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Published on: November 21, 2018
Symptom burden in patients with hematologic malignancies and its influencing factors
Yuying Zhang1, Wei Zhang1, Weiguang Ma2
1School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Badachu Road #33, Beijing, 100144, China.
Objective:
To evaluate global, physical, and psychological symptom burden in patients with hematologic malignancies and its influencing factors.
Methods:
This study employed convenience sampling. Sociodemographic data and standardized scales (Memorial Symptom Assessment Scale, Cancer Coping Modes Questionnaire, and Social Support Rate Scale) were collected. Statistical analyses included Kruskal-Wallis H test, Mann-Whitney U test, Spearman correlation, and generalized linear modeling.
Findings:
A total of 501 questionnaires were distributed, and 405 valid questionnaires were finally recovered. Results showed an Memorial Symptom Assessment Scale total score of 0.36 (0.16, 0.67), with physical symptom dimension score 0.44 (0.17, 0.86) significantly exceeding psychological symptom dimension score 0.28 (0, 0.67). Lack of energy was the most prevalent (58.52%) and burdensome symptom. Generalized linear regression identified female gender (β = 0.096, p = 0.008), fewer treatment sessions (β = - 0.003, p = 0.028), resignation coping (β = 0.042, p < 0.000), and fantasy coping (β = 0.029, p < 0.001) as significant predictors of higher overall burden. Compared to other malignancy types, leukemia(β = -0.244, p = 0.001), lymphoma (β = - 0.282, p < 0.000), myelodysplastic syndrome (β = - 0.189, p = 0.034), and multiple myeloma (β = - 0.32; p < 0.000) demonstrated protective effects against symptom burden.
Conclusion:
Patients experience a significant burden of physical symptoms during hospitalization, and the burden of psychological symptoms in patients may be underestimated. Therefore, it is crucial to construct and apply a more accurate assessment system of psychological symptom burden. Additionally, establishing a standardized symptom burden screening mechanism is recommended to effectively identify high-risk patients and enable immediate interventions for high-burden symptoms.
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