Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Att genomgå stamcellstransplantation: Patienters uppfattning om och faktorer av betydelse för symptom, funktionellt status och hälsorelaterad livskvalitet
Sektionen för omvårdnad vid Institutionen för neurobiologi, vårdvetenskap och samhälle, Institutionen för laboratoriemedicin och Institutionen för medicin vid Karolinska Universitetssjukhuset, Huddinge , Karolinska Institutet, Stockholm.ORCID iD: 0000-0003-0622-7794
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 [sv]
livskvalitet, stamcellstransplantation
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:rkh:diva-714ISBN: 91-7140-825-8 (print)OAI: oai:DiVA.org:rkh-714DiVA: diva2:645111
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
List of papers
1. Health-related quality of life in women with breast cancer undergoing autologous stem-cell transplantation
Open this publication in new window or tab >>Health-related quality of life in women with breast cancer undergoing autologous stem-cell transplantation
Show others...
1996 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, ISSN 0162-220X, Vol. 19, no 5, 368-375 p.Article in journal (Refereed) Published
Abstract [en]

The functional capacity and the health-related quality of life were investigated in nine women (ages 23-58 years) undergoing high-dose chemotherapy with autologous stem-cell transplantation (ASCT). Data were obtained by using two questionnaires: the Sickness Impact Profile (SIP) and the Swedish Health-Related Quality of Life Questionnaire (SWED-QUAL). The patients answered the questionnaires on three occasions: on admission to the transplant unit, at discharge from the unit, and 7-15 weeks after ASCT. It was found that the women were affected by the treatment in various dimensions of daily life. The transplantation primarily affected their self-rated physical health and functions. Their physical-health status was poorest at the time of discharge. The women's emotional status was found to be poor during the whole study period. The results of the present study indicate that professional nursing is essential for breast cancer patients undergoing ASCT.

Keyword
cell transplantation, stem cells, quality of life
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-388 (URN)8885485 (PubMedID)
Available from: 2012-09-27 Created: 2012-09-27 Last updated: 2015-10-26Bibliographically approved
2. Symptom distress, functional status and health-related quality of life before high-dose chemotherapy with stem-cell transplantation
Open this publication in new window or tab >>Symptom distress, functional status and health-related quality of life before high-dose chemotherapy with stem-cell transplantation
Show others...
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
Keyword
cancer patients, chemotherapy, quality of life, stem-cell transplantation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-390 (URN)10.1046/j.1365-2354.2003.00315.x (DOI)12641559 (PubMedID)
Available from: 2012-09-27 Created: 2012-09-27 Last updated: 2015-10-26Bibliographically approved
3. Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation
Open this publication in new window or tab >>Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation
2004 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, ISSN 0162-220X, Vol. 27, no 1, 55-64 p.Article in journal (Refereed) Published
Abstract [en]

The main aim of this study was to investigate the patients' self-reported symptom occurrence, symptom intensity (SI), and symptom distress (SD) from admission for stem-cell transplantation (SCT) until discharge from the ward. Forty-three patients participated and data were collected at 7 different time-points by using the self-administered Symptom Frequency, Intensity, and Distress questionnaire for SCT (SFID-SCT). The results showed that symptom occurrence followed a curve on which the highest frequencies of symptoms were reported from the day of the SCT (T2) until the end of the protective care period (T5). The mean SI and SD scores became higher when the number of reported symptoms increased. Between T2 and T5, 33% to 54% of the patients reported >10 simultaneous symptoms. Symptoms reported by more than 50% of the patients during T2-T5 were tiredness, loss of appetite, mouth dryness, nausea, sleeping disturbances, diarrhea, and changes of taste. Loss of appetite, tiredness, and mouth dryness were, in descending order, the 3 symptoms reported as most intense and distressing. A statistically significantly higher SD-score was found for the patients undergoing allogeneic SCT on the day before start of the conditioning regimen, as compared to the patients undergoing autologous SCT. Patients reporting no anxiety on admission were found to have higher, mean SD-scores at the end of the hospital stay than anxious patients. The SFID-SCT questionnaire was found to give useful information not only about symptom occurrence but also about SI and SD. To use an instrument that distinguishes between these aspects of the symptom experience may help health care professionals to support the patients through the SCT-process.

Place, publisher, year, edition, pages
Baltimore Maryland: , 2004
Keyword
cancer patients, stem-cell transplantation, symptom distress
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-391 (URN)15108952 (PubMedID)
Available from: 2012-09-27 Created: 2012-09-27 Last updated: 2015-10-26Bibliographically approved
4. Factors associated with poor general health after stem-cell transplantation
Open this publication in new window or tab >>Factors associated with poor general health after stem-cell transplantation
2007 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, ISSN 0941-4355, Vol. 15, no 7, 849-857 p.Article in journal (Refereed) Published
Abstract [en]

Aims: To describe functional status (FS), general health (GH) and symptom distress (SD) from admission to 1 year post-SCT and to identify medical, demographic, and/or patient-reported outcome variables associated with patient-perceived GH. Material and Methods: Forty-one patients (27 women) with a median age of 44 (18-65) years answered three questionnaires (SIP, SWED-QUAL, and SFID-SCT) from admission to 1 year post-SCT. Results: At discharge, 59% of the patients reported poor FS and GH, and 24% reported > 10 simultaneous symptoms. After 1 year post-SCT, 22% still reported poor FS, 32% poor GH, and 12% > 10 simultaneous symptoms. Compared with admission, significantly larger proportions of the patients reported poor GH at discharge (20 vs 59%, p = .001), poor FS at 6 months (24 vs 59%, p = .004), and poor GH [The number of symptoms was found to be significantly associated with poor GH at discharge (OR 1.330, p = .009) and at 1 year post-SCT (OR 2.000, p = .010)]. Patients reporting "poor GH" at discharge and at 1 year post-SCT reported a median of 7 and 10 symptoms, respectively. Patients with "good GH" reported a median of three symptoms both at T1 and T4. "Tiredness", "anxiety", "mouth dryness", "loss of appetite", and "diarrhoea" were reported by a larger proportion of the patients reporting "poor GH". Conclusions: The results confirm that some patients who have undergone a SCT have a negatively affected life situation. The study indicates that actively asking for symptoms and applying the best treatment for symptom alleviation are among the most important measures that SCT teams can take to help the patients perceive better general health and an improved life situation.

Place, publisher, year, edition, pages
Berlin: Springer Berlin/Heidelberg, 2007
Keyword
hematopoietic stem-cell transplantation, general health, functional status, symptom distress, questionnaires, multiple regression analysis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-392 (URN)10.1007/s00520-006-0200-0 (DOI)17205276 (PubMedID)
Note

Som manuskript i avhandling. As manuscript in dissertation.

Available from: 2012-09-27 Created: 2012-09-27 Last updated: 2015-10-26Bibliographically approved

Open Access in DiVA

No full text

Other links

http://hdl.handle.net/10616/39628

Search in DiVA

By author/editor
Larsen, Joacim
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Total: 86 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf