Development of a conceptual model to illustrate the impact of multiple myeloma and its treatment on health-related quality of life

• Published in: Supportive care in cancer Vol. 23; no. 9; pp. 2789 - 2797
• Main Authors: Baz, R., Lin, H. M., Hui, A.-M., Harvey, R. D., Colson, K., Gallop, K., Swinburn, P., Laubach, J., Berg, D., Richardson, P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2015; Springer; Springer Nature B.V
• Subjects: Aged; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Care and treatment; Cross-Sectional Studies; Fatigue - psychology; Female; Health aspects; Humans; Male; Medical treatment; Medicine; Medicine & Public Health; Middle Aged; Models, Psychological; Multiple myeloma; Multiple Myeloma - drug therapy; Multiple Myeloma - psychology; Nursing; Nursing Research; Oncology; Original Article; Pain - psychology; Pain Medicine; Qualitative Research; Quality of Life; Rehabilitation Medicine; Surveys and Questionnaires; Health-related quality of life; Conceptual model; Multiple myeloma
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-015-2644-6

Purpose
Little qualitative research exploring the impact of multiple myeloma (MM) and its treatment on the health-related quality of life (HRQL) of patients has been published. This study aimed to explore the burden of MM symptoms and treatment and the impact of these on HRQL. A model was developed to illustrate key concepts and their interrelationships.
Methods
Patients with MM were recruited to this cross-sectional, qualitative study through a patient panel and at two clinical sites in the USA. An interview discussion guide was developed using a review of published literature and interviews with experienced MM clinicians. In-depth, semistructured telephone interviews with MM patients were conducted to explore their experiences of the disease and its treatment. Data were analyzed using a thematic analysis approach.
Results
Twenty MM patients at various stages of treatment participated in open-ended, semistructured interviews. Patients reported both current and previous MM symptoms; most had experienced fatigue and pain. Other commonly reported symptoms were fractures, anemia, neuropathy, aches, and infections. MM treatment was found to have a negative impact on patients’ HRQL; treatment-related adverse events included fatigue, neuropathy, insomnia, and gastrointestinal symptoms. MM treatment placed a substantial psychological and physical burden on patients, disrupting social activities, decreasing independence, and impacting on relationships. A model was developed to illustrate the relationship between these concepts.
Conclusion
The conceptual model developed in this study illustrates the many aspects of MM and its treatment and how they can have a negative impact on patients’ HRQL.