Table 2:

Table of Evidence

Article Citation	Sample	Design	Methods	Intervention	Limitations	Depression / Anxiety Outcomes
(Amonoo et al., 2020)	N=29 HSCT recipient in USA 0.4 – 39 years post-transplant 82.8% Female 89.6% white 79.3% college degree or higher Mean age = 62.3 years	One-arm pilot study design	Qualitative interviews and self-reported assessments	Positive psychology intervention to increase resilience	Participants majority educated, non-Latino, white, and women, single academic sample Small sample size Varied post-HSCT window Unknown treatment fidelity for self-administered exercises No control group	Anxiety – HADS: p>0.05 Depression – HADS: p> 0.05 Exact p values not available
(Amonoo, et al., 2021)	N=25 Allogeneic HSCT adults in USA 95% white 55% female Mean age = 52.6 years	Single arm, proof of concept trial	Convenience sample Baseline assessment at 100-day post HSCT follow up, then post intervention assessments	Positive psychology intervention	Poor attrition: 2 deaths; 9 withdrawals d/t physical symptoms, and 2 lost to follow up Not blinded to study, no control group	Anxiety – HADS: d=−.031 Depression – HADS: D= −0.29
(Balck et al., 2019)	N=95 total N=46 intervention group N = 49 control group >18 years of age, currently undergoing HSCT in Germany 37.8% Female Mean age = 52.58 years	Randomized pre-test post-test control group design	Intervention group and control group completed questionnaires 2 days prior to HSCT, and between days +10 to +12 (T2) between days +20 to +22 (T3) Randomly assigned to intervention and control group	Problem solving training 5 individual sessions at days −1, +2, +4, +7, and + 9	Significant retention issues, including deterioration of physical condition (n = 13), deceased patients (n = 2), and loss of motivation (n=15) Single center study Unknown demographic variables of participants Limited follow up after patient discharged from hospital	Anxiety – HADS*: Intervention group had significantly less anxiety at both time points than control group p = 0.003, p = 0.04 d= 0.13 Depression – HADS*: No significant changes in depression, p = 0.24, p =0.87
(Cohen et al., 2004)	Total N = 39 N = 20 intervention group N = 19 wait list control group Patients with lymphoma CHOP or similar chemo currently or within past year in USA 66.7% Female Mean age: 51 years 36% Hodgkin’s Lymphoma	Quasi-experimental study with waitlist control group	TY “Tibetan yoga” or waitlist control group assigned sequentially using minimization Stratified to group by cancer type status of chemotherapy, age, gender, and baseline anxiety score Baseline measurements, again 1 week, 1 month, and 3 months after intervention	Tibetan yoga – meditative technique “mind body” controlled breathing, visualization, mindfulness techniques, and postures	Measures less responsive to changes per authors Floor effect, scores low at baseline / follow up indicating this group of participants had low levels of anxiety and depression Small sample size, underpowered	Anxiety -State*: P value > 0.90, Depression – CES-D*: P value =0.56,
(de Linares-Fernández, et al. 2017)	N = 36 N=21 intervention group N=15 control group Patients undergoing HSCT in Spain Mean age = 43.6 years 75% autologous HSCT	Pilot study Quasi-experimental design with control group with pre and post-test	Non-random sampling Intervention group received intervention at hospital or clinic Intervention group received pre HSCT chemo or apheresis + Control group admitted directly to hospital Measures on day 0 and at discharge	Adjuvant Psychological Therapy Behavioral Strategies based on CBT	Day 0 = anxiety inducing day, when baseline measures taken Small, nonrandom sample Other demographic information not reported	HADS – Anxiety*: Significantly reduced in intervention group compared to control p< 0.001 HADS -Depression*: Significantly reduced in intervention group compared to control, p < 0.001
(Duhamel, et al., 2010).	N=89 N= 52 intervention group N= 37 control group Adults with a HSCT received 12 – 36 months prior to enrollment and with significant distress in USA 81.2% white 52.55 % Female 47% Autologous 44% Allogeneic 9% unknown HSCT Mean age: 50.8 years	Randomized controlled trial	Random assignment to intervention or control group Baseline assessment, Post intervention assessment at 6, 9, and 12 months after baseline	CBT administered via telephone, individually	Participants majority white, excluded non-English speakers Differences between intervention and control group participants at baseline,	Depression – BSI: Intention to treat analysis, P=0.023 time by study group interaction.
