J Korean Acad Nurs.  2015 Oct;45(5):694-703. 10.4040/jkan.2015.45.5.694.

Factors Influencing Changes in Quality of Life in Patients undergoing Hematopoietic Stem Cell Transplantation: A Longitudinal and Multilevel Analysis

• Song CE
• So HS

• KMID: 2363094
• DOI: http://doi.org/10.4040/jkan.2015.45.5.694

Abstract

PURPOSE
This study was a prospective longitudinal study to identify changes in quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It was based on Roy's adaptation model.
METHODS
The questionnaires were administered before HSCT, 30 and 100 days after HSCT. Of the 48 potentially eligible patients, 44 (91.7%) participated in the study and 40 (90.9%) completed the questionnaires at 100 days after HSCT. Multilevel analysis was applied to analyze changes in quality of life.
RESULTS
Overall, quality of life showed a decreasing tendency from pre-HSCT to 100 days after HSCT. The adaptation level of participants was compensatory. Type of conditioning was the significant factor influencing quality of life before HSCT (beta00=79.92, p <.001; beta01= - 12.64, p <.001) and the change rate of quality of life (beta10= - 1.66, p =.020; beta11=2.88, p =.014). Symptom severity (beta20= - 1.81, p =.004), depression (beta30= - 0.58, p =.001), social dependency (beta40= - 0.35, p =.165), and loneliness (beta50= - 0.23, p =.065) had a negative effect on changes in quality of life. Symptom severity and depression were statistically significant factors influencing changes in quality of life.
CONCLUSION
According to the results of this study, the development of nursing intervention is needed to improve quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation in the early immune reconstruction period. The interventions should include programs to enhance coping capacity and programs to help control symptom severity and depression. Also these interventions need to be started from the beginning of HSCT and a multidisciplinary approach would be helpful.

Keyword

Hematopoietic stem cell transplantation; Quality of life; Multilevel analysis

MeSH Terms

Adult
Aged
Dependency (Psychology)
Depression
Female
*Hematopoietic Stem Cell Transplantation
Humans
Loneliness
Longitudinal Studies
Male
Middle Aged
Multilevel Analysis
Neoplasms/therapy
Prospective Studies
*Quality of Life
Severity of Illness Index
Surveys and Questionnaires
Transplantation, Homologous

Figure

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  Figure 1 Individual differences of changes in quality of life.

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  Figure 2 Initial status and change rate in quality of life over time by types of conditioning.

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