Quality of Life After Hodgkin Lymphoma Treatment
Quality of Life After Hodgkin Lymphoma Treatment
Purpose/Objectives: To describe changes in health-related quality of life (HRQOL) and to identify supportive care services used after treatment for Hodgkin lymphoma (HL) in young adults.
Design: A longitudinal, repeated-measures study design was used to test the feasibility of data collection at the conclusion of treatment for HL and at one, three, and six months post-treatment.
Setting: Participants were identified from two large comprehensive cancer centers in New England.
Sample: 40 young adults with newly diagnosed HL were enrolled in the study prior to the completion of chemotherapy or radiation.
Methods: Data were collected by interviews, standardized questionnaires, and medical record reviews.
Main Research Variables: HRQOL variables defined as symptom distress, functional status, emotional distress, and intimate relationships; use of specific supportive care services; and baseline demographic and disease-related information.
Findings: Results indicate that symptom distress improved at one month post-treatment and remained low at three and six months. Similarly, functional status improved at one month post-treatment. Only 13% of the sample had significant emotional distress at baseline, and this decreased to 8% over time. Patients placed high value on their intimate relationships (i.e., family and friends or sexual partners). A variety of supportive care services were used after treatment, the most common of which were related to economic issues. However, by six months post-treatment, services shifted toward enhancing nutrition and fitness.
Conclusions: The results from this study suggest that HRQOL in young adults with HL improved one-month post-treatment and that interest in using supportive care services was high.
Implications for Nursing: Facilitating the use of supportive care services at the end of cancer treatment appears to be an important part of helping young adults transition to survivorship.
Knowledge Translation: Supportive care services appear to be a vital component of the transition to survivorship and often change over time from an emphasis on economic issues to enhancing wellness through nutrition and fitness programs.
About 9,060 new cases of Hodgkin lymphoma (HL) occurred in 2012 in the United States, with 159,846 people receiving treatment or in remission (Leukemia and Lymphoma Society, 2012). HL affects a disproportionate number of young adults, both men and women. The probability of long-term, disease-free survival is excellent; indeed, individuals with stage I or II HL receiving curative regimens have an estimated five-year survival rate of 90%–95%, which decreases to 60%–80% for those with stage III or IV disease (American Cancer Society, 2010).
An illness such as cancer in young adults has the potential to interrupt the ability to attain expected developmental milestones, such as establishing personal independence, developing intimate relationships with friends and marital partners, and accomplishing career and work goals (Arden-Close, Pacey, & Eiser, 2010; Newton, 2000; Roper, McDermott, Cooley, Daley, & Fawcett, 2009). A serious life-changing event can suddenly alter a young adult's already vulnerable self-esteem and fragile identity, which can have a negative impact on health-related quality of life (HRQOL) (Sidell, 1997; Zebrack, 2000). Therefore, gaining an understanding of the impact of cancer on young adults' HRQOL is important because they may experience a deeper sense of loss than older adults, who have greater life experience and may be more accepting of adverse events (Schroevers, Ranchor, & Sanderman, 2003). This knowledge can serve as a basis for development of evidence-based interventions that are designed to enhance the transition to survivorship, minimize deleterious effects on accomplishing normal developmental tasks, and improve HRQOL.
Abstract and Introduction
Abstract
Purpose/Objectives: To describe changes in health-related quality of life (HRQOL) and to identify supportive care services used after treatment for Hodgkin lymphoma (HL) in young adults.
Design: A longitudinal, repeated-measures study design was used to test the feasibility of data collection at the conclusion of treatment for HL and at one, three, and six months post-treatment.
Setting: Participants were identified from two large comprehensive cancer centers in New England.
Sample: 40 young adults with newly diagnosed HL were enrolled in the study prior to the completion of chemotherapy or radiation.
Methods: Data were collected by interviews, standardized questionnaires, and medical record reviews.
Main Research Variables: HRQOL variables defined as symptom distress, functional status, emotional distress, and intimate relationships; use of specific supportive care services; and baseline demographic and disease-related information.
Findings: Results indicate that symptom distress improved at one month post-treatment and remained low at three and six months. Similarly, functional status improved at one month post-treatment. Only 13% of the sample had significant emotional distress at baseline, and this decreased to 8% over time. Patients placed high value on their intimate relationships (i.e., family and friends or sexual partners). A variety of supportive care services were used after treatment, the most common of which were related to economic issues. However, by six months post-treatment, services shifted toward enhancing nutrition and fitness.
Conclusions: The results from this study suggest that HRQOL in young adults with HL improved one-month post-treatment and that interest in using supportive care services was high.
Implications for Nursing: Facilitating the use of supportive care services at the end of cancer treatment appears to be an important part of helping young adults transition to survivorship.
Knowledge Translation: Supportive care services appear to be a vital component of the transition to survivorship and often change over time from an emphasis on economic issues to enhancing wellness through nutrition and fitness programs.
Introduction
About 9,060 new cases of Hodgkin lymphoma (HL) occurred in 2012 in the United States, with 159,846 people receiving treatment or in remission (Leukemia and Lymphoma Society, 2012). HL affects a disproportionate number of young adults, both men and women. The probability of long-term, disease-free survival is excellent; indeed, individuals with stage I or II HL receiving curative regimens have an estimated five-year survival rate of 90%–95%, which decreases to 60%–80% for those with stage III or IV disease (American Cancer Society, 2010).
An illness such as cancer in young adults has the potential to interrupt the ability to attain expected developmental milestones, such as establishing personal independence, developing intimate relationships with friends and marital partners, and accomplishing career and work goals (Arden-Close, Pacey, & Eiser, 2010; Newton, 2000; Roper, McDermott, Cooley, Daley, & Fawcett, 2009). A serious life-changing event can suddenly alter a young adult's already vulnerable self-esteem and fragile identity, which can have a negative impact on health-related quality of life (HRQOL) (Sidell, 1997; Zebrack, 2000). Therefore, gaining an understanding of the impact of cancer on young adults' HRQOL is important because they may experience a deeper sense of loss than older adults, who have greater life experience and may be more accepting of adverse events (Schroevers, Ranchor, & Sanderman, 2003). This knowledge can serve as a basis for development of evidence-based interventions that are designed to enhance the transition to survivorship, minimize deleterious effects on accomplishing normal developmental tasks, and improve HRQOL.
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