Longitudinal Research on Adolescents and Young Adults with Bone Tumor after Limb Salvage Surgery

• Main Authors: Lo Wan Chen, 羅琬真
• Other Authors: Hsiu Mei Huang
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/w23mxq

碩士 === 國立臺北護理健康大學 === 護理研究所 === 107 === Background: Surgery is one of the treatment methods for bone tumor, and amputation used to be the predominant surgical method applied. However, the advance in chemotherapy, diagnostic radiology, and surgical techniques has enabled most patients to retain their limbs through limb salvage surgery. Nevertheless, such surgery involves excising a considerable part of the infected bone for tumor removal, after which the damaged bone requires suitable reconstruction. This can substantially affect patients’ muscle strength, joint movement, recovery of limb functions, and gait. Moreover, the pain associated with bone reconstruction can restrict patients’ mobility and prevent them from independently performing activities of daily living, which can in turn hinder their interpersonal relationships. Objective: This study compared the pre-surgery and post-surgery levels of pain, symptom distress, physical activity, and quality of life between adolescents and young adults with bone tumor. Methods: A longitudinal research design was adopted, targeting adolescents and young adults who had been diagnosed with primary bone tumor and received their first limb salvage surgery. A total of 20 participants were recruited in a medical center in northern Taiwan through convenience sampling, and their data were collected using a structured questionnaire that consisted of items covering the respondent’s demographic information and disease attributes, the Brief Pain Inventory (Chinese Version), a symptom distress scale, the International Physical Activity Questionnaire (Taiwan Version), and the Short Form (36) Health Survey. The data were collected at three time points, namely one month before surgery, one month after surgery, and three months after surgery. The software for data analysis was SPSS 25.0 for Windows. Results: Of the three time points, one month after surgery was the time the level of pain affected the participants the most, and the participants’ physical activity was also affected the most at this time point. The quality of life was worst one month after surgery, but as the level of pain gradually alleviated with time, physical activity increased and the quality of life improved. By contrast, symptom distress worsened as time passed. The level of pain and symptom distress did not affect the physical component summary (PCS) of quality of life, but total equivalent physical activity and PCS exhibited a significant difference (p=.04), suggesting that PCS deteriorated with increased physical activity. In terms of the mental component summary (MCS) of quality of life, significant differences were observed in the level of pain, symptom distress, and equivalent physical, suggesting that MCS deteriorated with increased level of pain, symptom distress, and physical activity. Conclusion and Clinical: The findings of this study can help clinical and nursing personnel understand the process of which patients with bone tumor recover from limb salvage surgery. Patients invariably expect an instant recovery after receiving surgery; however, they have to endure the discomfort of chemotherapy and post-surgery limitation to limb mobility, which occur concurrently and are interrelated with each other. Clinical and nursing personnel are advised to incorporate considerations for patients’ pre-surgery and post-surgery level of pain, symptom distress, physical activity, and quality of life into the provision of personalized care and subsequent recovery plans, thus increasing the patients’ confidence in their ability to confront the negative effect on their quality of life. Nevertheless, more in-depth research is required for the adequate provision of care.