| Objective To understand the current status of cancer-related fatigue,coping style,psychological flexibility,and quality of life in patients with acute leukemia(AL)chemotherapy;To explore the correlation among the four factors and construct a structural equation model among four factors and then clarify the magnitude and direction of the effect from those four factors;To provide a reference for helping patients to change their positive coping styles,reduce symptoms of cancer-related fatigue,maintain good psychological flexibility,and improve and improve quality of life.Methods Patients who were admitted to the Department of Hematology in Beijing People's Liberation Army General Hospital from December 2018 to September 2019 and were diagnosed with AL in the chemotherapy stage were selected as the research subjects.The Self-made general information questionnaire,Piper cancer-related fatigue scale(PFS),Medical coping style questionnaire(MCMQ),and Functional assessment of cancer therapy-Leukemia(FACT-Leu)were used to investigate,and 280 questionnaires were collected.Epidata 3.1 software was used to establish a database,and the data was analyzed by using SPSS 24.0 and AMOS 23.0 statistical software.According to the characteristics of the data,the demographic data and disease-related data of the present subjects were described using the ratio and the composition ratio,and the mean and standard deviation were used to evaluate the measurement data obeying the normal distribution.T-test of independent sampler,one-way ANOVA and multiple stepwise regression analysis were used to analyse the influencing factors of quality of life.Aiming at the coping styles among patients with AL chemotherapy,cancer-related fatigue,psychological elasticity and quality of life,Pearson correlation analysis was used to analyze the correlation among the four factors.A hypothetical structural equation model was established based on the coping styles,cancer-related fatigue, psychological elasticity,and quality of life.The structural equation analysis was performed by using AMONS 23.0.The maximum likelihood method is used for parameter estimation,and a well-fitting modified model is established.Results 1.A total of 332 questionnaires were distributed,319 questionnaires were returned,and 280 questionnaires were valid.The average age of the patients was 45.34±7.87,AML the majority of the patients;the subjects were mostly non-first-time treatment;58.6% of the patients with more than six months of disease;42.4% of the patients were at the stage of induced remission,33.2% of the patients stage of consolidation and 24.4% were maintained;170 patients(60.6%)had dry mouth or oral ulcers during the recent week.There were 192 patients with pain in the recent week with mild pain,and fatigue was the main factor in other reactions.2.The total score of quality of life from AL patients receiving chemotherapy was 106.69 ± 15.46,and the scores in each dimension from high to low were physiological status(18.68 ± 4.58),social / family status(16.8 ± 5.37),functional status(16.37 ± 6.37),and emotional status(12.57 ± 3.71).Among the leukemia-specific programs,the five items that had the greatest impact on the quality of life were "worry about infection","worry about new symptoms of the disease","fever annoys me","swelling" and " There are lumps or swelling." A univariate analysis of the impact of general data on the quality of life showed that BMI,education,payment method,disease diagnosis,course of treatment,chemotherapy course and oral ulcer had significant differences in total score of the quality of life in patients with AL chemotherapy(P <0.05).3.The coping style scores of AL patients with chemotherapy were compared with the norms,and the avoidance dimension scores were significantly higher than the norms(P <0.05);The avoidance dimension scores and the coping style total scores were different with significant statistical significance between AML and ALL patients.(p <0.05);Avoidance coping style scores were positively correlated with total quality of life scores and yield coping style scores were negatively correlated with total quality of life scores.All these results had significant statistical differences(P <0.05)),4.There were 231 patients(82.5%)with fatigue in the last week.The overall score of cancer-related fatigue was 3.92 ± 1.12,which was mainly moderate fatigue.The score of cognitive fatigue dimension between AML and ALL patients had significant statistical significance(p <0.05);The total score of fatigue was negatively correlated with the total quality of life score.The result had a significant statistical difference(P <0.05).5.The overall psychological elasticity score of patients was 65.37 ± 13.69,the score of tenacity dimension was 34.17 ± 9.89,the score of strength dimension was 21.47 ± 3.92,and the score of optimism dimension was 9.74 ± 1.74;The score of toughness dimension,optimism dimension and The total score of psychological elasticity was positively correlated with the total score of quality of life,and there were statistical differences(P <0.05).6.The structural equation constructed shows a negative effect between avoidance coping style and cancer-related fatigue(? =-0.221,P <0.001);a yielding coping style has a direct negative effect on quality of life(?=-0.198,P=0.028);In mental resilience,tenacity has a negative effect on cancer-related fatigue(? =-0.196,P=0.002),and there is a direct positive effect on optimism and quality of life(? = 0.221,P =0.024);cancer There was a direct negative effect between sexual fatigue and quality of life(? =-0.255,P =0.012).Conclusion: 1.The quality of life of patients with AL chemotherapy is poor,especially in terms of emotion,BMI,education level,payment method,disease diagnosis,course of disease,chemotherapy treatment and oral ulcer are the main factors that lead to poor quality of life in patients with AL chemotherapy.2.Patients with AL chemotherapy generally suffer from cancer-related fatigue,and the degree of fatigue is mainly moderate fatigue;mental resilience is generally better,but lacks optimism;most patients are more inclined to face the disease in an evasive manner.3.The medical coping style and psychological resilience of patients with AL chemotherapy directly or indirectly affect the quality of life of patients with AL chemotherapy.Cancer-induced fatigue affects the quality of life of patients as both a direct variable and an intermediate variable.Therefore,in the care of patients with AL chemotherapy,cancer-induced fatigue can be used as the main intervention indicator,and the medical coping style and psychological resilience as the secondary intervention indicators to improve the patient's quality of life. |
PDF Full Text Request