ObjectivesTo investigate the psychological emotion and physical symptoms of patients with hematologic disease undergoing hematopoietic stem cell transplantation (HSCT), to analyze the relationship between the two and their influencing factors, and to provide reference for nursing intervention.
MethodsFrom March 2018 to May 2019, 70 cases of patients with hematologic disease undergoing HSCT who were admitted to the Department of Hematology, West China Hospital of Sichuan University were collected as study subjects. Collect general clinical data of patients. The Huaxi Emotional-Distress Index (HEI) and Patient Health Questionnaire (PHQ) -15 were used before the transplantation (T1), during pretreatment period (T2), myelosuppression period (T3), and after the recovery of blood routine examination indicators (T4), to evaluate psychological emotion and physical symptoms of patients. The HEI and PHQ-15 scores at different time points were compared using analysis of variance for repeated measurement. Comparison of gender, education, marital status, occupation, type of disease, source of hematopoietic stem cells, type of HSCT, ratio of somatic symptoms, and proportion of patients with adverse psychological and emotional conditions were performed using chi-square test. This study was reviewed by Biomedical Ethics Sub-committee of West China Hospital of Sichuan University (approval number: 2016 no. 73). All patients signed the informed consent for clinical research at the time of enrollment.
Results① All 4 questionaires of 64 patients (91.4%) were qualified in this study. Among them, there were 38 male patients (59.4%) and 26 female patients (40.6%). The age ranged from 18 to 61 years, with an average of 39.1 years. All 64 patients received HSCT for the first time. ② From T1 to T4, PHQ-15 scores of all 64 patients received HSCT were (3.6±2.6), (13.8±5.5), (12.3±5.8), and (8.6±5.2) points; HEI scores were (4.1±4.1), (10.0±5.7), (8.5±5.2) and (6.3±4.7) points. Differences between the HEI scores (F=173.716,P=0.000), PHQ-15 scores (F=175.060,P=0.000) at different time points were statistically significant. ③ At T1, there were significant differences in the incidence rates of physical symptoms in patients receiving different types of HSCT (χ2=6.688,P=0.035). There were statistically significant differences in the incidence rates of adverse psychological emotions in patients with different marital status, educational levels, and disease type (χ2=5.486,P=0.033;χ2=10.127,P=0.038;χ2=6.574,P=0.037). At T2, there were statistically significant differences in the incidence rates of adverse psychological emotions of patients with different educational levels and HSCT types (χ2=18.018,P=0.001;χ2=6.112,P=0.047). At T3, there were statistically significant differences in the incidence rates of adverse psychological emotions of patients with different marital status, hematopoietic stem cell sources and HSCT types (χ2=5.579,P=0.031;χ2=6.087,P=0.048;χ2=8.304,P=0.016). At T4, the differences in the incidence rates of physical symptoms between patients with different education levels and disease types and HSCT types were statistically significant (χ2=12.598,P=0.013;χ2=7.537,P=0.023;χ2=6.855,P=0.032). The difference of incidence rates of adverse psychological emotions in patients with different educational levels was also statistically significant (χ2=15.596,P=0.004).
ConclusionsPsychological emotion and physical symptoms scores of patients with hematologic disease before and after receiving HSCT showed a trend of increase first and decrease later. The incidence rates of psychological emotions and physical symptoms at different time points were affected by different marital status, educational levels, disease types, hematopoietic stem cell sources and transplant types. Clinical nursing practice should pay attention to the psychological emotion and physical symptoms of patients during HSCT, especially the pretreatment period, and take targeted nursing interventions.
