Congress Abstracts 2004

44

DEPRESSION AND FATIGUE IN LYMPHOMA STEM CELL TRANSPLANT PATIENTS. Majeda El Banna, MSN, Ann Berger, PhD, RN, AOCN^®, Lynne Farr, PhD, Barbara Friesth, DNS, RN, and Elizabeth Schreiner, BSN, RN, University of Nebraska Medical Center, Omaha, NE.

Oncology nurses are working with an increasing number of stem cell transplant (SCT) patients, yet research regarding symptoms during and after SCT is scarce. Nurses need information regarding symptoms experienced by lymphoma patients who undergo SCT in order to provide quality care.

Therefore, the purpose of this longitudinal study was to describe patterns of and relationships between depression and fatigue before treatment, during chemotherapy, and in the recovery period in SCT patients. A secondary purpose was to describe the patterns of the dimensions of fatigue (behavioral/severity, sensory, cognitive/mode, and affective/emotional meaning) and their relationships to depression.

The Piper Integrated Fatigue Model guided this investigation.

A repeated measures descriptive design was used to collect data from 27 Hodgkin’s and non-Hodgkin lymphoma patients undergoing SCT at a midwestern university. Patients mean age was 49 years (SD = 13.71). Patients completed the Piper Fatigue Scale (PFS) and the Center of Epidemiologic Studies-Depression Scale (CES-D) at baseline, two days before transplantation (day –2), and during the immediate recovery period (day +2, day +7, and day +14). Days are numbered with respect to the transplant day (day zero). The tool’s validity and reliability had been documented in patients with cancer.

Descriptive statistics were obtained and data analyzed using RM-ANOVA and correlations.

Results showed the highest depression and fatigue (total and all dimensions) were reported at day +7. RM-ANOVA results confirmed that all depression and fatigue scores (total and all dimensions) changed significantly from baseline to day +7. Correlations between depression and fatigue scores (total and all dimensions) varied at different points in time. The highest relationships were reported at day +2 and ranged (r = 0.622–0.952, p < 0.05–0.001). These findings indicate that day +7 is the time when these symptoms were most intense and that they were correlated at all times. Clinical implications are that depression and fatigue peak approximately seven days after SCT and that assessment of these symptoms are important before, during, and after transplant.