Article

A Pilot Study of Activity Engagement in the First Six Months After Stem Cell Transplantation

Kathleen Doyle Lyons

Jay G. Hull

Lynn D. Root

Elizabeth Kimtis

Anna Schaal

Diane M. Stearns

Idalina C. Williams

Kenneth R. Meehan

Tim Ahles

exercise, stem cell transplantation
ONF 2010, 38(1), 75-83. DOI: 10.1188/11.ONF.75-83

Prpose/Objectives: To describe the natural pace and pattern of activity resumption in the first six months after stem cell transplantation (SCT).

Design: Longitudinal, descriptive survey.

Setting: Bone marrow transplantation program of a National Cancer Institute-designated comprehensive cancer center in the northeastern United States.

Sample: 18 men and 18 women who underwent either autologous (83%) or allogeneic (17%) transplantation.

Methods: Participants were surveyed 30 days, 100 days, and six months after SCT. Descriptive statistics were followed by exploratory linear mixed modeling with factors of time, gender, and the interaction between time and gender.

Main Research Variables: A modified checklist version of the Activity Card Sort was used to measure activity retention.

Findings: Participants generally were performing 49% of their usual activities 30 days after transplantation, 70% of their premorbid activities 100 days after transplantation, and 77% of their premorbid activities six months after transplantation. Level of activity engagement increased over time, with the greatest changes observed from 30-100 days after SCT. Men retained more of their activities than women in the domains of low physical-demand leisure and social activities.

Conclusions: Rehabilitation screening may be most helpful in the period from 100 days to six months, when activity levels begin to plateau. Activity recovery may differ for men and women; future research should explore how this could affect rehabilitation needs.

Implications for Nursing: Nurses can use structured surveys to explore and promote patients' satisfaction with and ability to engage in daily activities and ensure appropriate referrals to rehabilitation during recovery from SCT.

Jump to a section

    References

    Andorsky, D. J., Loberiza, F. R., & Lee, S. J. (2006). Pre-transplantation physical and mental functioning is strongly associated with self-reported recovery from stem cell transplantation. Bone Marrow Transplantation, 37, 889-895. doi: 10.1038/sj.bmt.1705347
    Baker, F., Curbow, B., & Wingard, J. R. (1991). Role retention and quality of life of bone marrow transplant survivors. Social Science and Medicine, 32, 697-704.
    Baum, C. M., & Edwards, D. (2001). Activity Card Sort. St. Louis, MO: Washington University School of Medicine.
    Baum, C. M., & Edwards, D. (2008). Activity Card Sort (2nd ed.). Bethesda, MD: American Occupational Therapy Association Press.
    Bieri, S., Roosnek, E., Helg, C., Verholen, F., Robert, D., Chapuis, B., … Chalandon, Y. (2008). Quality of life and social integration after allogeneic hematopoietic SCT. Bone Marrow Transplantation, 42, 819-827. doi: 10.1038/bmt.2008.253
    Byar, K. L., Eilers, J. E., & Nuss, S. L. (2005). Quality of life 5 or more years post-autologous hematopoietic stem cell transplant. Cancer Nursing, 28, 148-157.
    Cordingley, L., Webb, C., & Hiller, V. (1997). Q methodology. Nurse Researcher, 4(3), 31-45.
    DeMarinis, V., Barsky, A. J., Antin, J. H., & Chang, G. (2009). Health psychology and distress after haematopoietic stem cell transplantation. European Journal of Cancer Care, 18(1), 57-63. doi: 10.1111/j.1365-2354.2008.00931.x
    Everard, K. M., Lach, H. W., Fisher, E. B., & Baum, M. C. (2000). Relationship of activity and social support to the functional health of older adults. Journal of Gerontology: Psychological and Social Sciences, 55, 208-212.
    Goldman, L., & Ausiello, D. (Eds.). (2008). Cecil medicine. Philadelphia, PA: Saunders Elsevier.
    Harder, H., Cornelissen, J. J., Van Gool, A. R., Duivenvoorden, H. J., Eijkenboom, W. M., & van den Bent, M. J. (2002). Cognitive functioning and quality of life in long-term adult survivors of bone marrow transplantation. Cancer, 95, 183-192. doi: 10.1002/cncr.10627
    Heinonen, H., Volin, L., Uutela, A., Zevon, M., Barrick, C., & Ruutu, T. (2001a). Gender-associated differences in the quality of life after allogeneic BMT. