Relationship Between Symptom Distress And Quality Of Life In Patients With Pituitary Adenoma After Operation

Objective:To investigate the correlation between symptom distress and quality of life(QOL)in patients with pituitary adenoma after transsphenoidal surgery.Providing advice and evidence for improving the quality of life.Methods:Between January 2015 and January 2018,198 patients who underwent transsphenoidal surgery(postoperative time>6 months)in two tertiary hospitals in Jiangsu Province were selected.The self-made General Information questionnaire(GIQ),the Health status questionnaire(SF-36 Chinese version)and the symptom disturbance scale(SCS)were used to complete the effective questionnaire.The research data are entered into the database by double check,and the data are analyzed by SPSS 17.0 software.Descriptive statistics were performed using mean,standard deviation,and constituent ratio.Spearman correlation analysis was used to analyze the correlation between symptomatic distress and quality of life in patients with pituitary adenoma,and P<0.05 was considered statistically significant.Results:1.Totally 217 questionnaires were sent out.A total of 203 respondents answered all the questions,with only 198 questionnaires being efficient.The response rate is 93.5%and the efficient recovery is 91.2%.2.The incidence of symptom disturbance:The top five symptoms with the highest incidence were fatigue(124,62.63%),sleep disorder(120,60.61%),blurred vision(118,59.60%),headache(110,55.56%)and changes in emotional response(109 cases,55.50%).The symptoms of lowest incidence are nasal congestion(58,29.29%)and bloody secretion in nasal(58 cases,29.29%).3.The top five symptoms with the highest score of symptom severity were sleep disorder,fatigue,decreased libido,headache,changes in emotional response.4.The top five symptoms with the highest incidence were fatigue,changes in emotional response,sleep disorder,blurred vision,decreased libido.5.The quality of life of patients in pituitary adenoma after transsphenoidal surgery:the scores of eight dimensions were:79.11 ±22.65,58.46±35.55,52.98± 11.13,54.17±14.21,68.06±16.99,77.90±20.06,54.04±37.74,65.45±1 8.27,respectively.Compared with the norm,the scores of the other seven dimensions were lower than that of the norm,except for the energy dimension(P<0.05).6.Spearman relationship analysis showed that:(1)There was a negative correlation between the total score of symptom severity and the scores of all dimensions of quality of life,and the difference was statistically significant(r=-0.373;r=-0.463;r=-0.419;r=-0.320;r=-0.357;r=-0.343;r=-0.310;r=-0.376,P<0.05).(2)There was a negative correlation between the total score of the degree of symptom distress and the scores of each dimension of quality of life,the difference is statistically significant(r=-0.523;r=-0.555;r=-0.339;r=-0.390;r=-0.380;r=-0.392;r=-0.480,P<0.05).(3)The top five symptoms with the highest score of symptom severity were correlated with each dimension of quality of life:there was a negative correlation between sleep disorder and quality of life score,the difference was statistically significant(r=-0.279;r=-0.203;r=-0.205;r=-0.332;r=-0.217;r=-0.195;r=-0.166;r=-0.164,P<0.05).There was a negative correlation between fatigue and quality of life scores,and the difference was statistically significant(r=-0.276;r=-0.229;r=-0.228;r=-0.189;r=-0.213;r=-0.222;r=-0.147;r=-0.193,P<0.05).The scores of decreased libido,physiological function and emotional function were all negatively correlated,and the difference was statistically significant(r=-0.175;r=-0.165,P<0.05),and was associated with physiological function,physical pain,general health status,energy and social function.There was no significant difference in mental health scores among the six dimensions.There was a negative correlation between headache and quality of life scores,and the difference was statistically significant(r=-0.309;r=-0.266;r=-0.327;r=-0.313;r=-0.213;r=-0.188;r=-0.115;r=-0.210,P<0.05).There was a negative correlation between changes in emotional response and quality of life score.The difference was statistically significant.The difference was statistically significant(r=-0.163;r=-0.264;r=-0.296;r=-0.152;r=-0.168;r=-0.226;r=-0.206;r=-0.165,P<0.05).(4)The correlation between the top five symptoms with the highest score of symptom distress and each dimension of quality of life was analyzed:there was a negative correlation between fatigue and quality of life scores,the difference was statistically significant(r=-0.159;r=-0.277;r=-0.169;r=-0.205;r=-0.273;r=-0.271;r=-0.174;r=-0.190,P<0.05).The changes in emotional response were negatively correlated with the scores of physiological function,general health status,energy,social function,emotional function and mental health.There was no significant difference between the two groups(P<0.05),and there was no significant difference in the score of somatic pain between the two groups(P<0.05).There was a negative correlation between sleep disorder and quality of life(r=-0.224;r=-0.326;r=-0.188;r=-0.285;r=-0.212;r=-0.165;r=-0.164,P<0.05).There was a negative correlation between blurred vision and each dimension in quality of life(r=-0.254;r=-0.266;r=-0.185;r=-0.225;r=-0.221;r=-0.177;r=-0.251;r=-0.187,P<0.05).There was a negative correlation between decreased libido and the affective function(r=-0.154,P<0.05)and it was associated with physiological function,general health status,energy,social function and physiological function.There was no significant difference in seven dimensions of physical pain and mental health.Conclusion:1.The incidence of symptom disturbance(top five):fatigue,sleep disorder,blurred vision,headache and changes in emotional response.2.The top five scoring items among the symptom intensity overall were sleep disorder,fatigue,decreased libido,headache,changes in emotional response.3.The top five symptoms with the highest scores of symptoms distress were fatigue,changes in emotional response,sleep disorder,blurred vision,decreased libido.4.The relationship between the severity of symptoms and the degree of symptom distress and quality of life:(1)There was a negative correlation between the total score of the symptom intensity,the symptom distress and the scores of each dimension in quality of life.(2)Correlation analysis between the top five scoring items in symptoms intensity and each dimension in quality of life:there was a negative correlation between sleep disorder and quality of life score.Fatigue and quality of life scores were negatively related to each dimension.The scores of decreased libido,physiological function and emotional function were negatively correlated with physiological function,physical pain,general health status,energy,social function and mental health.Headache had a negative correlation with the scores of all dimensions of quality of life,and the change in emotional response has a negative correlation with the scores of each dimension of quality of life.(3)The correlation between the top five symptoms with the highest score of symptom distress and each dimension of quality of life was analyzed.:there was a negative correlation between fatigue and the scores of each dimension in quality of life.The change of emotional response was negatively correlated with the scores of physiological function,general health condition,energy,social function,emotional function and mental health,but had no statistical significance with the score of somatic pain dimension.There was a negative correlation between sleep disorder and quality of life score,blurred vision and quality of life dimension score,sexual desire reduction and emotional function dimension score negatively correlated with physiological function and physiological function.There was no significant correlation between physical pain,general health status,energy,social function,and mental health.