Distress prior to undergoing hematopoietic stem cell transplantation: demographic and symptom correlations and establishing a baseline.
BACKGROUND
Distress can arise from physical and/or psychosocial impairments and has been documented in patients after hematopoietic stem cell transplantation in the outpatient setting. It has not been evaluated in inpatients admitted to undergo the transplant, nor has potential correlations with length of hospital stay, physical function, and pain after receiving the transplant.


OBJECTIVE
To measure distress in patients admitted to the hospital to undergo hematopoietic stem cell transplantation, and to evaluate potential correlations with length of hospital stay, physical function, pain, and depression/anxiety.


METHODS
Eighty patients were given a questionnaire to report levels of distress and physical and psychosocial functioning. Hierarchical multiple regression analysis was used to test the relationship of demographic and transplant factors with length of stay (LOS), distress, presence of pain, and depression/anxiety.


RESULTS
Patients reported pretransplant distress with an average score of 2.2 out of 10, and 16 out of 80 patients reported clinically relevant distress. Pain was reported by 42.5% of patients, and 28.8% reported depression/anxiety. Physical functioning was generally high. Distress was correlated with depression/anxiety (P-value <0.01) and pain (0.04) but not with LOS, physical function, patient age, or transplant type.


CONCLUSIONS
LOS after receiving stem cell transplant was not related to pretransplant distress. Distress exists pretransplant but is generally low. Pain and the presence of depression/anxiety may be risk factors for distress. Measuring distress prior to transplant gives a baseline from which to measure changes, potentially leading to earlier intervention.
Department of Physical Medicine & Rehabilitation.
Sean Robinson
SR
Smith
Adult Blood and Marrow Transplantation Program, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
Mary Elizabeth
ME
Hobson
Department of Physical Medicine & Rehabilitation.
Andrew J
AJ
Haig
BMT rehabilitation; Distress Thermometer; bone marrow transplant; cancer rehabilitation; patient-reported outcomes; symptom management
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