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Bae and Kim: The Relationships among Social Support, Hope, Anxiety, and Depression in Patients Expecting to Receive Hematopoietic Stem Cell Transplantation
Original Article

Korean J Adult Nurs 2016;28(1):30-42.

Published online: February 2016

DOI: https://doi.org/10.7469/kjan.2016.28.1.30

The Relationships among Social Support, Hope, Anxiety, and Depression in Patients Expecting to Receive Hematopoietic Stem Cell Transplantation

Ka Ryeong Bae1, Sue Kim2,

1College of Nursing, Yonsei University, Seoul

2College of Nursing ․ Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea

Corresponding author: Kim, Sue College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3276, Fax: +82-2-392-5440, E-mail: suekim@yuhs.ac

Received 27 October 201525 January 2016       Accepted 12 February 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study aimed to examine the relationships among social support(family support, medical team support), hope, anxiety, and depression in patients with hematologic cancers before they received hematopoietic stem cell transplantation (HSCT) to obtain baseline data for developing a nursing intervention.

Methods

The participants were 70 adult patients expecting to receive HSCT from 5 university hospitals in Seoul, Gyeonggi-do, and Jeollanam-do regions. A cross-sectional survey was done using standardized instruments for social support (Tae's Family Support Scale and Professional Medical Support Scale), hope (Kim & Lee Hope Scale), anxiety and depression (Hospital Anxiety and Depression Scale). The data were analyzed by SPSS/WIN 19.0 program using frequency, percentage, item mean and standard deviation, t-test, ANOVA, and Pearson's correlation coefficient.

Results

Hope was significantly correlated with social support (r=.40, p=.001), anxiety (r=-.40, p<.001) and depression (r=-.58, p<.001). Anxiety was correlated with depression (r=.54, p<.001).

Conclusion

The findings of this study show greater social support for patients who expect to receive HSCT is significantly correlated to a higher level of hope, as well as low levels of anxiety and depression. In nursing practice, clinical nurses may develop a nursing intervention to reinforce social support and hope, as well as reduce anxiety and depression for patients preparing for HSCT.

Keywords: Hematopoietic stem cell transplantation (HSCT), Social support, Hope, Anxiety, Depression

REFERENCES

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Table 1.
The Demographic and Clinical Characteristics of the Participants (N=70)
Characteristics Categories Categories n(%) M±SD
General characteristics Gender Male 48 (68.6)  
Female 22 (31.4)  
Age (year) ＜30 16 (22.8) 40.71±12.02
30~39 13 (18.6)
40~49 21 (30.0)
≥50 20 (28.6)
Marital status Single 18 (25.7)
Married 50 (71.4)
Divorced 2 (2.9)
Education level ≤High school 40 (57.1)
Above college 30 (42.9)
Job Employed 26 (37.1)
Unemployed 44 (62.9)
Religion Yes 42 (60.0)
No 27 (38.6)
Nonresponse 1 (1.4)
Family income per month (10,000 won) ＜100 13 (18.6)
100~199 11 (15.7)
200~299 16 (22.9)
≥300 30 (42.9)
Family support obligation Yes 43 (61.4)
No 27 (38.6)
Clinical characteristics Diagnosis Leukemia 37 (52.8)
Lymphoma 23 (32.9)
Other 10 (14.3)
Type of transplant Autologous transplant 28 (40.0)
Allogeneic sibling transplant 19 (27.1)
Allogeneic unrelated transplant 23 (32.9)
Time since diagnosis (month) ＜6 27 (38.6) 11.77±2.35
6~12 27 (38.6)
13~24 10 (14.3)
＞24 6 (8.6)
Type of pre-therapy CT 55 (78.6)
CT+ RT, OP 14 (20.0)
None 1 (1.4)
Main caregiver Spouse 39 (55.7)
Parents 20 (28.6)
Children/Daughter-in-law 4 (5.7)
Other 5 (7.1)
None 2 (2.9)
Economical burden Own self 31 (44.3)
Spouse 22 (31.4)
Parents 14 (20.0)
Children 1 (1.4)
Others 2 (2.9)

CT=chemotherapy; RT=radiation therapy; OP=operation.

