A Longitudinal Study On Correlated Symptoms Of The Patients With Colorectal Cancer Undergoing Adjuvant Chemotherapy And Influence On Quality Of Life

ObjectiveThe purpose of the study was to identify the effects of correlated symptoms on quality of life by investigating the frequency, severity and distress of symptoms and quality of life in postoperative patients with colorectal cancer during adjuvant chemotherapy cycles longitudinally, in hope that evident can be provided for medical staff who can make efficient ways to manage these symptoms to reduce the negative impact of chemotherapy and improve patients’ quality of life eventually.MethodsConvenience sampling was used in this study. Postoperative patients with colorectal cancer undergoing adjuvant chemotherapy with XELOX as well as meeting the criteria were investigated with demographic charts, Memorial Symptom Assessment Scale(MSAS) and Quality of Life Instruments for Cancer Patients-Colorectal Cancer(QLICP-CR) three times (first cycle, forth cycle and eighth cycle of XELOX) during December,2011and January,2013. Data was analyzed by SPSS17.0Results1The most common correlated symptoms of colorectal cancer patients during adjuvant chemotherapy were:lack of energy, lack of appetite, nausea, nervousness, worry, numbness/tingling in hands/feet, change in food preference, a feeling of’I don’t look like myself’ and changes in skin.2Among the symptoms above, lack of energy and lack of appetite ranked the highest in every dimension of MS AS. There was a significant increase in incidence rate in these symptoms:numbness/tingling in hands/feet, a feeling of’I don’t look like myself’ and changes in skin. Meanwhile, there was a significant increase in frequency dimension in symptoms:lack of energy, lack of appetite and numbness/tingling in hands/feet. Furthermore, a significant increase was found in distress dimension of seven symptoms, which were lack of energy, lack of appetite, worry, numbness/tingling in hands/feet, change in food preference, a feeling of’I don’t look like myself’ and changes in skin.3There were no significant changes in general quality of life during chemotherapy. However, there was a significant decrease in psychological, social domain, common symptom and side effect domain and a significant increase in special domain.4During the chemotherapy cycles, there was a significantly negative correlation between MSAS and general QOL.5Multiple linear regressions showed:Nausea and lack of energy accounted for28.6%of the variance in quality of life in early stage of chemotherapy. Lack of energy, lack of appetite and the feeling’I don’t look like myself’ accounted for38.2%of the variance in quality of life in mid stage of chemotherapy. Lack of energy, change in food preference, numbness/tingling in hands/feet and changes in skin accounted for63.7%of the variance in quality of life in later stage of chemotherapy.Conclusions1The most common correlated symptoms of colorectal cancer patients during adjuvant chemotherapy were:lack of energy, lack of appetite, nausea, nervousness, worry, numbness/tingling in hands/feet, change in food preference, a feeling of’I don’t look like myself’ and changes in skin. Their frequency, severity and distress changed constantly, thus, sufficient assessments need to be done for symptom management.2Though there were no significant changes in general quality of life during chemotherapy. There was a significant decrease in psychological domain and social domain common symptom and side effect domain, which indicates care and support are needed to improve quality of life.3The significantly negative correlation between MSAS and general QOL demonstrates the higher score MSAS gets, the poorer QOL can be.4Correlated symptoms influencing quality of life were different in each period of chemotherapy. Thus, targeted nursing interventions are need. According to the results, the effects of correlated symptoms decreased over time which indicates that proper interventions need to be taken in early period of chemotherapy.