Investigation on quality of life and associated factors in adult patients with acute leukemia

Abstract

Objective To investigate influencing factors of life quality of adult patients with acute leukemia (AL), and to provide a basis for the intervention of their life quality. Methods During September to December 2016, a total of 142 cases of AL adult patients admitted in Department of Hematology, West China Hospital were recruited as study subject by convenient sampling. General Data Questionnaire of AL Adult Patients which was self-designed by researchers and Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) which was used to investigate life quality of leukemia patients were conducted among patients to understand life quality of AL adult patients and related factors. Independent sample t test and one-way ANOVA were used to compare the scores of FACT-Leu dimensions of AL adult patients with different general data. Multiple stepwise regression analysis was used to analyze the factors influencing the quality of life of AL adult patients. Informed consent was obtained from all subjects. Results ① A total of 142 sets of questionnaires were hand out and 137 sets of valid questionnaires were collected. The feedback rate of valid questionnaires was 96.47%. The median age of the 137 AL adult patients was 39 years old (15-72 years old), average age was (38.4±13.8) years old. And 56(40.9%) patients were male, 81(59.1%) patients were female. The average score of FACT-Leu of 137 AL adult patients was (107.7±28.8) scores. ② According to the survey results of General Data Questionnaire of AL Adult Patients and FACT-Leu among 137 AL adult patients, female patients′ scores of emotional well-being (EWB) dimension, Functional Assessment of Cancer Therapy-General (FACT-G) and FACT-Leu were (15.3±5.7) , (62.1±19.0) , (103.5±28.7) scores and lower than those of male patients, which were (17.3±5.0) , (69.4±18.9) , (113.8±28.2) scores, and the difference were statistically significant (t=2.145, 2.206, 2.072; P=0.034, 0.029, 0.040). Scores of physical well-being (PWB), leukemia specific dimensions, FACT-G and FACT-Leu of patients continuing to work after onset of AL were (19.8±5.3) , (47.1±10.8), (72.6±18.4), (119.6±26.5) scores, and higher than those of patients who didn′t continue to work after onset, which were (16.9±6.6), (41.6±11.9), (63.2±19.1), (104.8±28.7) scores, and the difference were statistically significant (t=2.451, 2.168, 2.301, 2.439; P=0.018, 0.032, 0.023, 0.016). Score of EWB dimension (n=74) of acute myeloid leukemia (AML) patients was (17.2±4.8) scores, and higher than that of acute lymphoblastic leukemia (ALL) patients (n=63), which was (14.8±5.9) scores, and the difference was statistically significant (t=2.587, P=0.011). Self-care ability score and PWB dimension, EWB dimension, functional well-being (FWB) dimension, leukemia specific dimension, FACT-G and FACT-Leu scores were positively correlated (r=0.539, 0.500, 0.405, 0.557, 0.495, 0.561; P=0.000, 0.000, 0.000, 0.000, 0.000, 0.000). ③ Results of multiple stepwise regression analysis of related factors affecting AL adult patients′ life quality showed that self-care ability score was the main influencing factor of scores of PWB dimension, EWB dimension, FWB dimension, leukemia specific dimension, FACT-G, FACT-Leu (t=7.567, 6.774, 5.108, 7.850, 6.769, 8.003; P=0.000, 0.000, 0.000, 0.000, 0.000, 0.000). Gender was the main influencing factor of scores of PWB dimension, EWB dimension, FWB dimension, leukemia specific dimension, FACT-G, FACT-Leu (t=-2.501, -2.896, -2.311, -2.096, -3.060, -3.007; P=0.014, 0.004, 0.022, 0.038, 0.003, 0.003). Occupational status after onset was the main influencing factor associated with AL patients′ scores of social/family well-being (SWB) dimension (t=2.070, P=0.040). And the male patients, patients continuing to work after onset and with higher self-care ability score reported better quality of life. Conclusions In order to improve the life quality of AL adult patients, nurses of Hematology Department and patients′ family should pay attention to the AL adult female patients and patients with low self-care ability score, and enhance the self-care ability assessment and exercise education, and encourage the patients to participate in light-physical work during stable stage. Key words: Leukemia; Leukemia, myeloid, acute; Precursor cell lymphoblastic leukemia-lymphoma; Quality of Life; Oncologic nursing; Questionnaires