PREDICTING FACTORS OF HEALTH-RELATED QUALITY OF LIFE AMONG PERSONS WITH HEMATOLOGICAL MALIGNANCY RECEIVING CHEMOTHERAPY

Abstract

The purpose of this cross-sectional descriptive correlation study was to examine a causal model of social support, symptom distress, functional status, general health perception on health-related quality of life (HRQOL) among persons with hematological malignancy receiving chemotherapy, within a theoretical framework derive from Wilson and Cleary’s health-related quality of life model. Three hundred and one participants with hematological malignancies were randomly selected from four University hospitals and one regional hospital in Thailand. The data were collected by the Personal Data form, the Medical Record form, the Social Support Questionnaire (SSQ), The Memorial Symptoms Assessment Scale (MSAS), the Inventory of Functional Status-Cancer (IFS-CA), the General Health Perception subscale of SF-36 (GHP), and the Functional Assessment of Cancer Treatment-Neutropenia (FACT-N). The Cronbach's alpha of SSQ, MSAS, IFS-CA, GHP, and FACT-N were 0.88, 0.92, 0.76, 0.75, and 0.88, respectively. The Structural Equation Modeling in Mplus version 6.12 was used to analyze the data. The analysis was partly supported the hypothesis model. The results, however, revealed that the hypothesized model good fit to the empirical data. The fit indices chi-square = 45.105, degree of freedom =32, p-value = 0.062, Comparative fit Index =0.988, Tucker-Lewis Fit Index=0.980, and Root Mean Squared Error of Approximation = 0.024, showed the good fit. The model explained 65.5% of the variance of HRQOL. Symptom distress was the most influential factor affecting HRQOL. It had statistically significant negative effect on functional status and general health perception (β= -0.53, p <.05). Functional status had statistically significant positive indirect effect on HRQOL though general health perception (β=0.38, p <.05) where as general health perception had statistically significant positive direct effect on HRQOL (β=0.52, p <.05). Finally, social support had statistically significant direct effect on HRQOL (β=0.42, p <.05). These finding demonstrated that symptom distress can impact ability to perform functional status. Such alteration of functional status affect patient's perception about their own health. All of these can contribute to a decline in HRQOL-related neutropenia. Above all social support can promote HRQOL-related neutropenia in persons with hematological malignancy receiving chemotherapy. The present study finding can guide oncology nurses to conduct nursing intervention for improving HRQOL in persons with hematological malignancy.