Factors Affecting the Relationship between Physical Symptom Burden and Traumatic Stress Symptoms in Patients with Newly Diagnosed Acute Leukemia: A Multi-site Observational Study

Abstract

Acute leukemia (AL) is a life-threatening hematologic malignancy that poses a significant threat to both the physical and psychological well-being of those affected. Traumatic stress symptoms, which encompass the immediate psychological and physiological response to a traumatic event, such as the diagnosis of AL, are a manifestation of the distress experienced by such individuals. It has been shown that physical suffering activates traumatic stress symptoms in patients with AL, but the potential influence of variables that may moderate the association between physical symptoms and traumatic stress symptoms in AL remains understudied. This study aims to investigate this relationship and thereby to identify potential targets for therapeutic intervention. The data for this study are drawn from 85 adult patients with newly diagnosed AL recruited from four cancer care centers in Ontario, Canada. Self-report questionnaires were used at baseline to assess traumatic stress symptoms, physical symptoms, attachment security, spiritual well-being, and patient satisfaction with care. Quantitative data analyses using descriptive statistics and cross-sectional techniques, including multivariate analyses to evaluate moderation effects, were conducted to determine: the frequency of traumatic stress symptoms; the presence, severity, and distress associated with physical symptoms; and the extent to which the relationship between physical symptom burden and traumatic stress symptoms is moderated by intervening variables. The results of this study provide preliminary evidence for a moderating effect of spiritual well-being on the positive association between physical symptom burden and traumatic stress symptoms. Future work should explore this relationship in a larger sample to guide the development and improvement of tailored interventions to alleviate traumatic stress in this patient population.