ปัจจัยที่มีความสัมพันธ์กับคุณภาพชีวิตในผู้ป่วยมะเร็งโลหิตวิทยาที่ได้รับยาเคมีบำบัด

Watiya Audon; Prapaporn Chinuntuya

doi:10.60099/jtnmc.v38i01.260163

Authors

Watiya Audon Srisavarindhira Thai Red Cross Institute of Nursing
Prapaporn Chinuntuya Srisavarindhira Thai Red Cross Institute of Nursing

DOI:

https://doi.org/10.60099/jtnmc.v38i01.260163

Keywords:

Chemotherapy, Patients with Hematologic Malignancy, Quality of Life, Theory of transition, illness representation

Abstract

Introduction: Hematologic malignancy is a significant public health problem worldwide and in Thailand, being listed among the top ten cancers. In recent years, the number of new cases has been increasing, resulting in a considerable disease burden for patients and negatively impacting their health and quality of life.

Objectives: To 1) describe levels of quality of life in patients with hematologic malignancies undergoing chemotherapy across three dimensions: perception of symptoms, functional, and global health status and quality of life, and 2) investigate factors associated with quality of life, including illness representation, knowledge about the disease and chemotherapy treatment, stress, and social support. Meleis’s Transition Theory was utilized as a framework for this study.

Design: A descriptive correlational research.

Methodology: The participants included 116 patients with hematologic malignancies who were undergoing chemotherapy and receiving care at the Hematology Clinic of a tertiary hospital in Bangkok. The participants were purposively selected according to the inclusion criteria. Data were collected using six questionnaires including the Personal Data Record Form and Illness and Treatment Record Form, the Brief Illness Perception Questionnaire, the Assessment of Knowledge in Cancer Patients undergoing Chemotherapy Questionnaire, the Thai Version of 10-item Perceived Stress Scale, the MOS Social Support Survey and the EORTC QLQ-C30 Questionnaire. All instruments were content validated by experts, and the reliabilities were assessed using Cronbach’s alpha coefficient and Kuder Richardson-20, depending on the questionnaire type. Descriptive statistics and Pearson’s Correlation Coefficient were used to analyze the data.

Results: Patients with hematologic malignancies undergoing chemotherapy reported high levels of quality of life in all dimensions. Two variables that were significantly associated with quality of life including illness representation and stress. Both illness representation and stress were positively correlated with the quality of life in the symptom dimension (r = .401, p < .001; r = .396, p < .001, respectively). However, these variables were negatively correlated with the functional dimension (r = -.518, p < .001; r = -.350, p < .001, respectively), as well as the global health status and quality of life dimension (r = -.461, p < .001; r = -. 275, p < .01, respectively). This study found no significant relationship between knowledge about the disease and chemotherapy, social support, and quality of life.

Recommendations: It is recommended that healthcare professionals, particularly nurses, conduct regular assessments and monitoring of quality of life in patients with hematologic malignancies undergoing chemotherapy, especially during their transition period. Furthermore, interventions aimed at promoting positive illness representation and reducing stress should be implemented to improve all dimensions of patients’ quality of life.

Downloads

Download data is not yet available.

References

World Health Organization (WHO). Global Health Estimates 2020: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2019; 2020. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death.

Strategy and Planning Division. Public Health Statistics A.D. 2019: Ministry of Health; 2019. Available from: http://dmsic.moph.go.th/index/detail/8297. (in Thai)

Goswami P, Oliva EN, Ionova T, Else R, Kell J, Fielding AK, et al. Quality-of-life issues and symptoms reported by patients living with haematological malignancy: a qualitative study. Ther Adv Hematol 2020;11. 2040620720955002. doi: 10.1177/204062 0720955002. PubMed PMID: 33101618.

Batra A, Kalyani CV, Rohilla KK. Incidence and severity of self-reported chemotherapy side-effects in patients with hematolymphoid malignancies: a cross-sec-tional study. Cancer Res Stat Treat 2020;3:736-41.

Husson O, de Rooij BH, Kieffer J, Oerlemans S, Mols F, Aaronson NK, et al. The EORTC QLQ-C30 summary score as prognostic factor for survival of patients with cancer in the “real-world”: results from the population-based PROFILES registry. Oncologist 2020;25:e722-32. doi: 10.1634/theoncologist. 2019-0348. PubMed PMID: 32297435.

Aaronson NK. Methodologic issues in assessing the quality of life of cancer patients. Cancer 1991;67 (Suppl 3):844-50.

de Souza Vieira M, Avancinib LP, da Costab Glenda LP, Petarlic B, Pereirad TSS, Marques-Rochaa JL, et al. Quality of life and associated factors in patients with hematological cancer according to EORTC QLQ-C30. J Hum Growth Dev 2022;32:309-20.

Osmialowska E, Stas J, Chabowski M, Jankowska-Polanska B. Illness perception and quality of life in patients with breast cancer. Cancers (Basel) 2022;14: 1214. doi: 10.3390/cancers14051214. PubMed PMID: 35267522.

Fanakidou I, Zyga S, Alikari V, Tsironi M, Stathoulis J, Theofilou P. Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: the role of breast reconstruction. Qual Life Res 2018;27:539-43.

