Google Scholar 

  7. Lee SJ, Loberiza FR, Antin JH, Kirkpatrick T, Prokop L, Alyea EP et al. Routine screening for psychosocial distress following hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 35: 77–83.

    Article  CAS  PubMed  Google Scholar 

  8. Widows MR, Jacobsen PB, Fields KK . Relation of psychological vulnerability factors to posttraumatic stress disorder symptomatology in bone marrow transplant recipients. Psychosom Med 2000; 62: 873–882.

    Article  CAS  PubMed  Google Scholar 

  9. Carroll BT, Kathol RG, Noyes R Jr, Wald TG, Clamon GH . Screening for depression and anxiety in cancer patients using the Hospital Anxiety and Depression Scale. Gen Hosp Psychiatry 1993; 15: 69–74.

    Article  CAS  PubMed  Google Scholar 

  10. Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S . The prevalence of psychological distress by cancer site. Psychooncology 2001; 10: 19–28.

    Article  CAS  PubMed  Google Scholar 

  11. Holland JC, Andersen B, Breitbart WS, Dabrowski M, Dudley MM, Fleishman S et al. Distress management. J Natl Compr Canc Netw 2007; 5: 66–98.

    Article  PubMed  Google Scholar 

  12. Institute of Medicine. Implementing Cancer Survivorship Care Planning. The National Academies Press: Washington, DC, 2007.

  13. President's Cancer Panel. Living beyond cancer: Finding a new balance. President's Cancer Panel 2003–2004, Annual Report. National Cancer Institute, National Institutes of Health, Department of Health and Human Services: Bethesda, MD, 2004.

  14. Hewitt M, Rowland JH . Mental health service use among adult cancer survivors: analyses of the national health interview survey. J Clin Oncol 2002; 20: 4581–4590.

    Article  PubMed  Google Scholar 

  15. Eakin EG, Strycker LA . Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives. Psychooncology 2001; 10: 103–113.

    Article  CAS  PubMed  Google Scholar 

  16. Carlson LE, Angen M, Cullum J, Goodey E, Koopmans J, Lamont L et al. High levels of untreated distress and fatigue in cancer patients. Br J Cancer 2004; 90: 2297–2304.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM . The PTSD Checklist: reliability, validity, and diagnostic utility. Paper presented at the annual meeting of the International Society for Traumatic Stress Studies; San Antonio, TX, 1993.

    Google Scholar 

  18. Andrykowski MA, Cordova MJ, Studts JL, Miller TW . Posttraumatic stress disorder after treatment for breast cancer: Prevalence of diagnosis and use of the PTSD Checklist–Civilian Version (PCL-C) as a screening instrument. J Consult Clin Psychol 1998; 66: 586–590.

    Article  CAS  PubMed  Google Scholar 

  19. Cordova MJ, Andrykowski MA, Kenady DE, McGrath PC, Sloan DA, Redd WH . Frequency and correlates of posttraumatic-stress-disorder-like symptoms after treatment for breast cancer. J Consult Clin Psychol 1995; 63: 981–986.

    Article  CAS  PubMed  Google Scholar 

  20. Derogatis LR . Brief Symptom Inventory: Administration, Scoring, and Procedures Manual. 3rd edn. National Computer Systems Inc.: Minneapolis, MN, 1993.

    Google Scholar 

  21. Zabora JR, Blanchard CG, Smith ED, Roberts CS, Glajchen M, Sharp JW et al. Prevalence of psychological distress among cancer patients across the disease continuum. J Psychosoc Oncol 1997; 15: 73–87.

    Article  Google Scholar 

  22. Cella DF . FACT manual: Functional Assessment of Cancer Therapy Scale and the Functional Assessment of HIV Infection (FAHI) Scale. Rush-Presbyterian-St Luke's Medical Center: Chicago, 1994.

    Google Scholar 

  23. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 1993; 11: 570–579.

    Article  CAS  PubMed  Google Scholar 

  24. McQuellon RP, Russell GB, Cella DF, Craven BL, Brady M, Bonomi A et al. Quality of life measurement in bone marrow transplantation: Development of the Functional Assessment of Cancer Therapy—Bone Marrow Transplant (FACT-BMT) scale. Bone Marrow Transplant 1997; 19: 357–368.

    Article  CAS  PubMed  Google Scholar 

  25. Manne S, Schnoll RA . Measuring supportive and unsupportive responses to cancer treatment: a factor analysis of the partner responses to cancer inventory. J Behav Med 2001; 24: 297–321.