Table 2.
Degree of Social Support, Hope, Anxiety, and Depression (N=70)
Variables Possible range Min Max M±SD n (%) Mean per rating
Social support 16~80 43 80 68.63±10.27   4.29
Family support 8~40 10 40 35.74±5.77   4.47
Medical team support 8~40 13 40 32.89±6.87   4.11
Hope 39~156 99 155 130.50±13.67   3.35
Conviction of potential recovery 11~44         3.64
Friendly relations 6~24         3.56
Meaning of life 5~20         3.51
Confidence 3~12         3.30
Self esteem 2~8         3.15
Korean wishful thinking 2~8         3.11
Internal satisfaction 7~28         3.06
Spiritual belief 3~12         2.57
Anxiety 0~21 0 12 5.74±2.80    
Non-case 0~7       60 (85.7)  
Doubtful case 8~10       9 (12.9)  
Definite case 11~21       1 (1.4)  
Depression 0~21 0 17 8.04±4.15    
Non-case 0~7       34 (48.6)  
Doubtful case 8~10       17 (24.3)  
Definite case 11~21       19 (27.1)  
Table 3.
Social Support and, Hope According to the Demographic and Clinical Characteristics (N=70)
Characteristics Categories Social support Hope
M±SD t or F (p) Scheffé M±SD t or F (p) Scheffé
Gender Male 68.71±10.67 0.10 130.15±13.91 -0.28
Female 68.45±9.57 (.924) 131.14±13.43 (.781)
Age (year) ＜30 69.75±9.75 0.65 125.06±13.34 2.31
30~39 71.23±9.71 (.588) 127.23±12.92 (.084)
40~49 66.48±10.24   135.86±11.80  
≥50 68.30±11.26   131.20±14.88  
Marital status Single 69.17±9.38 0.04 125.11±12.86 1.90
Married 68.42±10.73 (.965) 132.32±13.84 (.157)
Divorced 69±11.31   132.00±2.83  
Education level ≤High school 66.18±11.19 5.69 125.83±13.33 12.51
Above college 71.90±7.94 (.020) 136.63±11.69 (＜.001)
Job Employed 69.50±10.35 0.54 134.00±11.66 1.69
Unemployed 68.11±10.3 (.589) 128.36±14.45 (.096)
Religion Yes 68.52±10.28 2.80 133.17±14.66 2.87
No 67.93±9.57 (.068) 126.96±10.85 (.064)
Nonresponse 92.00±0.00   111.00±0.00  
Family income per month (10,000 won) ＜100a 65.15±11.44 3.02 126.85±16.30 2.05
100~199b 65.36±13.27 (.036) 132.27±12.79 (.115)
200~299c 66.06±8.47 d＞a, b, c 125.06±10.93  
≥300d 72.70±8.28   134.23±13.36  
Family support obligation Yes 68.16±11.15 -0.48 133.79±12.96 2.69
No 69.37±8.82 (.635) 125.15±13.31 (.009)
Diagnosis Leukemia 66.95±10.86 1.06 128.14±12.95 1.20
Lymphoma 70.48±9.05 (.353) 132.52±11.66 (0.308)
Other 70.60±10.55   134.30±19.49  
Type of transplant Autologous transplanta 70.64±8.45 1.96 134.96±12.27 3.15
Allogeneic sibling transplantb 69.28±10.65 (.110) 134.06±12.08 (.020)
Allogeneic unrelated transplantc 69.11±9.92   125.58±13.42 a. b＞c
Time since diagnosis (month) ＜6 68.57±10.77 0.58 130.25±14.43 0.54
6~12 67.05±9.44 (.682) 131.79±14.23 (.833)
13~24 70.00±13.00   129.67±6.51  
＞24 69.40±4.28   134.20±9.78  
Type of pre-therapy CT 68.42±10.87 0.20 130.93±13.92 2.83
CT+RT, OP 69.79±8.06 (.821) 130.86±10.44 (.066)
None 64.00±0.00   99.00±0.00  
Main caregiver Spouse 68.08±11.03 0.87 133.05±14.61 0.94
Parents 70.95±9.14 (.489) 125.95±12.37 (.449)
Children/daughter-in-law 68.50±9.61   129.75±9.43  
Other 68.20±9.83   130.40±14.86  
None 57.50±4.95   126.50±4.95  
Economical burden Own self 69.35±11.09 0.63 133.97±12.87 1.47
Spouse 66.00±9.44 (.644) 128.64±12.71 (.221)
Parents 70.14±10.11   124.50±14.61  
Children 75.00±0.00   141.00±0.00  
Others 72.50±10.61   132.50±26.16  

CT=chemotherapy; RT=radiation therapy; OP=operation.

