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中国一项横断面调查研究:多发性骨髓瘤患者治疗期间症状亚型分类。

Classification of symptom subtypes in patients with multiple myeloma during treatment: a cross-sectional survey study in China.

机构信息

Department of Hematopathology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.

Fudan University School of Nursing, Shanghai, China.

出版信息

BMJ Open. 2023 Mar 14;13(3):e066467. doi: 10.1136/bmjopen-2022-066467.

Abstract

OBJECTIVES

To classify subgroups of cancer-related symptoms in patients with multiple myeloma (MM) during treatment and examine between-group differences in demographic and clinical characteristics in addition to functional status.

DESIGN

Cross-sectional survey study.

SETTING

Haematology department of two tertiary hospitals affiliated with Guilin Medical University in China.

PARTICIPANTS

Using a convenience sampling method, questionnaires were distributed to patients with MM visiting two hospitals in Guilin, China.

INTERVENTIONS

The patients were categorised into subgroups based on cancer-related symptoms using a latent class analysis. An analysis of covariance was performed to examine how demographic and clinical characteristics and functional status differed among the subgroups.

RESULTS

In total, 216 patients completed the survey, with an average age of 60.3 years. A three-class solution was identified: low symptom burden group (class 1, 36.6%), moderate symptom burden group (class 2, 34.2%) and high symptom burden group (class 3, 29.2%). Patients with low monthly family income (OR=3.14, p=0.010) and complications of MM bone disease (OR=2.95, p=0.029) were more likely to belong to class 2. The predictors of high-burden symptoms were treated with painkillers, antidepressants or hypnotic drugs (OR=3.68, p=0.012) and <5000 daily step counts (OR=2.52, p=0.039) in class 3. Functional status was correlated with symptom burden, with patients in classes 3 and 1 reporting significantly higher and lower functional status, respectively (p<0.05).

CONCLUSIONS

Patients with MM experienced varying degrees of symptoms during treatment. The identification of patients with high symptom burden management should focus on the assessment of demographic and clinical characteristics, in addition to functional status.

摘要

目的

对多发性骨髓瘤(MM)患者治疗过程中的癌因性症状进行亚组分类,并在功能状态的基础上,检查不同亚组间的人口统计学和临床特征差异。

设计

横断面调查研究。

地点

中国桂林两所医科大学附属医院的血液科。

参与者

采用便利抽样方法,向在中国桂林两所医院就诊的 MM 患者发放问卷。

干预措施

采用潜在类别分析,根据癌因性症状将患者分为亚组。采用协方差分析检验亚组间人口统计学和临床特征及功能状态的差异。

结果

共有 216 名患者完成了调查,平均年龄为 60.3 岁。确定了一个三分类方案:低症状负担组(第 1 类,36.6%)、中症状负担组(第 2 类,34.2%)和高症状负担组(第 3 类,29.2%)。月家庭收入较低(OR=3.14,p=0.010)和有 MM 骨病并发症(OR=2.95,p=0.029)的患者更有可能属于第 2 类。高负担症状的预测因素是使用止痛药、抗抑郁药或催眠药(OR=3.68,p=0.012)和每日步数<5000(OR=2.52,p=0.039),这是第 3 类的预测因素。功能状态与症状负担相关,第 3 类和第 1 类患者的功能状态分别显著更高和更低(p<0.05)。

结论

MM 患者在治疗过程中经历了不同程度的症状。对高症状负担患者的管理应侧重于评估人口统计学和临床特征,以及功能状态。

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