Lekdamrongkul Pichitra, Pongthavornkamol Kanaungnit, Molassiotis Alex, Sriyuktasuth Aurawamon, Siritanaratkul Noppadol, Chansatitporn Natkamol
Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Support Care Cancer. 2021 Nov;29(11):6511-6522. doi: 10.1007/s00520-021-06246-1. Epub 2021 Apr 28.
To investigate health-related quality of life (HR-QoL) and its influencing factors among non-Hodgkin's lymphoma (NHL) survivors after completion of primary treatment.
A cross-sectional study with 312 NHL survivors after completing primary treatment using self-reported data collected through face-to-face interviews or postal survey between May 2019 and December 2019. Sociodemographic factors, clinical characteristics, physical symptom distress, anxiety, depression, unmet supportive care needs, and adaptation (post-traumatic growth and post-traumatic stress disorder) were assessed. Data analysis included ANOVA tests to investigate HR-QoL among NHL survivors at different time points and GEE to assess predictors of HR-QoL.
The mean score of HR-QoL was 136.05 (SD 19.12). HR-QoL scores reported by NHL survivors in phase I (6 months or less post-treatment) were significantly lower than those in phase II (> 6 months-4 years), phase III (> 4-9 years), and phase IV (over 9 years post-treatment). Regarding HR-QoL domains, NHL survivors in phase I had significantly lower physical well-being and functional well-being scores than those in phases II, III, and IV; and significantly lower lymphoma domain score than those in phase III. GEE analysis showed that physical symptom distress, anxiety, depression, unmet supportive care needs, poor adaptation, and receiving chemotherapy disrupted HR-QoL (all P < .001).
Healthcare providers should re-prioritize intervention guidelines and survivorship care planning to promote HR-QoL among NHL survivors, particularly in phase I, through reducing physical and psychological symptom distress, addressing unmet needs, and enhancing adaptation outcomes.
调查非霍奇金淋巴瘤(NHL)幸存者在完成初始治疗后的健康相关生活质量(HR-QoL)及其影响因素。
一项横断面研究,对312名完成初始治疗的NHL幸存者进行研究,使用2019年5月至2019年12月期间通过面对面访谈或邮寄调查收集的自我报告数据。评估社会人口学因素、临床特征、身体症状困扰、焦虑、抑郁、未满足的支持性护理需求和适应情况(创伤后成长和创伤后应激障碍)。数据分析包括方差分析以调查不同时间点NHL幸存者的HR-QoL,以及广义估计方程(GEE)以评估HR-QoL的预测因素。
HR-QoL的平均得分为136.05(标准差19.12)。NHL幸存者在I期(治疗后6个月或更短时间)报告的HR-QoL得分显著低于II期(>6个月至4年)、III期(>4至9年)和IV期(治疗后9年以上)。关于HR-QoL领域,I期的NHL幸存者在身体幸福感和功能幸福感得分方面显著低于II期、III期和IV期;淋巴瘤领域得分显著低于III期。GEE分析表明,身体症状困扰、焦虑、抑郁、未满足的支持性护理需求、适应不良以及接受化疗会破坏HR-QoL(所有P<0.001)。
医疗服务提供者应重新调整干预指南和生存护理计划的优先级,以通过减轻身体和心理症状困扰、满足未满足的需求以及改善适应结果,促进NHL幸存者的HR-QoL,特别是在I期。