Quality of life and changes in the social dimension of hematopoietic stem cell transplants recipients

Machado, Celina Angélica Mattos; Marques, Angela da Costa Barcellos; Nogueira, Luciana de Alcantara; Lenhani, Bruna Eloise; Felix, Jorge Vinicius Cestari; Guimarães, Paulo Ricardo Bittencourt; Kalinke, Luciana Puchalski

doi:10.1590/0034-7167-2020-0644

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (1) • 2021 • https://doi.org/10.1590/0034-7167-2020-0644 copy

Quality of life and changes in the social dimension of hematopoietic stem cell transplants recipients

Calidad de vida y cambios en el dominio social de los receptores de trasplantes de células madre hematopoyéticas

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to assess/correlate health-related quality of life with the social dimension of hematopoietic, autologous and allogeneic stem cell transplant patients in the three years post-transplant.

Methods:

longitudinal, observational study with 55 patients, in a reference hospital in Latin America, from September 2013 to February 2019, using the Quality of Life Questionnaire-Core and Functional Assessment Cancer Therapy Bone Marrow Transplantation.

Results:

A total of 71% underwent allogeneic transplantation. The social dimension had low averages since the baseline stage (55, 21) and low scores (56) for quality of life in pancytopenia. There was a significant positive correlation between social dimension, quality of life in pancytopenia (p<0.01) and follow-up after hospital discharge (p<0.00). There is a significant difference (p<0.00) throughout the stages, however, not in terms of the type of transplant (p>0.36/0.86).

Conclusions:

patients with better assessments in the social dimension have a better quality of life. Interventions focusing on the multidimensionality of the quality of life construct are necessary.

Descriptors:
Quality of Life; Hematopoietic Stem Cell Transplantation; Social Isolation; Oncology Nursing; Neoplasms

	Pre-HSCT n=55	Pancytopenia n=50	Pre-discharge n=49	Post-HSCT 100 days n=41	Post-HSCT 180 days n=38	Post-HSCT 360 days n=32	Post-HSCT 2 years n=25	Post-HSCT 3 years n=22
	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD
HRQoL	76.82 17.69	56.67 20.27	69.05 19.17	74.39 21.28	76.97 20.27	71.35 20.62	73.67 21.07	81.44 15.20
SF	55.15 31.89	37.67 31.19	33.28 0.26	38.39 0.44	33.02 0.63	28.27 0.58	29.94 0.88	33.94 0.70
Spearman	0.23	0.34	0.26	0.44	0.63	0.58	0.88	0.70
p value	0.09	0.01^* * p<0.05; SF - Social Function; SD - Standard Deviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation	0.06	0.00^* * p<0.05; SF - Social Function; SD - Standard Deviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation	0.00^* * p<0.05; SF - Social Function; SD - Standard Deviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation	0.00^* * p<0.05; SF - Social Function; SD - Standard Deviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation	0.00^* * p<0.05; SF - Social Function; SD - Standard Deviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation	0.00^* * p<0.05; SF - Social Function; SD - Standard Deviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation

Scores	Pre-HSCT n=55	Pancytopenia n=50	Pre-discharge n=49	Post-HSCT 100 days n=41	Post-HSCT 180 days n=38	Post-HSCT 360 days n=32	Post-HSCT 2 years n=25	Post-HSCT 3 years n=22
Scores	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD	Mean SD
HRQoL (QLQ C-30)	76.82 17.69	56.67 20.27	69.05 19.17	74.39 21.28	76.97 20.27	71.35 20.62	73.67 21.07	81.44 15.20
SFWB	21.07 5.24	18.15 5.17	17.36 5.38	20.09 6.14	21.12 5.78	20.06 5.66	21.62 3.63	20.45 6.02
Spearman	-0.00	-0.19	-0.02	0.15	0.29	0.46	0.75	0.53
p value	0.95	0.16	0.88	0.33	0.07	0.00^* * p<0.05; SFWB - Social and Family Well-Being; SD - Standard Deviation, HRQoL - Health-Related Quality of Life, HSCT - Hematopoietic Stem Cell Transplant.	0.00^* * p<0.05; SFWB - Social and Family Well-Being; SD - Standard Deviation, HRQoL - Health-Related Quality of Life, HSCT - Hematopoietic Stem Cell Transplant.	0.0^* * p<0.05; SFWB - Social and Family Well-Being; SD - Standard Deviation, HRQoL - Health-Related Quality of Life, HSCT - Hematopoietic Stem Cell Transplant.

