SAN DIEGO, CaliforniaFew studies have addressed the psychological
effect of multiple myeloma, even though the disease has a discouraging
prognosis and is often associated with significant pain. To learn more about
this issue, Angela Poulos, RN, CNS, MS, a clinical nurse specialist in
radiation oncology at the Mayo Clinic, examined the link between pain, mood
disturbance, and quality of life (QOL) in these patients.
The study, presented at the Oncology Nursing Society’s 26th Annual
Congress (abstract 146), was based on a survey mailed to 346 adult multiple
myeloma patients identified from the Mayo Clinic database. The survey included
the Brief Pain Inventory (short form), the Quality of Life Scale (cancer
patient version), Profile of Mood States, and a demographic tool. A total of
206 patients responded.
On the pain scale, 80 respondents reported no pain, 65 said they had mild
pain, 38 ranked their pain as moderate, and 22 reported severe pain.
Quality-of-life scores ranged from 1.6 to 9.4, with a mean of 6.2 (higher
scores correspond to a better quality of life). Older patients tended to report
higher quality of life.
The researchers found significant associations between total pain and mood
disturbance and between pain interference and mood disturbance. A joint
predictive model composed of pain, mood disturbance factors, and demographic
characteristics explained 74.6% of the variability in the quality-of-life
The researchers concluded that pain remains untreated in many multiple
myeloma patients, and that pain and mood disturbance scores are significant
predictors of quality of life. The study also suggests that patients with
multiple myeloma experience more mood disturbance than do patients with other
types of cancer (based on data from other studies).
Pain control and treatment of psychosocial disturbance may improve quality
of life in this patient group. The researchers recommend that adjunctive,
multidisciplinary measures be explored, including support groups, counseling,
and routine assessments of pain control in the outpatient setting.