Pain and Mood Disturbance Predict Patient Quality of Life

SAN DIEGO, California—Few 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 scores.

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.