In a groundbreaking pilot study, researchers at Brigham and Women's Hospital and Dana-Farber Cancer Institute have discovered a promising approach to alleviate distress, enhance quality of life, improve physical function, and reduce fatigue in blood cancer patients who have undergone hematopoietic stem cell transplantation. The study, published in the June 2024 issue of JNCCN,Journal of the National Comprehensive Cancer Network, evaluated the feasibility of a nine-week, phone-delivered, positive psychology program called Positive Affect for the Transplantation of Hematopoietic stem cells intervention, specifically tailored to the needs of this patient population.
The pilot study, conducted from August 2021 to August 2022, involved 70 adult blood cancer patients who had received HSCT. Participants were randomized into two groups, with the intervention beginning approximately 100 days after HSCT. Those in the PATH arm engaged in weekly positive psychology exercises focused on gratitude, personal strengths, and meaning. The study found that 91% of participants completed all nine sessions, indicating high uptake and engagement with the intervention.
Lead researcher Hermioni L. Amonoo, MD, MPP, MPH, from Brigham and Women's Hospital/Dana-Farber Cancer Institute, emphasized the accessibility and convenience of the PATH intervention. "We designed PATH with the needs of HSCT survivors in mind. First, PATH is accessible to patients, as they can learn the skills and engage with the intervention over phone from wherever they are, eliminating the need to travel to the cancer center. Second, the weekly exercises can be completed by patients at their convenience using the PATH manual, which guides patients on how to use the exercises and skills. This means that the actual phone sessions only last 15-20 minutes, in contrast to other well-established psychotherapies like cognitive behavioral therapy, which typically last 60-90 minutes per session."
The intervention showed promising effects on patient-reported outcomes immediately after completion of the program and again at week 18. Dr. Amonoo emphasized the importance of psychosocial resources and interventions like PATH in cancer care, stating, "Cancer care providers should consider the potential benefits of psychosocial resources and interventions like PATH that focus on enriching positive emotions to bolster their patients' well-being. While the active identification and treatment of psychological distress, like anxiety, in patients with cancer are crucial, encouraging patients to engage in simple, structured, and systematic exercises aimed at fostering positive thoughts and emotions, such as gratitude, has the potential to enhance well-being as well."
Jessica Vanderlan, PhD, Manager of the Siteman Psychology Service at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, who was not involved in the research, commented on the significance of the study. "This positive psychology intervention highlights the importance of not only screening for distress but the promise of creating mechanisms that enhance well-being and reduce distress in our patients. Development of clinical interventions that are brief (15-20 minutes) and delivered by phone could greatly improve patient access to care. This type of accessibility is important in an oncology population, especially in acute recovery periods with many competing demands and physical symptoms."
The PATH intervention's high completion rate (94% completed at least six of the nine sessions) and positive reception by participants underscore its potential as a scalable and effective tool for improving the psychological well-being of blood cancer patients post-HSCT. As the study demonstrates, integrating positive psychology exercises into the care of HSCT survivors can significantly impact their quality of life and overall well-being.
The findings of this pilot study pave the way for further research and the potential integration of the PATH intervention into standard care for blood cancer patients undergoing HSCT. By addressing the psychological needs of these patients through accessible, tailored, and effective interventions, healthcare providers can significantly improve patient outcomes and support their journey towards recovery and improved quality of life.
