| Abstract [eng] |
Haematopoietic stem cell transplantation (HSCT) offers a chance of recovery for onco-hematological patients. However the aggressiveness of the treatment and the complications it causes is associated with a high risk of death or long-term disability. In recent decades, with the increase in the number of HSCT, there is a large body of research on the changes in psychological well-being (anxiety, depression, distress) during treatment and their relationship to quality of life in patients with HSCT, but there is a paucity of studies further analysing the relationship and impact of other psychological constructs (empowerment, hopelessness, benefit finding, and communication with medical staff) on patients' adaptation during and after treatment, and their possible associations with medical outcomes. This thesis aimed to assess the psychological factors that predict and moderate quality of life in HSCT patients before and in the early post-transplantation period. Two-phase longitudinal study revealed significant phenomena both for oncopsychology research and for clinical work with patients. Patients' ability to find the benefits during aggressive treatment and a high sense of empowerment are associated with better psychological well-being (lower rates of anxiety, depression and hopelessness) and predict better quality of life both before and after HSCT. Patients' feelings of hopelessness are significantly reduced after HSCT, but depression and anxiety remain stable over the course of the treatment, leading to recommendations for clinicians to draw special attention to patients' psychological well-being even before the start of treatment. This study showed, that satisfaction regarding communication with physicians increases feelings of empowerment and benefits finding, which indirectly mediates patients' quality of life after HSCT. |
