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Song and So: Factors Influencing Changes in Quality of Life in Patients undergoing Hematopoietic Stem Cell Transplantation: A Longitudinal and Multilevel Analysis
Original Article

Journal of Korean Academy of Nursing 2015; 45(5): 694-703.

Published online: 30 October 2015

DOI: https://doi.org/10.4040/jkan.2015.45.5.694

Factors Influencing Changes in Quality of Life in Patients undergoing Hematopoietic Stem Cell Transplantation: A Longitudinal and Multilevel Analysis

Chi Eun Song1, Hyang Sook So2

1Chonnam National University Hwasun Hospital, Chonnam, Korea.

2College of Nursing, Chonnam National University, Gwangju, Korea.

Address reprint requests to: So, Hyang Sook. College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea. Tel: +82-62-530-4952, Fax: +82-62-227-4009, hsso0075@chonnam.ac.kr

Received 6 January 2015       Revised 31 January 2015       Accepted 19 June 2015

© 2015 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was a prospective longitudinal study to identify changes in quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It was based on Roy's adaptation model.

Methods

The questionnaires were administered before HSCT, 30 and 100 days after HSCT. Of the 48 potentially eligible patients, 44 (91.7%) participated in the study and 40 (90.9%) completed the questionnaires at 100 days after HSCT. Multilevel analysis was applied to analyze changes in quality of life.

Results

Overall, quality of life showed a decreasing tendency from pre-HSCT to 100 days after HSCT. The adaptation level of participants was compensatory. Type of conditioning was the significant factor influencing quality of life before HSCT (β00=79.92, p <.001; β01= - 12.64, p <.001) and the change rate of quality of life (β10= - 1.66, p =.020; β11=2.88, p =.014). Symptom severity (β20= - 1.81, p =.004), depression (β30= - 0.58, p =.001), social dependency (β40= - 0.35, p =.165), and loneliness (β50= - 0.23, p =.065) had a negative effect on changes in quality of life. Symptom severity and depression were statistically significant factors influencing changes in quality of life.

Conclusion

According to the results of this study, the development of nursing intervention is needed to improve quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation in the early immune reconstruction period. The interventions should include programs to enhance coping capacity and programs to help control symptom severity and depression. Also these interventions need to be started from the beginning of HSCT and a multidisciplinary approach would be helpful.

Keywords: Hematopoietic stem cell transplantation, Quality of life, Multilevel analysis

Figures and Tables

Figure 1

Individual differences of changes in quality of life.

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Figure 2

Initial status and change rate in quality of life over time by types of conditioning.

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Table 1

Demographic and Clinical Characteristics of Participants (N =43)

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Table 2

Mean Score of Research Variables at Study Time Points

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HSCT=Hematopoietic stem cell transplantation.

Table 3

The Effects of Symptom Severity, Depression, Social Dependency, and Loneliness on Changes in Quality of Life (N =43)

jkan-45-694-i003

*MAC=Myeloablative conditioning, dummy variable; Reference group=Reduced intensity conditioning.

Notes

This article is based on a part of the first author's doctoral thesis from Chonnam National University.

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