	Pre-HSCT		Pancytopenia		Pre-discharge		Post-HSCT 100 days		Post-HSCT 180 days		Post-HSCT 360 days		Post-HSCT 2 years		Post-HSCT 3 years
	Mean SD		Mean SD		Mean SD		Mean SD		Mean SD		Mean SD		Mean SD		Mean SD
	Aut n=16	All n=39	Aut n=16	All n=34	Aut n=16	All n=33	Aut n=13	All n=28	Aut n=12	All n=26	Aut n=11	All n=21	Aut n=7	All n=18	Aut n=4	All n=18
HRQoL	70.8 16.3	79.2 17.8	59.3 19.2	55.3 20.9	73.9 15.1	66.7 20.6	80.7 13.3	71.4 23.7	75.6 21.4	77.5 20.1	72.7 16.7	70.6 22.7	63.1 28.8	77.7 16.4	75.0 21.5	82.8 13.8
FS	62.5 33.6	52.1 31.1	46.8 29.3	33.3 31.5	46.8 28	35.8 35.3	71.7 32.1	52.9 40	86.1 18.5	67.9 36.7	81.8 26.3	75.4 29.6	59.5 40.6	85.1 22	66.6 40.8	79.6 33.1
Spearman HRQoL and SF	0.05	0.37	0.27	0.34	0.15	0.28	0.37	0.47	0.79	0.59	0.78	0.50	0.79	0.83	0.73	0.64
p value	0.82	0.02^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	030	0.04^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.57	0.10	0.20	0.01^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.00^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.00^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.00^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.02^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.03^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.00^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.26	0.00^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.
SFWB	20.8 6.9	21.1 4.4	17.0 6.5	18.6 4.3	16.7 6.7	17.6 4.6	19.9 7.9	20.1 5.2	20.8 5.7	21.2 5.9	20.7 7.9	19.7 4.4	21.5 4.8	21.6 3.1	16.8 11.3	21.3 4.1
Spearman HRQoL and SFWB	-0.46	0.26	-0.38	-0.06	-0.27	0.09	0.45	0.00	0.59	0.16	0.78	0.29	0.54	0.62	1	0.33
p value	0.06	0.10	0.14	0.72	0.30	0.59	0.11	0.96	0.04^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.42	0.00^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	0.19	0.20	0.00^* * p <0.05; Aut - Autologous; All - Allogeneic; SF - Social Function; SFWB - Social and Family Well-Being; SD - Standard Feviation, HRQoL - Health-Related Quality of Life; HSCT - Hematopoietic Stem Cell Transplantation.	-	0.01

Factors	HRQoL		Social function		Social/family well-being
Factors	F	p	F	p	F	P
Intercept	1362.54	0.00	262.49	0.00^* * p <0.05; HRQoL - Health-Related Quality of Life; F - Snedecor Statistics.	890.64	0.00
Group	0.25	0.61	0.84	0.36	0.03	0.86
Stage	6.18	0.00^* * p <0.05; HRQoL - Health-Related Quality of Life; F - Snedecor Statistics.	7.97	0.00^* * p <0.05; HRQoL - Health-Related Quality of Life; F - Snedecor Statistics.	6.83	0.00^* * p <0.05; HRQoL - Health-Related Quality of Life; F - Snedecor Statistics.
Groups/Stage	1.65	0.12	1.34	0.23	0.58	0.76

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[1] Corresponding author: Luciana Puchalski Kalinke E-mail: lucianakalinke@yahoo.com.br