    Article  CAS  PubMed  Google Scholar 

  26. Frazier PA, Tix AP, Barnett CL . The relational context of social support: relationship satisfaction moderates the relations between enacted support and distress. Pers Soc Psychol Bull 2003; 29: 1133–1146.

    Article  PubMed  Google Scholar 

  27. Lepore SJ, Ituarte PHG . Optimism about cancer enhances mood by reducing negative social interactions. Cancer Res Ther Control 1999; 8: 165–174.

    Google Scholar 

  28. Lepore SJ . A social-cognitive processing model of emotional adjustment to cancer. In: Andersen BL, Baum A (eds). Psychosocial Interventions for Cancer. American Psychological Association: Washington DC, 2001. pp 99–116.

    Chapter  Google Scholar 

  29. Lepore SJ, Silver RC, Wortman CB, Wayment HA . Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers. J Pers Soc Psychol 1996; 70: 271–282.

    Article  CAS  PubMed  Google Scholar 

  30. Tabachnick BG, Fidell LS . Using Multivariate Statistics, 4th edn. Allyn & Bacon: Needham Heights, MA, 2001.

    Google Scholar 

  31. Smith MY, Redd W, DuHamel K, Vickberg SJ, Ricketts P . Validation of the PTSD Checklist—Civilian Version in survivors of bone marrow transplantation. J Trauma Stress 1999; 12: 485–499.

    Article  CAS  PubMed  Google Scholar 

  32. Kadan-Lottick NS, Vanderwerker LC, Block SD, Zhang B, Prigerson HG . Psychiatric disorders and mental health service use in patients with advanced cancer. Cancer 2005; 104: 2872–2881.

    Article  PubMed  Google Scholar 

  33. Addis ME, Mahalik JR . Men, masculinity, and the contexts of help seeking. Am Psychol 2003; 58: 5–14.

    Article  PubMed  Google Scholar 

  34. Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC . Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 603–613.

    Article  PubMed  Google Scholar 

  35. Vickberg SMJ, DuHamel KN, Smith MY, Manne SL, Winkel G, Papadopoulos EB et al. Global meaning and psychological adjustment among survivors of bone marrow transplant. Psychooncology 2001; 10: 29–39.

    Article  Google Scholar 

  36. Ponterotto JG, Ruckdeschel DE . An overview of coefficient alpha and a reliability matrix for estimating adequacy of internal consistency coefficients with psychological research measures. Percept Mot Skills 2007; 105: 997–1014.

    Article  PubMed  Google Scholar 

  37. Massie MJ . Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 2004; 32: 57–71.

    Article  Google Scholar 

  38. Devine EC, Westlake SK . The effects of psychoeducational care provided to adults with cancer: meta-analysis of 116 studies. Oncol Nurs Forum 1995; 22: 1369–1381.

    CAS  PubMed  Google Scholar 

  39. Meyer TJ, Mark MM . Effects of psychosocial interventions with adult cancer patients: a meta-analysis of randomized experiments. Health Psychol 1995; 14: 101–108.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge the contributions of Yeraz Markarian, Julian Silva and the participating HSCT survivors. This research was supported by the National Cancer Institute Grant nos. R01CA093609, 1F32CA130600 (CM) and K07CA104701 (CR).

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    C E Mosher, K N DuHamel & Y Li

  2. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA

    K N DuHamel, C M Rini & W H Redd

  3. Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA

    L Isola, E Scigliano & C Grosskreutz

  4. Department of Pediatrics, Hackensack University Medical Center, Hackensack, NJ, USA

    L Labay

  5. Department of Hematology and Oncology, Hackensack University Medical Center, Hackensack, NJ, USA

    S Rowley

  6. Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    E Papadopoulos & C Moskowitz

Authors
  1. C E Mosher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K N DuHamel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C M Rini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L Isola
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L Labay
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S Rowley
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. E Papadopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C Moskowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. E Scigliano
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. C Grosskreutz
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. W H Redd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C E Mosher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mosher, C., DuHamel, K., Rini, C. et al. Barriers to mental health service use among hematopoietic SCT survivors. Bone Marrow Transplant 45, 570–579 (2010). https://doi.org/10.1038/bmt.2009.166

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2009.166

Keywords

This article is cited by

Search

Advanced search

Quick links