Acute health-related quality of life in children undergoing stem cell transplant: I. Descriptive outcomes
Acute health-related quality of life in children undergoing stem cell transplant: I. Descriptive outcomes
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DOI：
10.1038/sj.bmt.1703377
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发表时间：
2002-03-01
影响因子：
4.8
通讯作者：
Rai, SN
中科院分区：
文献类型：
--
作者：
Phipps, S;Dunavant, M;Rai, SN
有关骨髓或干细胞移植(BMT)对儿童的急性影响的经验文献很少。在这项研究中，153名接受骨髓移植的儿童进行了前瞻性纵向设计的反应评估。在入院时对儿童进行移植评估，然后进行每周评估至+6周，然后进行每月评估至+6个月。数据通过父母报告和患者报告(对于5岁及以上的患者)使用基本量表获得。主要发现是：(1)接受骨髓移植的儿童入院时的痛苦程度已经很高(定义为高水平的躯体症状和情绪障碍，以及低水平的活动)，在条件训练后急剧增加，在移植后约1周达到峰值；(2)这种增加的痛苦是一过性的，到+4到+5周迅速下降到入院水平，然后在4-6个月进一步下降到假定的基础水平；(3)父母和孩子报告描绘的痛苦轨迹非常相似，各自都为研究结果的有效性提供了确凿的支持。这些发现证实了一些广泛存在的临床印象，这些印象以前没有经验地记录下来，并指出需要新的干预措施或更密集的支持性护理方法，旨在减少移植急性期的痛苦程度。
There has been little empirical documentation of the acute effects of bone marrow or stem cell transplant (BMT) on children. In the present study, the responses of 153 children undergoing BMT were assessed in a prospective, longitudinal design. Children were assessed at the time of admission for transplant, then underwent weekly assessments to week +6, followed by monthly assessment to month +6. Data were obtained both by parent report and patient report (for patients age 5 and up) using the BASES scales. The major findings are: (1) children undergoing BMT enter the hospital with an already heightened level of distress (defined by high levels of somatic symptoms and mood disturbance, and low levels of activity) that increases dramatically following conditioning, reaching a peak approximately 1 week following transplant; (2) this increased distress is transient, declining rapidly back to admission levels by week +4 to week +5, followed by a further decline to presumed basal levels by months 4-6; and (3) the trajectories of distress depicted by both parent and child report are remarkably similar, each providing confirmatory support for the validity of the findings. These findings confirm a number of widely held clinical impressions that had not previously been documented empirically, and point to the need for new interventions or more intensive approaches to supportive care aimed at reducing levels of distress during the acute phase of transplant.