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To identify symptom clusters in haematological malignancy patients during chemotherapy and determine the factors associated with different symptom clusters.
A cross-sectional study.
Convenience sampling was used to investigate haematological malignancy patients hospitalised for chemotherapy at a tertiary teaching hospital in Chengdu, China, from January 2021 to December 2023. Participants completed the Chinese version of the Condensed Memorial Symptom Assessment Scale. Hierarchical cluster analysis was used to identify symptom clusters; univariate analyses and logistic regression analyses were used to determine their related factors. This study was reported following the STROBE checklist.
A total of 600 participants were included in the study. We have identified the psychological, sleep, pain-fatigue, gastrointestinal-asthenia symptom clusters in haematological malignancy patients during chemotherapy. Binary logistic regression analysis indicated that being female and having lactate dehydrogenase levels of 220 IU/L or higher are associated with an increased risk for the psychological symptom cluster. The sleep symptom cluster is more likely to occur in females, those with a prognostic nutritional index < 45, lactate dehydrogenase ≥ 220 IU/L and platelet-to-lymphocyte ratio ≥ 107.85. Female, the prognostic nutritional index < 45 and age ≥ 60 years are correlated with the pain-fatigue symptom cluster. The gastrointestinal-asthenia symptom cluster is related to female, a diagnosis of acute leukaemia or lymphoma, lactate dehydrogenase ≥ 220 IU/L and prognostic nutritional index < 45.
Adult haematological malignancy patients undergoing chemotherapy experience multiple symptoms that can be further divided into four symptom clusters. The occurrence of symptom clusters is influenced by a combination of patient sociodemographic characteristics, disease conditions and biochemical indicators.
The symptom burden is a major issue for haematological malignancy patients during chemotherapy. Health caregivers should focus on the connection between symptoms rather than individual symptoms when developing and providing interventions. Identifying the factors influencing symptom clusters in haematological malignancy patients should be the basis for accurate, efficient and cost-effective interventions.
The patients completed the questionnaires during the data collection in this study.
Quarantine during the COVID-19 pandemic resulted in longer-term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID-19.
Lockdowns and restrictions during the COVID-19 pandemic result in longer-term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle-strengthening programme for elderly people.
A parallel-group, assessor-blinded randomised controlled trial was performed according to CONSORT guidelines.
This study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep- and diet-related health education. The OEP group also received a 12-week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale-15 (GDS-15) and the 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks.
Physical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, −2.78; TUGT, −3.73; BBS, 2.17; GDS-15, −0.72; SF-12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, −0.10; GDS-15, 1.07; SF-12 MCS, −5.95; all p < .001).
Our findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID-19 pandemic.
Relevance to clinical practice: Otago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer-term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID-19 pandemic period.
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