(Faryabi, et al, 2021)	N = 45 N = 15 CBT group N= 15 acceptance and commitment therapy (ACT) group N= 15 control group Patients with leukemia currently hospitalized in Iran 46.6% Female 11% Bachelor’s degree or higher Mean age = 54.8 years	Quasi-experimental study design with pre-test post-test and control group	Convenience sampling Participants randomized to three groups Measures at baseline and post intervention	CBT: focused on minimizing psychological effects of disease ACT: mindfulness and acceptance to change behaviors and increase flexibility	Study did not discuss specifics of intervention, how often and how long patients received therapy Small sample size Unclear why patients were hospitalized of changes in hospitalization status Timing of measures + intervention not discussed	Anxiety – BAI: Both the CBT and ACT groups experienced significant decrease in anxiety compared to the CG p <0.05 The ACT vs. CBT experienced greater decrease in anxiety p < 0.01
(Huberty, et al., 2016)	N = 38 national sample Polycythemia Vera (PV n = 16), Essential thrombocythemia (ET n = 16), and myelofibrosis (MF n=6) nationally distributed sample in USA 89.5% Female 97.3% Caucasian 65.8% Bachelor’s degree or higher Median age = 56 years	Single arm pre-test post-test quasi-experimental intervention Nonrandomized	Recruitment via social media, convenience sample Surveys administered at baseline week 0, midpoint (week 7), post intervention week 12, and follow up week 16	60 minute online streamed yoga weekly for 12 weeks	Small sample size Mostly white, well educated, female sample No control group High risk for bias One adverse event: irritated large spleen	Anxiety – PROMIS: Pre to post intervention with p = 0.002 d = −.67 Depression – PROMIS: Pre to post intervention with p = 0.049 and effect size d= 0.41
(Huberty, et al., 2019)	N=48 N= 27 yoga intervention group N=21 wait list control group Polycythemia Vera = 31% Essential Thrombocythemia = 39% Myelofibrosis 29.2% 93% Female 93% white 83% college degree or higher Mean age = 56.9 years	Pilot randomized trial with a waitlist control group	Online recruitment Randomized to yoga or waist list control group Measures at baseline, midpoint, post intervention, and follow up Self-report measures and online web analytic program	12 weeklong yoga intervention, 60 minutes / week Yoga incorporated mindfulness; hatha and vinyasa style classes – avoided poses that would exacerbate splenomegaly	Homogenous sample Did not account for confounding factors Self-reported data Strict exclusion criteria, excluded participants with depression or current yoga practices	Anxiety –PROMIS: d= -0.27 to -0.37 Depression –PROMIS: d= −0.53 to -0.78
(Moeini, et al., 2014)	N=64 N = 32 Intervention group N = 32 control group Patients with leukemia not undergoing chemotherapy, admitted to intensive care unit in Iran 39% Female 48.4% High school graduate Mean age = 41.2 years	Pretest-posttest randomized clinical trial	Randomized clinical trial with spiritual care program Intervention during hospitalization	Spiritual care program given for three consecutive days Expression of needs, therapeutic listening, active touch, etc.	Limited inclusion criteria for study Short duration implementation and evaluation Limited discussion of intervention and measurement specifics Single center study	Anxiety – DASS-42*: Significant decrease in anxiety in intervention group over time compared to control group p <0.001
(Perez, et al., 2020)	N = 30 Patients with history of lymphoma within 2 years of completing treatment in USA 50% female 96% white 73.3% College degree or higher N=52.4 years	Exploratory mixed methods study with qualitative arm and single arm pilot design	Data captured at baseline, post program completion, and one month post program completion Treatment completers if > 75% of sessions N=20 completed sessions	8-week resiliency group program based on the Stress management and Resilience Training – Relaxation Response Resilience Program	No control groups Single academic center Majority white and highly educated small sample size Patients reported technical challenges and scheduling challenges with the telehealth program	Depression – CES-D: depression decreased; p > 0.05, d= 0.29 Anxiety – GAD-7: anxiety decreased; p = 0.07, d=0.41

Abbreviations in order of use:

JHNEBP (Johns Hopkins Nursing Evidence Based Practice); CBT (Cognitive Behavioral Therapy); HSCT (Hematopoietic Stem Cell Transplant); HADS (Hospital Anxiety and Depression Scale); STATE (Spielberger State Anxiety Inventory); CES-D (Centers of Epidemiologic Studies – Depression); BSI-D (Brief Symptom Inventory – Depression); BAI (Beck Anxiety Inventory); PROMIS (Patient Reported Outcomes Measurement Information System); MPN (Myeloproliferative Neoplasms); DASS (Depression Anxiety Stress Scale); GAD-7 (General Anxiety Disorder)