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Symptom distress, functional status and health-related quality of life before high-dose chemotherapy with stem-cell transplantation
Department of Nursing, Karolinska Institutet, Stockholm.ORCID iD: 0000-0003-0622-7794
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2003 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, ISSN 0961-5423, Vol. 12, no 1, 71-80 p.Article in journal (Refereed) Published
Abstract [en]

The aims of this study were to describe how a group of patients with different malignant diseases perceived symptom distress (SD), functional status (FS) and health-related quality of life (HRQOL) on admission to the hospital for stem-cell transplantation (SCT), to compare the obtained data regarding FS and HRQOL with similar data from two general-population groups, and to relate the results to disease- and treatment-specific data. Fifty-one patients participated in the study. Three instruments were used to collect data: SFID-SCT, SIP and SWED-QUAL. The majority of the patients (92%) reported ongoing symptoms even before the SCT with tiredness (67%) and anxiety (53%) as the two most commonly reported symptoms. Although tiredness and anxiety were reported to be the most frequently occurring symptoms, these symptoms were not considered to cause that much distress. Instead, vomiting, reduced mobility and fever, although less commonly occurring, were reported as highly distressing when present. Compared with the general-population groups, the patients reported significantly poorer FS and HRQOL but no statistically significant correlations were found between SD, FS or HRQOL and the time since the last chemotherapy cycle or cycles respectively. Patients with advanced disease and patients with multiple myeloma were found to report more SD and poorer FS and HRQOL.

Place, publisher, year, edition, pages
Oxford, 2003. Vol. 12, no 1, 71-80 p.
Keyword [en]
cancer patients, chemotherapy, quality of life, stem-cell transplantation
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:rkh:diva-390DOI: 10.1046/j.1365-2354.2003.00315.xPubMedID: 12641559OAI: oai:DiVA.org:rkh-390DiVA: diva2:557164
Available from: 2012-09-27 Created: 2012-09-27 Last updated: 2015-10-26Bibliographically approved
In thesis
1. Att genomgå stamcellstransplantation: Patienters uppfattning om och faktorer av betydelse för symptom, funktionellt status och hälsorelaterad livskvalitet
Open this publication in new window or tab >>Att genomgå stamcellstransplantation: Patienters uppfattning om och faktorer av betydelse för symptom, funktionellt status och hälsorelaterad livskvalitet
2006 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stem-cell transplantation (SCT) is one therapy alternative in cases of malignant diseases. The SCT process begins with a course of high-dose chemotherapy with or without irradiation, which results in side-effects that can range from minimal to life-threatening. The symptoms occurring from the conditioning regimen are well known, but the patients' experiences of them have been only minimally studied. The overall aim of this thesis was to ask for and describe the symptoms adult patients' undergoing SCT experience and how intense and distressing these symptoms are perceived before, during and after SCT. Furthermore the aim was also to describe functional status (FS), health-related quality of life (HRQOL) and general health (GH) from admission to one year post-SCT and to identify medical, demographic and/or patient reported outcome variables associated with patient-perceived GH. A total of 51 patients was consecutively recruited from the department of haematology at Huddinge University Hospital. The majority of the patients suffered from acute or chronic leukaemia, multiple myeloma and breast cancer. Three questionnaires were used to collect data: the Symptom, Frequency, Intensity and Distress Questionnaire for SCT (SFID-SCT), the Sickness Impact Profile (SIP) and the Swedish Healthrelated Quality of Life Questionnaire (SWED-QUAL). The patients answered the questionnaires at nine time-points, from admission to one year post-SCT. A majority of the patients (92%) reported one or more ongoing symptoms already on admission and at this timepoint the symptom manifestation was related to the malignancy the patient was suffering from. From the day of the stem-cell infusion and up to approximately 10 days after the transplantation, between 33% and 54% of the patients reported >10 simultaneous symptoms. Tiredness (81-91%), loss of appetite (88-93%) and mouth dryness (70-83%) were the most frequently reported symptoms during this period. Also nausea, sleeping problems, diarrhoea and changes of taste were reported by >50% of the patients during the protectivecare period. Vomiting, reduced mobility and fever are examples of symptoms that, once they occurred, were perceived as distressing. Overall, during the hospital stay, the patients reported the occurring symptoms as quite or very intense at 1,036/2,251 (46%) occasions. The corresponding figure for symptom distress (quite or very distressing) was 51% (916/1,813 occasions). The patients reported that the occurring symptoms led to a worse I HRQOL and that they especially had an impact on physical performances. Patients who on admission reported anxiety experienced less symptom distress at the end of the protective-care period and at discharge, as compared with patients reporting no anxiety on admission. The patients' FS and GH improved over time from discharge to one year post-SCT. About one-third of the patients suffered from reduced FS, poor GH and a number of simultaneously occurring symptoms to handle on a daily basis one year post-SCT. The regression analyses identified 'number of simultaneously occurring symptoms' as associated with poor GH at discharge from the hospital and at one year post-SCT. To actively and systematically measure, follow and document patients' self-reported symptoms, FS, 1 HRQOL and GH and to encourage and facilitate evidence based strategies for alleviation and management of symptoms are some of the most important tasks for the nurse and the other members of the SCT-team in order to alleviate distressing symptoms and contribute to a better health and life situation for individuals undergoing SCT.

Place, publisher, year, edition, pages
Västra Frölunda: Intellecta DocuSys, 2006. 45 p.
Keyword
livskvalitet, stamcellstransplantation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-714 (URN)91-7140-825-8 (ISBN)
Public defence
2006-10-10, H1 Röd, Karolinska Institutet, Alfred Nobels allé 23, Huddinge, 09:30
Available from: 2014-07-04 Created: 2013-09-03 Last updated: 2015-10-26Bibliographically approved

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