Symptom Distress and Quality of Life in Cancer Patients Following Hematopoietic Stem Cell Transplantation

[[abstract]]本研究主要探討癌症病患接受造血幹細胞移植症狀困擾與生活品質情形，採橫斷相關性研究設計，於中部某醫學中心血液腫瘤科以方便取樣進行收案，收案條件為(一)年滿二十歲；(二)診斷為實體與血液腫瘤病患、接受週邊造血幹細胞移植；(三)無認知功能缺損、具口語表達能力；(四)同意參與研究者，共收案100人。問卷包括「基本屬性」、「症狀困擾量表中文修訂版」、「中文版癌症治療功能性評估-骨髓移植第四版」。資料統計採個人電腦SPSS18.0統計軟體進行分析統計。結果為(一)病患平均移植為32.67個月，症狀困擾平均得分40.77分，為低等困擾程度；(二)整體生活品質平均為110.05，為中高的程度；(三)症狀困擾與生活品質有顯著負相關(r=-.652, p＜.05)；其中急慢性移植物抗宿主反應、年齡大於50歲、移植前有職業者可顯著預測症狀困擾；移植後有職業者、急性移植物抗宿主反應與復發可顯著預測生活品質。期望透過研究結果加強血液腫瘤專業醫護人員症狀護理能力，針對年紀大於50歲之移植病患特別關注其症狀困擾的影響，加強護理人員對急慢性移植物抗宿主反應的專業知識與衛教能力，並諮詢對於病患返家後工作的銜接與因應，以期提升移植後的生活品質。 Purpose: To explore symptom distress and quality of life (QOL) in cancer patients following hematopoietic stem cell transplantation (HSCT) in Taiwan. Methods: A cross-sectional correlational study was conducted by recruiting 100 patients who underwent transplantation at a bone marrow transplantation unit. The sample was selected using convenience sampling. The inclusion criteria were as follows: (1) aged 20 years or older, (2) had undergone hematopoietic stem cell transplant, (3) had no obvious cognitive impairments, and (4) had consented to participate. A questionnaire was employed to collect participants' demographic data, and it incorporated the Symptom Distress Scale-Chinese Modified Form (SDS-CMF) and the Traditional Chinese version of the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation Subscale (FACT-BMT). Statistical analyses were conducted using SPSS version 18.0. Results: The mean time post transplantation of the participants was 32.67 months. The mean SDS-CMF score for all patients was 40.77, which indicated low symptom distress. In addition, the mean overall FACT-BMT score for all patients was 110.05, which indicated that the patients had favorable QOL. Symptom distress and QOL had a significant negative correlation, with lower symptom distress resulting in higher QOL. Multiple regression analysis revealed the following predictors associated with QOL: acute graft-versus-host disease, patient age ＞ 50 years, and employment prior to undergoing HSCT. Implications for practice: Medical teams including physicians, clinical psychologists, social workers, and care coordination nurses must work with patients for symptom management of graft-versus-host disease. In addition, supporting patients with career planning may improve their QOL. This research is especially useful for consideration among older populations