Childhood Cancer Symptom Cluster: Leukemia and Health-Related Quality of Life.
Cheryl C Rodgers, Mary C Hooke, Olga A Taylor and 6 others
PMID 30767969WHAT IT FOUND
Children with leukemia had better quality of life after about 12 months, but those with worse symptom clusters had lower quality of life.
Assess fatigue, pain, sleep, nausea and depression together.
Key findings
01Mean health-related quality of life rose from 70.08 at the start of post-induction therapy to 75.77 at the start of maintenance therapy.
02More severe symptom clusters at the start of post-induction therapy were associated with lower health-related quality of life at both the start of post-induction therapy and the start of maintenance therapy.
03A more severe symptom cluster over time was associated with lower health-related quality of life at the start of maintenance therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not test a symptom-management intervention, so it cannot show that relieving the symptom cluster caused quality-of-life improvement. The sample was broad, from 3 to 18 years, so symptom patterns may differ by age group. Children with pre-existing cognitive disabilities were excluded, so results may not apply to them. Symptoms and quality of life were reported by children or parents, not measured objectively. Quality of life was measured only at the start of post-induction and maintenance, while symptoms were measured at four points, and the interval varied with treatment delays. Adherence to individualized symptom management plans was not measured and may have affected the results. Other factors such as adaptation to diagnosis and confidence in managing symptoms may have influenced quality of life.
Declared interests
The work was part of a larger study funded by the National Institutes of Health. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that treating the symptom cluster will improve quality of life. This study measured an association over time, not a tested symptom-management intervention.