Frank H. Baker - US grants

Bone marrow transplantation (BMT) is a medical procedure that offers the potential for a complete cure of a patient's cancer, but it also introduces risks for severe psychological, interpersonal, financial and physical impairment. While the survival rate for BMT continues to rise, little is known about how this arduous and demanding treatment procedure affects the quality of lives of recipients and adjustment of survivors. A prospective longitudinal cohort design (total number of patients equal about 425) is proposed to follow groups of bone marrow transplant recipient survivors over time (up to 24 months). Complete illness history and psychosocial status will be assessed one month before BMT. New patients will enter the study at approximately the rate of 8 to 9 per month; to meet the target sample size of 425, new cases will be accepted for 51 months. Interviews will be conducted with patients at The Johns Hopkins Hospital Oncology Center before their transplants and at intervals post-BMT of 3, 6, 12, 18, and 24 months. The proposed study has both descriptive and predictive goals. First, the purpose is to describe the experience of bone marrow transplantation and how it affects the lives of recipients; and second, the research will examine the relationships between the psychological, social, economic, and health resources of the patients and their subsequent adjustment and life satisfaction. In addition to information obtained by self-report from the patient, data will also be obtained from a family member, caregivers, and medical and social service records. Statistical analyses employed will be those appropriate to a cohort-sequential, multivariable, multiwave model with structured means.

The overall purpose of this project is to develop methods for assessing quality of life (QOL) that will provide comparable data in cancer patients from culturally diverse populations including African Americans and Hispanic Americans, and varying in levels of literacy and socioeconomic status. During the first phase, appropriate QOL measures for cancer patients from these special populations will be developed by adapting existing QOL measures, developing new items and scales as necessary, translating measures into Spanish, and examining and modifying measures to promote understandability across cultural as well as educational and socioeconomic barriers. These measures will be rated and reviewed by advisory boards comprised of people knowledgeable about the culture and language of the special population groups in the Washington-Baltimore SMSA in terms of their relevance and sensitivity to differences of language and dialect, customs, beliefs and traditions. During the second phase the QOL scales will be administered by trained interviewers from the African American and Hispanic population groups to people from these groups who are undergoing diagnosis and treatment for cancer. The scales will be examined for maintenance of psychometric properties across these minority groups and across subgroups varying in levels of literacy and socio- economic status. During the third phase, the refined QOL measures will examined for psychometric efficacy, efficiency and construct validity in repeated administrations to panels of cancer patients from the special populations groups of concern who are undergoing diagnosis, treatment and supportive care.

The overall purpose of this project is to develop methods for assessing quality of life (QOL) that will provide comparable data in cancer patients from culturally diverse populations including African Americans and Hispanic Americans, and varying in levels of literacy and socioeconomic status. During the first phase, appropriate QOL measures for cancer patients from these special populations will be developed by adapting existing QOL measures, developing new items and scales as necessary, translating measures into Spanish, and examining and modifying measures to promote understandability across cultural as well as educational and socioeconomic barriers. These measures will be rated and reviewed by advisory boards comprised of people knowledgeable about the culture and language of the special population groups in the Washington-Baltimore SMSA in terms of their relevance and sensitivity to differences of language and dialect, customs, beliefs and traditions. During the second phase the QOL scales will be administered by trained interviewers from the African American and Hispanic population groups to people from these groups who are undergoing diagnosis and treatment for cancer. The scales will be examined for maintenance of psychometric properties across these minority groups and across subgroups varying in levels of literacy and socio- economic status. During the third phase, the refined QOL measures will examined for psychometric efficacy, efficiency and construct validity in repeated administrations to panels of cancer patients from the special populations groups of concern who are undergoing diagnosis, treatment and supportive care.