Patient-reported distress and problems among elderly patients with hematological malignancy in Korea

Abstract

Purpose: Treatment for hematological malignancies (HMs) and functional decline associated with age can cause distress in elderly patients with HMs. However, information about the nature and effects of distress in this population is scarce. Therefore, this study examined the level of distress, its source, and the practical/familial/physical/emotional problems among elderly patients with HMs.Methods: We conducted a cross-sectional study of patients with HMs aged ≥ 65 years who visited an outpatient clinic at a tertiary medical center in Korea between November 2019 and March 2020. Patientreported distress and problems were measured using the Distress Thermometer (DT) and 39-item Problem List by the National Comprehensive Cancer Network. Descriptive statistics, χ2 test or Fisher's exact test, and multivariate logistic regression analyses were conducted (N = 132).Results: In total, 62.1% of patients were had moderate to severe distress (DT score ≥ 4), experiencing an average of nine problems. Signi cant sources of distress on multivariate logistic analysis included problems with transportation, depression, and constipation, accounting for 47% of distress variance.Most patients had physical (97.0%) or emotional problems (79.5%). Among these, fatigue (60.6%), worry (59.8%), tingling (59.8%), getting around (47.0%), and memory/concentration (40.2%) were the most frequently reported problems.Conclusions: Elderly patients with HMs have a high burden of distress, which is affected by different sources, compared with patients with general cancer. Thus, in this population, assessment and management of distress need to be conducted considering the unique features of their source and burden. Further research on distress should consider the cancer type and population age.

Common patient‐reported sources of cancer‐related distress in adults with cancer: A systematic review

“…Among physical concerns, pain, 35,41,42,44,45,53,58,61,64,68 sleep disturbance, 23,35,41,42,44,45,53,61,64,68 fatigue, 35,41,42,44,45,53,58,68 eating, 24,35,37,41,44,53,64 memory/concentration, 41,42,44,53,61 appearance, 35,42,44,53 changes in urination, 36,37,44,68 constipation, 35,36,42,64 were found to be positively associated with actionable CRD severity in four or more studies. Among practical concerns, at least four studies found housing, 24,35,41,42,53,64 insurance/financial, 23,41,42,53 and work/school 41,42,53,68 to be positively associated with actionable CRD severity. No family or spiritual concerns were reported by four or more studies.…”

“…Fifteen studies observed relationships between individual reported sources of CRD and reporting actionable levels of CRD severity. Emotional concerns of sadness, 23 , 24 , 34 , 35 , 36 , 37 , 42 , 45 , 53 , 61 , 64 , 68 nervousness, 24 , 35 , 36 , 41 , 42 , 44 , 45 , 53 , 61 , 64 , 68 depression, 23 , 34 , 35 , 37 , 41 , 42 , 44 , 53 , 61 , 64 fears, 23 , 35 , 37 , 42 , 44 , 45 , 53 , 61 , 64 , 68 worry, 23 , 34 , 35 , 37 , 42 , 45 , 53 , 61 , 64 ...…”

“…Emotional concerns of sadness, 23 , 24 , 34 , 35 , 36 , 37 , 42 , 45 , 53 , 61 , 64 , 68 nervousness, 24 , 35 , 36 , 41 , 42 , 44 , 45 , 53 , 61 , 64 , 68 depression, 23 , 34 , 35 , 37 , 41 , 42 , 44 , 53 , 61 , 64 fears, 23 , 35 , 37 , 42 , 44 , 45 , 53 , 61 , 64 , 68 worry, 23 , 34 , 35 , 37 , 42 , 45 , 53 , 61 , 64 , 68 and loss of interest in usual activities…”

“…Among physical concerns, pain, 35 , 41 , 42 , 44 , 45 , 53 , 58 , 61 , 64 , 68 sleep disturbance, 23 , 35 , 41 , 42 , 44 , 45 , 53 , 61 , 64 , 68 fatigue, 35 , 41 , 42 , 44 , 45 , 53 , 58 , 68 eating, 24 , 35 , 37 , 41 , 44 , 53 , 64 memory/concentration, 41 , 42 , 44 , 53 , 61 appearance, 35 , 42 , 44 , 53 changes in urination, 36 , 37 , 44 , 68 constipation, 35 , 36 , 42 , 64 were found to be positively associated with actionable CRD severity in ...…”

Identifying the Risk Factors of Suicidal Ideation in Patients With Hematologic Malignancies Using a Multidimensional Approach

“…Physical problems (eg, fatigue, GI problems, and immobility) were experienced by 97% of the population, whereas depression was experienced by 80%. 46 Therefore, if clinicians can link specific physical or psychological symptoms to suicidal ideation in this population, they may be able to identify risk groups for suicidal ideation and initiate preventative interventions. Further research is required to identify symptoms related to suicidal ideation in this population.…”