Quality of life and distress assessed with self and external assessment screening tools in patients with hematologic malignancies attending treatment in an acute hospital

Abstract

Purpose In this study, we examined distress levels and quality of life (QoL) of patients with hematologic malignancies under treatment in an acute setting. We used external- and self-assessment instruments for distress. Additionally, we investigated the relation between distress and QoL as well as whether highly distressed patients differed from less distressed patients concerning their QoL. Methods A cross-sectional study with patients of the Medical Clinic II of the University Hospital Frankfurt was conducted. One hundred and nine patients were assessed with an expert rating scale and completed self-report questionnaires. Data were exploratively analyzed and group comparisons between patients who scored above the cut-off of the respective screening instruments and those who did not were conducted. Results Patients with hematologic malignancies experience high levels of distress and low QoL. Especially, role and social functioning are affected. Patients suffer most from fatigue, appetite loss, and insomnia. Using established cut-offs, all screening instruments were able to differentiate between patients regarding distress and QoL. Patients scoring above the cut-off were significantly more distressed and had a lower QoL. There was a medium-to-strong correlation between distress and QoL indicators. Conclusion Cancer-specific screening instruments seem to be able to identify treatment needs more specifically. They also allowed a better differentiation concerning QoL. The close link between distress and QoL needs to be recognized to enable a holistic approach to treatment and thereby optimize the quality of treatment.

Quality of life, psychological distress, and prognostic perceptions in patients with multiple myeloma

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“…20 Compared to other patients with hematologic malignancies, patients with MM have more pronounced QOL impairments across all domains. 22,23 Furthermore, nearly a quarter of patients with MM, regardless of treatment line, suffered from clinically significant depression, anxiety, or PTSD symptoms. Although prior studies have shown substantial distress in other patients with hematologic malignancies such as those with AML, the anxiety experienced by AML patients improved significantly with ongoing treatment, whereas distress was reported across the disease continuum in MM.…”

Quality of life in patients with lymphoproliferative neoplasms at diagnosis and after the first-line treatment

“…33 Similar conclusions were reached by other authors who showed that patients with more stress had worse QoL. 32 In our study, patients experienced negative emotions more often during the diagnosis period, likely due to the state of uncertainty about their future and a high level of mental tension. Of course, therapy can also evoke such emotions, but the appropriate support from family, friends and medical staff can reduce their severity.…”

“…31 Interestingly, in German observations conducted among 109 patients with HMs, the mean values in both spheres were much lower (37.4 ±37.6 for role functioning and 43.9 ±36.8 for social functioning). 32 It is possible that due to the changes described above, there were significant differences in the emotional domain, assessed in terms of mental tension, worry, irritation, and depression. As shown by the results of a crosssectional study conducted among 87 patients with HMs, a disorder in this sphere of life significantly affects one's global QoL.…”

Suicidal ideation, distress, and related factors in a population of cancer patients treated in a general acute hospital

“…These studies also suggest that supplementing item 9 with other screening measures may improve its usefulness in screening for suicide. Using screening instruments that assess population-specific risk factors rather than general ones might help increasing their sensitivity and specificity and simultaneously make them more parsimonious, as a study by Senf et al [19] suggests. This is a factor to be considered when deciding on the optimal screening tool in a certain health care context or for a certain population.…”