Fatigue and physical activity in patients undergoing hematopoietic stem cell transplant.
OBJECTIVE
To examine the patterns of fatigue, physical activity, health status, and quality of life before and after high-dose chemotherapy and hematopoietic stem cell transplantation (HSCT) and to examine the feasibility of obtaining real-time fatigue and physical activity data.


METHODS
Prospective, repeated measures.


METHODS
Two midwestern academic medical centers.


METHODS
Convenience sample of autologous or allogeneic patients undergoing HSCT (N = 20 baseline, N = 17 post-transplant).


METHODS
Subjects were assessed over a five-day period before and after HSCT for a total of 10 days. Subjects rated fatigue intensity three times daily and wore a wrist actigraph to measure physical activity. At the end of both five-day periods, subjects completed measures of perceived health status (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) and life satisfaction Quality of Life Index).


METHODS
Fatigue, physical activity, perceived health status, and quality of life.


RESULTS
Study results indicate that fatigue significantly increased and physical activity decreased following high-dose chemotherapy and HSCT. The decline coincided with diminished physical, emotional, role, and cognitive functioning. The symptoms that patients experienced (i.e., fatigue, pain, nausea and vomiting, sleep disturbances, appetite loss, and diarrhea) increased during the acute post-transplant period. No significant changes in life satisfaction were found.


CONCLUSIONS
The study findings suggest that patients receiving high-dose chemotherapy followed by HSCT experience increased fatigue, reduced physical activity, diminished functioning, and poorer quality of life immediately after transplant. Findings demonstrate that real-time fatigue and physical activity data can feasibly be collected in acutely ill patients.


CONCLUSIONS
Patients undergoing HSCT require considerable supportive nursing care immediately following transplant. Clinicians and researchers need to strive for effective symptom management to improve the likelihood of successful outcomes.
Danaher
Eileen Hacker
EH
Department of Medical Surgical Nursing, College of Nursing, University of Illinois, Chicago, IL, USA. ehacker@uic.edu
Ferrans
Carol
C
Verlen
Ellen
E
Ravandi
Farhad
F
van Besien
Koen
K
Gelms
Julie
J
Dieterle
Natalie
N