Research Of Symptom Clusters And Quality Of Life In Adolescent Osteosarcoma Patients During Chemotherapy

Objective:To investigate the frequency and severity of symptoms and quality of life in adolescent osteosarcoma patients during chemotherapy and explore the distribution and composition of symptom clusters.We also analyze the relationships between symptom clusters and quality of life in order to provide support for put making targeted symptom management strategy.Methods:In this study,a cross-sectional design was used to investigate the general data,symptom experience,quality of life and functional state of adolescent osteosarcoma patients who received chemotherapy between October 2016 to October 2017 from two tertiary hospitals in Shanghai.The survey tools include patient general information questionnaire,the M.D.Anderson Symptom Inventory(MDASI),Pediatric Quality of Life Inventory3.0Cancer Module(Peds QLTM3.0)and Karnofsky Performance Scale(KPS).The data were inputted and analyzed by SPSS vision 19.0.The demographic and clinical characteristics,symptom experience,quality of life and functional status of the subjects were analyzed by descriptive statistical methods.The symptom clusters were determined by exploratory factor analysis.The relationship between symptom clusters and quality of life were determined by Spearman correlation analysis and multiple linear regression analysis.Results:1.A total of 140 questionnaires were sent out,127 valid questionnaires were recovered,and the effective recovery rate was 90.71%.2.Adolescent osteosarcoma patients experienced(8.23 ± 2.28)symptoms during chemotherapy,the incidence of each symptom is between 21.26% — 96.06% and the severity score is from(0.34±0.80)to(4.43±1.80).3.There are four symptom clusters in adolescent osteosarcoma patients during chemotherapy: digestive system symptom cluster,pain related symptom cluster,respiratory system symptom cluster and nervous system symptom cluster.The variance contribution rate of each symptom cluster was 19.04%,18.20%,16.35% and 12.59% respectively,which explained 66.17% of the total variation.4.During chemotherapy,the quality of life of adolescent osteosarcoma patients was between(62.98±8.37),and the scores of each dimension were lower.5.There was a negative correlation between the symptom cluster and their quality of life and functional status in adolescent osteosarcoma patients.Pain related symptom cluster was an effective predictor of quality of life in adolescent patients with osteosarcoma during chemotherapy.Conclusion:1.There were several symptoms in adolescent osteosarcoma patients during chemotherapy,the incidence of symptoms is high and the severity is different.Medical staff should pay attention to the evaluation and management of patients’ symptoms.2.There were four symptom clusters in adolescent osteosarcoma patients during chemotherapy,including digestive system symptom cluster,pain related symptom cluster,respiratory system symptom cluster and nervous system symptom cluster.3.The symptom clusters of adolescent osteosarcoma patients was negatively correlated with their quality of life and functional state,which suggested that effective management of symptom clusters could improve the quality of life and the level of functional state of adolescent osteosarcoma patients.