Nakajima Shohei, Kamibeppu Kiyoko
Department of Family Nursing, The University of Tokyo, Japan.
Global Nursing Research Center, The University of Tokyo, Japan.
Blood Cell Ther. 2022 Mar 25;5(2):35-44. doi: 10.31547/bct-2021-005. eCollection 2022 May 25.
To examine the relationship between health-related quality of life (HRQOL) and fulfillment of informational needs among patients for allogeneic hematopoietic stem cell transplant (HSCT) and caregivers who visit long-term follow-up (LTFU) clinics within 1.5 years of post-HSCT.
We conducted a cross-sectional survey at two university hospitals in Japan between May and December 2018 using self-administered questionnaires and medical records. Based on previous research and patient interviews, informational needs of patients and caregivers were categorized into general information, post-discharge treatments, side effects and complications, self-care, psychosocial problems, and social resources. The HRQOL of patients and caregivers was measured using the Japanese Functional Assessment of Cancer Therapy-Bone Marrow Transplant (for patients) and Caregiver Quality of Life Index-Cancer (for caregivers). In addition, the pooled-regression actor-partner interdependence model approach was employed to analyze the relationships using R ver.3.6.0.
A total of 16 patients and 14 caregivers were analyzed. The mean total score of the FACT-BMT was 91.0, and the mean total score of the Caregiver Quality of Life Index-Cancer was 88.2. For both patients and caregivers, fulfillment of informational needs regarding side effects and complications (estimates = 0.55, t (16) = 4.88, < 0.001) and self-care (estimates = 0.73, t (13) = 5.02, < 0.001) exerted actor effects on their HRQOL, whereas fulfillment of informational needs regarding psychosocial problems (estimates = 0.35, t (13) = 2.90, = 0.012) exerted a partner effect on the mutual HRQOL.
Multidimensional physio-psychosocial approaches toward patients and their caregivers are important to enhance their HRQOL during the acute phase after HSCT. Detailed overviews of and methods to cope with patients' psychosocial issues should be provided before discharge, especially for caregivers unable to visit the LTFU clinics.
探讨异基因造血干细胞移植(HSCT)患者及其照顾者在HSCT后1.5年内前往长期随访(LTFU)门诊时,健康相关生活质量(HRQOL)与信息需求满足情况之间的关系。
2018年5月至12月期间,我们在日本的两家大学医院使用自填式问卷和医疗记录进行了一项横断面调查。基于先前的研究和患者访谈,将患者及其照顾者的信息需求分为一般信息、出院后治疗、副作用和并发症、自我护理、心理社会问题以及社会资源。使用日本癌症治疗功能评估-骨髓移植(针对患者)和照顾者生活质量指数-癌症(针对照顾者)来测量患者及其照顾者的HRQOL。此外,采用汇总回归行为者-伙伴相互依赖模型方法,使用R ver.3.6.0分析两者之间的关系。
共分析了16例患者和14名照顾者。FACT-BMT的平均总分是91.0,照顾者生活质量指数-癌症的平均总分是88.2。对于患者和照顾者而言,副作用和并发症方面信息需求的满足(估计值=0.55,t(16)=4.88,P<0.001)以及自我护理方面信息需求的满足(估计值=0.73,t(13)=5.02,P<0.001)对其HRQOL产生行为者效应,而心理社会问题方面信息需求的满足(估计值=0.35,t(13)=2.90,P=0.012)对彼此的HRQOL产生伙伴效应。
对患者及其照顾者采取多维度的生理-心理社会方法,对于提高HSCT急性期后的HRQOL非常重要。出院前应提供患者心理社会问题的详细概述及应对方法,特别是对于无法前往LTFU门诊的照顾者。