Symptom Clusters Investigation And The Study Of Quality Of Life In Leukemia Patients

Objective:To investigate the symptom clusters and the current situation of the quality of life in patients with leukemia, as well as to explore the impact of symptom clusters, self-care self-efficacy and self-Care Agency on the quality of life in leukemia patients. Thus to provide references and suggestions for healthcare provide to manage symptoms effectively, alleviate discomfort and improve the leukemia patients’quality of life.Methods:A total of77leukemia patients were recruited randomly from a comprehensive hospital in Jinan City, and investigated with social demography questionnaire, memorial symptom assessment scale, quality of Life Questionnaires-core30, Chinese Strategies Used by People to Promote Heal and exercise of self-care agency scale. Descriptive analysis was used to describe the social-demography and the current of quality of life, self-care self-efficacy and self-care agency. Analysis of variance was used to compile statistics of the difference level of leukemia patients’ quality of life among groups. Pearson correlation analysis was used to analyze the relationship between quality of life and symptom clusters, self-care self-efficacy and self-care agency. Multiple stepwise regression analysis was used to discuss the influencing factors of quality of life in patients with leukemia.Results:1. The two highest severity symptoms were sweats and worrying, the two highest incidence symptoms were hair loss and worrying. Six factors were obtained including somatic symptom cluster, affective symptom cluster, gastrointestinal symptom cluster, body image symptom cluster, mental symptom cluster and pain-related symptom cluster after factor analysis of28items from the MSAS,which the highest score is somatic symptom.2. The overall health status of leukemia patient’s quality of life was51.67±25.89, the highest score was cognitive function in function areas; lack of energy was the highest in symptoms areas, financial difficulty was the highest in single item. Scores of each dimension and overall health status of leukemia patients’ quality of life lower than that in the norm. Scores of the three dimensions of self-care self-efficacy were49.23±11.45,9.35±2.85and31.19±7.82, the four dimensions of self-care agency were19.47±5.85,34.52±7.51,34.89±7.46and20.07±4.36, Both of self-care self-efficacy and self-care agency were in medium level.3. The social demography had no statistically differences with the overall health status of leukemia patients’quality of life, except for ECOG had significant difference.4. Pearson correlation analysis results showed that Scores of symptom, somatic symptom cluster and affective symptom cluster were negatively with overall health status and functional areas; gastrointestinal symptom cluster had negative relation with overall health status, physical function, emotional function and cognitive function; body image symptom cluster was negatively with physical function, cognitive function and social function; mental symptom cluster and function areas(except for social function) were negatively corrected; pain-related symptoms cluster and function areas(except for role function and social function) were negatively corrected. The total score of self-care self-efficacy was significantly positive with overall health status and function areas. The total score of self-care agency only positively correlated with emotional clusters.5. The multiple linear regression analysis results showed that the main factors influencing the quality of life in leukemia patients were ECOG, somatic symptom cluster and self relief, which were used to explain34.0%of variances in the quality of life in leukemia patients.Conclusions1. Six factors were obtained including somatic symptom cluster, affective symptom cluster, gastrointestinal symptom cluster, body image symptom cluster, mental symptom cluster and pain-related symptom cluster after factor analysis of28items from the MSAS.2. Total level of quality of life and the scores of each dimension of leukemia patients were lower than that in norm. Thus healthcare providers should give more support and encourage to the leukemia patients.3. The symptom clusters were negatively with the overall health status and function areas, so the medical staff fully understand the patient’s symptoms, and according to the specific circumstances of the patient to formulate targeted interventions to improve their quality of life4. Both self-care self-efficacy and self-care agency of leukemia patients were in medium level, which were positively with quality of life in many function areas. Which showed that healthcare providers should take effective measures to improve the self-care of patients with leukemia, in turn to improve the level of patient’s quality of life.