Quality Of Life In Patients With Metastatic Bone Tumor And Its Influencing Factors

Objective:To investigate the quality of life of patients with metastatic bone tumors,and the influencing factors,as well as its correlation with nutrition,sleep,psychological resilience and social support,aiming to provide theoretical references for improving the quality of life of patients with metastatic bone tumor.Methods:This was a descriptive study involving 215 patients with metastatic bone tumors who were hospitalized in a tertiary hospital in Jinan City,Shandong Province from June 2019 to December 2020 using the method of convenience sampling.Each patient was asked to fill in the following the questionnaires,including the self-made Baseline Characteristic Questionnaire,Bone Metastases Module(EORTC QLQ-BM22),Pittsburgh sleep quality index(PSQI),Nutrition Risk Screening(NRS2002),Medical Outcomes Study Social Support Survey(MOS-SSS)and Connor-Davidson Resilience Scale(CD-RISC).Statistical analysis was performed using SPSS 22.0.Data were compared by the descriptive statistical analysis,independent samplet-test,oneway ANOVA,Pearson’s correlation analysis and multivariable regression analysis.Result:1.A total of 230 questionnaires were distributed in this study,and 230(100%)were recovered,involving 215 valid questionnaires,with an effective rate of 93.5%.2.Baseline characteristics of patients with metastatic bone tumors:A total of 215 patients with metastatic bone tumors with the mean age of 60.54±5.14 years were recruited,involving 137(63.7%)males.There were 141(65.6%)patients whose main caregivers were their spouses.167(77.7%)patients were married.116(54%)patients had resident medical insurance.83(38.6%)patients had the primary disease of lung cancer,and 82(38.1%)patients with metastatic bone tumors within 12 months.3.Quality of life in patients with metastatic bone tumors:The quality of life of patients with metastatic bone tumors maintained at a low level,with the mean total score of EORTC QLQ-BM22 of 53.13±10.39(28-80)points.Specifically,the mean scores on pain site,pain level,functional assessment and psychosocial assessment were 7.21±2.20(5-17),8.92±2.37(3-12),24.17±5.19(8-32),and 12.84±4.02(6-24)points,respectively.4.The correlation between the quality of life of patients with metastatic bone tumors with the nutrition,sleep,psychological resilience and social supportA total of 150(69.77%)patients with metastatic bone tumors whose nutritional risk assessment score was higher than 3 points,suggesting the risk of malnutrition,and 65(30.23%)were not at risk.The mean PSQI score of 215 patients with metastatic bone tumors was 8.17±2.83 points,and 142(66%)had a total score greater than 7 points,indicating the presence of sleep disorders.The mean psychological resilience score was 50.20±14.11 points,and the scores of deal with everything,handle unpleasant feelings,adapt when changes occur,feel in control and mental influence were 15.34±6.60,15.49±4.51,9.74±4.02,5.60±2.71,and 4.03±2.04 points,respectively.The mean total score of MOS-SSS was 56.98±12.27 points,and the scores of emotional/informational support,tangible support,positive social interaction and affectionate support were 24.53±6.31,11.61±3.63,11.47±3.77 and 8.80±3.06 points,respectively.The quality of life of patients with metastatic bone tumors was positively correlated with the nutrition(r=0.308,P<0.01),and PSQI scores(r=0.276,P<0.01),but negatively correlated with psychological resilience(r=-0.550,P<0.01)and social support(r=-0.521,P<0.01).5.Influencing factors for the quality of life of patients with metastatic bone tumors:(1)Univariate regression analysis showed that the age,pathological fracture,nerve compression,single lesion,primary disease and self-care ability were influencing factors for the quality of life of patients with metastatic bone tumors.Younger age,absence of pathological fractures,absence of nerve compression,and acceptable self-care ability indicated a better quality of life of patients with metastatic bone tumors.Primary disease of lung cancer and metabolic bone tumors with unknown causes indicated a poor quality of life.(2)Multivariable regression analysis showed that pathological fracture,nerve compression,self-care ability,nutrition,PSQI scores,psychological resilience and social support were risk factors for the quality of life of patients with metastatic bone tumors.Conclusion:1.The quality of life of patients with metastatic bone tumors is poor,Pain assessment and intervention should be timely given to reduce cancer pain symptoms.Moreover,social support and psychological counseling should be highlighted to improve their quality of life.2.Patients with metastatic bone tumors who accompany pathological fractures,nerve compression,and inability to take care of themselves have a lower quality of life.They should be well concerned for giving targeted care,thus improving the quality of life.3.The quality of life of patients with metastatic bone tumors is significantly positively correlated with nutrition and sleep,and negatively correlated with psychological resilience and social support.4.Multidisciplinary cooperation should be adopted to improve the sleep quality,nutrition,psychological and spiritual care,psychological resilience,and social support,thus improving their quality of life.