造血幹細胞移植後病人之生活品質及症狀探討

Quality of Life and Symptoms After Hematopoietic Stem Cell Transplantation

本研究目的為瞭解接受造血幹細胞移植後病人的症狀、生活品質及相關因素，採橫斷式描述相關性研究，於北部某醫學中心收案，以結構式問卷訪談152位個案，問卷包括基本屬性、疾病特性、症狀嚴重度及生活品質量表(FACTBMT)。結果發現病人症狀發生率前五項為疲倦、口乾、女性月經失調、皮膚脫屑、癢及精神不集中，各佔50.0% 以上，症狀嚴重度平均為1.24 分(SD±1.28)，前三項為女性月經失調、疲倦及性生活改變，同時發現在異體移植、移植1 年內、移植後收入減少及病人活動能力差者，其症狀嚴重度較高，達統計上差異。生活品質總分數為111.77 分(SD±23.81)，移植1 年內者的生活品質總分較移植1年以上者生活品質總分為低，具統計差異(t =-2.53, p=.014)。研究發現症狀嚴重度與生活品質呈負相關，達顯著差異(r ＝ -.71, p ＜ .001)，表示病人症狀嚴重度程度越高其生活品質越差。研究調查發現移植後病人須承受許多的症狀困擾，且需長期的門診追蹤及醫療照護，未來將研究結果運用於臨床的症狀處理，以提供病人更好的照顧品質及提升滿意度。

This study used a descriptive-correlation design in a medical center. A total of 152 patients were enrolled in the survey. A structured questionnaire was used to obtain demographic data as well as information on symptom severity and quality of life (QoL). The results showed that the five most common symptoms were fatigue, dry mouth, menstrual disorders, skin scaling, and itching, and inattentiveness, each of which had an incidence of more than 50%. The average score was 1.24 ±1.28; the three most common symptoms among patients were menstrual disorders, fatigue, and changes in sex life. Furthermore, the results demonstrated that patients with allogeneic transplantation, transplants for less than 1 year, reduced income after transplantation, and reduced performance in physical activities had a significantly higher risk of suffering from more severe symptoms. The overall QoL score based on the FACT-BMT was 111.77±23.81. Notably, the average score of patients who were transplanted within 1 year was signifi cantly lower than that of patients who were not transplanted within 1 year (t = -2.53, p = .014). We showed that the scores of symptom severity and those of QoL were negatively correlated (r = -.71, p < .01). Our study raised awareness of patient suffering after hematopoietic stem cell transplantation and demonstrated these patients’ need for care. To address this issue, more studies are required to improve the integration of multidisciplinary professional care.