The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT)
The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT)
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DOI：
10.1007/s00520-008-0420-6
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发表时间：
2008-11-01
影响因子：
3.1
通讯作者：
Marden, Susan
中科院分区：
文献类型：
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作者：
Bevans, Margaret F.;Mitchell, Sandra A.;Marden, Susan
工作目标尽管异基因造血干细胞移植（HSCT）取得了进展，但移植后并发症很常见，并且患者的症状经历没有得到很好的记录。方法采用前瞻性健康相关生活质量（HRQL）研究的76例受试者的数据。根据症状困扰量表（SDS）的11个症状确定症状发生、困扰和集群。结果参与者平均年龄为40岁（SD +/- 13.5）。大多数（54%）接受了强度降低的条件反射。普遍症状包括基线时的疲劳（68%）和担忧（68%），第0天的食欲变化（88%）以及第30天（90%）和第100天（81%）的疲劳。参与者报告以下症状严重令人痛苦：担心（16%）[基线]，失眠（32%）[第0天]，食欲变化（22%）[第30天]和疲劳（11%）[第100天]。第0天SDS总分最高（M = 26.6 +/- 7.6），报告的症状数量最多[中位数=8（1-11）]。症状形成簇，包括基线时的疲劳、外观变化和担忧，以及第0天和第30天的疲劳、失眠和肠道变化。与低症状困扰相比，中度/重度症状困扰的参与者报告较差的HRQL.Conclusion同种异体HSCT患者目前移植低症状困扰，但经历多种症状和高症状困扰HSCT调理后。了解异基因HSCT患者的症状经历可以指导管理策略并改善HRQL。
Goals of work Despite advances in allogeneic hematopoietic stem cell transplantation (HSCT), post-transplant complications are common, and patients' symptom experience has not been well documented.Purpose To characterize the symptom experience of adult patients pre-transplantation and days 0, 30, and 100 after allogeneic HSCT.Methods Data from 76 participants enrolled in a prospective health-related quality of life (HRQL) study were used. Symptom occurrence, distress, and clusters were determined based on the 11 symptoms of the Symptom Distress Scale (SDS).Results Participants were on average 40 years old (SD +/- 13.5). The majority (54%) received reduced intensity conditioning. Prevalent symptoms included fatigue (68%) and worry (68%) at baseline, appetite change (88%) at day 0, and fatigue at days 30 (90%) and 100 (81%). Participants reported the following symptoms as severely distressing: worry (16%) [baseline], insomnia (32%) [day 0], appetite change (22%) [day 30], and fatigue (11%) [day 100]. The total SDS score was highest at day 0 (M = 26.6 +/- 7.6) when the highest number of symptoms were reported [median=8 (1-11)]. Symptoms formed clusters comprised of fatigue, appearance change, and worry at baseline, and fatigue, insomnia, and bowel changes at days 0 and 30. Compared to those with low symptom distress, participants with moderate/severe symptom distress reported poorer HRQL.Conclusion Allogeneic HSCT patients present for transplantation with low symptom distress yet experience multiple symptoms and high symptom distress after HSCT conditioning. Understanding the symptom experience of allogeneic HSCT patients can guide management strategies and improve HRQL.