QUALITY OF LIFE WITH MULTIPLE MYELOMA DURING THE TREATMENT PERIOD WITH THE BIOLOGICAL MEDICINAL PRODUCT BORTEZOMIB

Diseminirani plazmocitom je neozdravljiva maligna krvna bolezen, za katero je značilno nenadzorovano razmnoževanje posebne vrste limfocitov vrste B, ki so že skoraj dosegli zrelost plazmatke v kostnem mozgu. Klinična slika je posledica odpovedi kostnega mozga, razraščanja plazmocitomskih celic in razgradnje okostja. Bolezenske težave, ki se pojavljajo ob tem, so slabokrvnost ali anemija, bolečine v kosteh, ponavljajoče bakterijske okužbe in ledvično odpovedovanje. Zdravljenje je raznoliko in dolgotrajno. Bortezomib je učinkovito in varno biološko zdravilo, s katerim v Sloveniji zdravimo vse več pacientov z diseminiranim plazmocitomom in z zdravljenjem začenjamo vse bolj zgodaj, ker tako izboljšamo njegovo učinkovitost. Raziskovalna metodologija: Raziskava je temeljila na kvantitativni metodologiji raziskovanja z metodo zbiranja podatkov, kjer smo uporabili anketni vprašalnik zaprtega tipa. Sodelovalo je 36 pacientov (17 moških in 19 žensk) z diseminiranim plazmocitomom na terapiji z bortezomibom. Vse zbrane podatke smo statistično obdelali s programom SPSS 18.0 (SPSS Inc, Chicago, IL) in jih prikazali s pomočjo tabel, izdelanih s pomočjo programa Microsoft Office Word. Rezultati: Z raziskavo dobljeni rezultati potrjujejo, da se pri pacientih v zelo visokem odstotku pojavlja skeletna bolečina, ki je najpogosteje lokalizirana v ledvenem delu hrbtenice in prisotna že pred začetkom zdravljenja z biološkim zdravilom bortezomib ter s strani pacientov opredeljena kot srednje huda bolečina. Posledično se pojavljajo tudi težave povezane z gibanjem in patološki zlomi kosti. Simptomi periferne nevropatije kot stranskega učinka zdravljenja se najpogosteje kažejo kot neprijeten občutek v dlaneh in/ali stopalih. Bolezen in njeno zdravljenje ovirata paciente pri opravljanju vsakodnevnih aktivnosti in aktivnosti v prostem času. Pri pacientih zajetih v raziskavo je prisoten strah pred poslabšanjem zdravstvenega stanja. Ob tem se najbolj bojijo hudih skeletnih bolečin in odvisnosti od drugih pri opravljanju osnovnih življenjskih aktivnosti. Sklep: Skeletna bolečina je najpogosteje lokalizirana v ledvenem delu hrbtenice. Posledično se pojavljajo tudi težave povezane z gibanjem in patološki zlomi kosti. Kakovost življenja pacientov z diseminiranim plazmocitomom je odvisna od uspešnosti zdravljenja. Manj kot je bolezen razširjena in bolj kot je uspešno zdravljenje, boljša je njihova kakovost življenja. Zaposleni v zdravstveni negi se pri vsakdanjem delu skupaj s pacienti srečujemo z različnimi problemi, ki jih poskušamo sproti reševati in tako prispevati h kakovosti njihovega življenja.Multiple myeloma is an incurable malignant blood disease, which is defined by an uncontrolled reproduction of a special type of lymphocytes type B, which already reached the maturity of plasma cells in the bone marrow. Clinical characteristic is the result of bone marrow failure, spreading of plasmasytomic cells and decomposition of bone structure. Disease problems, which occur hereby are blood deficiency or anemia, bone pain, recurring bacterial infections and kidney failure. Treatment is diverse and lengthy. Bortezomib is an efficient and safe biological medicine, with which more and more patients with multiple myeloma in Slovenia are treated and where treatment is commenced at an early stage to improve its efficiency. Research methodology: Research was based on quantitative methodology of reasearch with the method of data gathering, where we used a closed type survey questionnaire. 36 patients (17 males and 19 females) with multiple myeloma participated in the bortezomib therapy. All gathered data has been statistically processed with the SPSS 18.0 programme (SPSS Inc, Chicago, IL) and presented with the help of tables formed with the help of the Microsoft Office Word programme. Results: With research obtained results confirm that in a very high percentage of patients skeletal pain occured, and which was most often localized in the lumbar spine and was present even before the commencement of treatment with the biological medicinal product bortezomib and defined by the patients as an medium strong pain. Subsequently movement related problems and pathologic bone fractions occur. Symptoms of peripheral neuropathy as a side effect of the treatment most frequently manifests as an uncomfortable feeling in palms and/or feet. The disease and its treatment obstruct patients in performing their everyday activities and activities in their spare time. With patients involved in the research, fear of worsening of their health is present. Whereby, their biggest fear is skeletal pain and depending on others when performing their basic life activities. Conclusion: Skeletal pain is most commonly localized in the lumbar spine. Subsequently movement related problems and pathologic bone fractions occur. The quality of life of multiple myeloma patients depends on the success of treatment. The less the disease is spreaded and the more successful the treatment is, the better is the quality of their life. In our everyday work, health care employees together with patients are acquainted with different problems, which we try to solve as they come along and thus contribute to the quality of their life