Adamowicz K, Janiszewska J, Lichodziejewska-Niemierko M. Prognostic value of patient knowledge of cancer on quality of life in advanced lung cancer during chemotherapy. J Cancer Educ 2020;35:93-9.

Dehghan M, Jazinizade M, Malakoutikhah A, Madadimahani A, Iranmanesh MH, Oghabian S, et al. Stress and quality of life of patients with cancer: the mediating role of mindfulness. J Oncol 2020;2020. 3289521. doi: 10.1155/2020/3289521. PubMed PMID: 33381176.

Papathanasiou IV, Kelepouris K, Valari C, Papagiannis D, Tzavella F, Kourkouta L, et al. Depression, anxiety and stress among patients with hematological malignancies and the association with quality of life: a cross-sectional study. Med Pharm Rep 2020; 93:62-8.

Di Mattei VE, Perego G, Taranto P, Mazzetti M, Rancoita P, Milano F, et al. Socio-demographic and psychological factors associated with quality of life of women undergoing chemotherapy treatment for gynecological cancer. Support Care Cancer 2022:30; 7333-9.

Zhang Y, Cui C, Wang Y, Wang L. Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: a crosssectional study. Health Qual Life Outcomes 2020;18. 112. doi: 10.1186/s12955-020-01353-9. PubMed PMID: 32345317.

Suansomran S, Matchim Y, Baannasarn B. Factors predicting quality of life of patients with acute leukemia undergoing chemotherapy. Songklanagarind Journal of Nursing 2021;41(2):47-56..

Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 11th ed. Philadelphia: Wolters Kluwer; 2021.

Vatvani AD, Gunawan C, Waren K, Kurniawan A. Association between illness perception and health related quality of life in Indonesian cancer patients. Ann Oncol 2017;28(suppl 10):x163. doi: 10.1093/annonc/mdx676.028.

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189-98.

Institute of Geriatric Medicine. The mini mental state examination -Thai version (MMSE-Thai 2002). Nonthaburi: Department of Medical Service; 2002. (in Thai)

Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res 2006;60:631-7.

Thepphawan P, Watthnakitkrileart D, Pongthavornkamol K, Dumavibhat C. Cognitive representation, emotional responses and hospitalization experience in predicting decision making for receiving treatment among patients with acute coronary syndrome. Nursing Science Journal of Thailand 2012;29(2 Suppl 1):111-9. (in Thai)

Subongkot S, Srisawat S, Johns NP, Sookprasert A. Outcome of chemotherapy counseling in oncology patients by pharmacist. Isan Journal of Pharmaceutical Sciences 2009;5:34-45. (in Thai)

Baoraksa C, Chanthawong S. Assessment of knowledge in cancer patients undergoing chemotherapy at Udon Thani Hospital. Srinagarind Medical Journal 2018;33:495-500. (in Thai)

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385-96.

Wongpakaran N, Wongpakaran T. The Thai version of the PSS-10: an investigation of its psychometric properties. Biopsychosoc Med 2010;4:6. doi: 10. 1186/1751-0759-4-6. PubMed PMID: 20540784.

Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med 1991;32:705-14.

Khwandee N. The ralationship between pain, depression, social support and function recovery in elderly patients with hip fracture following surgery [Thesis]. Bangkok: Mahidol University; 2010. (in Thai) 2

Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365-76.

Chinuntuya P, Chutitorn AN. Factors predicting preoperative quality of Life in elderly patients with gastrointestinal cancer. Thai Red Cross Nursing Journal 2017;10:103-20. (in Thai)

Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. The EORTC QLQ-C30 scoring manual. 3rd ed. Brussels: European Organization for Research and Treatment of Cancer; 2001.

Despiegel N, Touboul C, Flinois A, Saba G, Suzan F, Gonzalez-McQuire S, et al. Health-related quality of life of patients with multiple myeloma treated in routine clinical practice in France. Clin Lymphoma Myeloma Leuk 2019;19:e13-28. doi: 10.1016/j. clml.2018.08.019. PubMed PMID: 30292736.

Tsai LY, Lee SC, Wang KL, Tsay SL, Tsai JM. A correlation study of fear of cancer recurrence, illness representation, self-regulation, and quality of life among gynecologic cancer survivors in Taiwan. Taiwan J Obstet Gynecol 2018;57:846-52.

Rood JA, Eeltink CM, van Zuuren FJ, Verdonck de Leeuw IM, Huijgens PC. Perceived need for information of patients with haematological malignancies: a literature review. J Clin Nurs 2015;24:353-69.

Doubova SV, Terreros-Munoz E, Delgado-Lopez N, Montano-Figueroa EH, Infante-Castaneda C, Perez-Cuevas R. Experiences with health care and health-related quality of life of patients with hematologic malignancies in Mexico. BMC Health Serv Res 2020;20: 644. doi: 10.1186/s12913-020-05498-7. PubMed PMID: 32650770.

Hue PTT, Chanruangvanich W, Puwarawuttipanit W. Factors associated with quality of life among patients with lung cancer. Nursing Science Journal of Thailand 2017;35(3 Suppl 1):79-86. (in Thai)