Methods: A descriptive correlational design was used to achieve the purposes. The sample consisted of adolescents with cancer aged 10-15 years old who were receiving cancer treatments at both inpatient and outpatient departments of Ramathibodi Hospital from February to June 2018. The inclusion criteria included 1) adolescents with any type of cancer; 2) aged 10-15 years old; 3) has received at least one cycle of chemotherapy prior to participation in this study and is receiving chemotherapy during data collection; 4) able to communicate and understand Thai; 5) willing to participate in this study; and 6) no a diagnosis of mental illness or cognitive impairment. Two questionnaires, specifically the Memorial Symptom Assessment Scale 10-18 and the Pediatric Quality of Life Inventory Version 4.0, were scored by participants a week after their chemotherapy administration. The results were analyzed using descriptive statistics, while the relationships among variables were analyzed using Pearson’s product-moment correlational statistic.
Results: The results showed that the majority of participants were male adolescents with mean age of 12.74 years old (SD = 20.44), leukemia (48%) and mean length of time since diagnosis to study entry of 1.8 years (SD = 31.48, median = 1). In terms of symptom experiences, adolescents with cancer experienced 11.80 symptoms as the mean number of symptom (SD = 5.61). Dry mouth (80%), lack of appetite (68%), lack of energy (64%), nausea and drowsiness (56%), and diarrhea (52%) were addressed as the most common symptoms. The mean rating of symptom frequency was 0.82 (SD = 0.46; range 0-4). The five most frequent symptoms were dry mouth, numbness, lack of energy, feeling sad, and feeling irritable. The mean rating of symptom severity was 0.62 (SD = 0.41, range = 0-4). The five most severe symptoms were swelling of arms or legs, hair loss, nausea, changes in the way food tastes, and feeling sad. Regrading symptom distress, the mean rating of symptom distress was 0.40 (SD = 0.42; range = 0-4). They experienced changes in the way food tastes, swelling of arms or legs, lack of energy, hair loss, and nausea as the most distressing symptoms. There were differences in every dimension of each symptom. For almost all symptoms reported by the sample, the frequency scores were seemingly higher than severity and distress scores. Regarding quality of life, the mean overall quality of life showed a high level, which was 72.09 scores (SD = 16.70). In each domain they had high quality of life on social functioning (84 scores, SD = 15.94), emotional functioning (77.4 scores, SD = 19.63), school functioning (68.4 scores, SD = 23.03), and physical functioning (63.6 scores, SD = 23.61). The symptom experiences (the number of symptoms experienced, symptom severity and symptom distress) were found to have significantly negative correlation to quality of life (r = -0.597, -0.594, and -0.582; p < 0.05, respectively). The participants who experienced more symptoms rated lower quality of life at a significant level of 0.05. Moreover, experiencing more severe symptoms also significantly lowered quality of life. Participants with more distressing symptoms also reported lower quality of life.
Conclusion: These results can be a basis for initiation of nursing care plans to manage symptoms leading to increased quality of life in this population.