Table 4.
Anxiety, Depression According to the Demographic and Clinical Characteristics (N=70)
Characteristics Categories Anxiety Depression
M±SD t or F (p) M±SD t or F (p) Scheffé
Gender Male 5.48±2.92 -1.17 7.96±4.43 -0.25
Female 6.32±2.44 (.246) 8.23±3.57 (.804)
Age (year) ＜30 6.00±2.94 0.61 8.38±4.87 1.02
30~39 6.54±2.85 (.610) 9.62±4.70 (.389)
40~49 5.33±2.67   7.67±3.72  
≥50 5.45±2.84   7.15±3.56  
Marital status Single 6.06±2.78 0.39 8.39±4.60 0.13
Married 5.58±2.86 (.676) 7.96±4.11 (.877)
Divorced 7.00±0.00   7.00±0.00  
Education level ≤High school 6.08±2.75 1.33 9.05±3.99 5.87
Above college 5.30±2.83 (.253) 6.70±4.05 (.018)
Job Employed 5.58±2.74 -0.38 7.31±3.48 -1.14
Unemployed 5.84±2.84 (.705) 8.48±4.49 (.258)
Religion Yes 5.62±2.87 2.68 7.57±4.12 1.90
No 5.70±2.48 (.076) 8.52±4.07 (.158)
Nonresponse 12.00±0.00   15.00±0.00  
Family income per month (10,000 won) ＜100 6.38±2.75 1.11 9.69±5.15 2.27
100~199 5.91±2.07 (.352) 5.55±3.80 (.089)
200~299 6.37±2.06   8.69±2.50  
≥300 5.07±3.29   7.90±4.25  
Family support obligation Yes 5.26±2.74 -1.88 7.12±3.69 -2.44
No 6.52±2.75 (.076) 9.52±4.49 (.017)
Diagnosis Leukemia 6.00±2.43 0.38 8.43±4.17 1.17
Lymphoma 5.35±2.62 (.684) 8.22±4.01 (.316)
Other 5.70±4.32   6.20±4.37  
Type of transplant Autologous transplant 5.32±3.12 0.84 7.12±3.94 1.83
Allogeneic sibling transplant 5.33±2.45 (.507) 7.17±3.67 (.133)
Allogeneic unrelated transplant 6.68±2.63   9.05±4.38  
Time since diagnosis (month) ＜6a 5.78±2.90 1.11 8.05±4.37 2.84
6~12b 5.58±2.48 (.319) 6.84±3.15 (.028)
13~24c 7.33±1.53   13.67±4.93 c＞a, b, d
＞24d 4.00±2.55   6.80±2.59  
Type of pre-therapy CT 5.62±2.83 1.89 7.91±4.20 0.20
CT+RT, OP 5.86±2.41 (.159) 8.64±4.22 (.818)
None 11.00±0.00   7.00±0.00  
Main caregiver Spouse 5.28±2.87 0.67 7.90±4.12 0.18
Parents 6.40±2.76 (.619) 8.60±4.41 (.948)
Children/daughter-in-law 6.75±1.71   7.50±4.51  
Other 5.80±3.42   8.00±5.05  
None 6.00±1.41   6.50±0.71  
Economical burden Own self 5.32±2.91 0.62 7.45±4.35 1.02
Spouse 6.50±2.02 (.647) 8.68±2.51 (.402)
Parents 5.64±3.13   8.43±3.92  
Children 5.00±0.00   2.00±0.00  
Others 5.00±7.07   10.50±14.85  

CT=chemo therapy; RT=radiation therapy; OP=operation.

Table 5.
Correlations between Social Support, Hope, Anxiety, and Depression (N=70)
Variables Social support Family support Medical team support Hope Anxiety
r (p) r (p) r (p) r (p) r (p)
Family support .77 (＜.001)   　 　 　
Medical team support .85 (＜.001) .31 (.008)   　 　
Hope .40 (.001) .28 (.018) .37 (.002)   　
Anxiety .03 (.799) -.02 (.896) .06 (.624) -.40 (.001)  
Depression -.09 (.447) .03 (.805) -.16 (.177) -.58 (＜.001) .54 (＜.001)
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