Congress Abstracts 2004

43

FATIGUE, PHYSICAL ACTIVITY, HEALTH STATUS, AND QUALITY OF LIFE IN STEM CELL TRANSPLANT PATIENTS. Eileen Hacker PhD, RN, AOCN^®, Carol Ferrans, PhD, RN, FAAN, and Farhad Ravandi, MD, University of Illinois at Chicago, Chicago, IL; and Koen van Besien, MD, University of Chicago, Chicago, IL.

Stem cell transplantation (SCT) potentially affects all aspects of a patient’s life, particularly during the acute post-transplant period. Problems such as fatigue and decreased physical activity may result in long-term consequences and diminished quality of life (QOL).

Very little is known about the patterns of fatigue, physical activity, health status, and QOL during this period. Obtaining subjective data is difficult as patients are frequently too ill to complete long questionnaires or participate in lengthy interviews. It is equally difficult to obtain objective physical activity data.

This study examined fatigue, physical activity, health status, and QOL immediately following SCT. The feasibility of using wrist actigraphy with a subjective event marker as a patient tolerable means for obtaining fatigue and physical activity data was also examined.

Wilson and Cleary’s Conceptual Model of Patient Outcomes guided the study.

This feasibility study used a prospective, repeated measures design. The convenience sample (n = 20) was drawn from two academic medical centers. Subjects were assessed over a five-day period pretransplant and immediately post-transplant (days 4–8). Subjects wore a wrist actigraph to measure physical activity. Subjects rated their fatigue intensity three times daily, entering this information directly into the subjective event marker of the wrist actigraph. At the end of both five-day periods, subjects completed the EORTC QLQ C-30 and the QLI.

Descriptive statistics, paired t-tests, and one-way repeated measures ANOVA were used to analyze the data.

Study results indicate that physical activity significantly declined following SCT (p < 0.001). This decline coincided with diminished physical (p < 0.05), emotional (p < 0.01), role (p < 0.01), and cognitive (p < 0.05) functioning. Symptoms experienced increased during the acute post-transplant period (fatigue, p < 0.001; pain, p < 0.001; nausea/vomiting, p < 0.001; sleep disturbances, p < 0.01; appetite loss, p < 0.001; and diarrhea, p < 0.001). Quality of life was significantly worse (p < 0.005). Findings suggest that SCT patients experience reduced physical activity, diminished functioning, increased symptoms, and poorer QOL during the acute post-transplant period. Findings demonstrate that it is feasible to obtain fatigue, physical activity, health status, and QOL information if the patient burden is reasonable. This information can be used to develop interventions that alleviate symptoms, increase physical activity, and improve health status and QOL.