Pain, mood disturbance, and quality of life in patients with multiple myeloma.

PURPOSE/OBJECTIVES: To determine the levels of pain intensity and pain interference in patients with multiple myeloma, the relationship between pain and mood disturbance, and factors that influence quality of life (QOL). DESIGN: Descriptive correlational mailed survey. SETTING: A private tertiary institution in the Midwest. SAMPLE: Convenience sample of 346 adult patients with multiple myeloma identified through an institutional database, 206 of whom responded to the surveys. METHODS: Mailed, self-administered questionnaires: Brief Pain Inventory Short Form, Profile of Mood States, QOL Scale (Cancer Patient Version), and a demographic tool. Treatment details were obtained from the database on subjects consenting to participate. MAIN RESEARCH VARIABLES: Pain intensity, pain interference, psychologic functioning, and QOL. FINDINGS: 29% (n = 60) of subjects reported moderate to severe pain intensity. Significant associations were found between pain intensity and mood disturbance scores. As pain interference increased, so did levels of mood disturbance. A joint predictive model explained 74.6% of the variability in total QOL scores. CONCLUSIONS: Cancer pain remains undertreated, and patients with myeloma are no exception. Pain and mood disturbance scores were significant predictors of QOL in this group of patients. Subjects with multiple myeloma reported higher levels of mood disturbance than patients with cancer from other studies. IMPLICATIONS FOR NURSING PRACTICE: The oncology nurse is in a key position to facilitate ongoing, adequate pain and psychosocial assessment of patients with myeloma. Further study is needed to determine if control of pain and mood disturbance factors has a positive effect on the various domains of QOL.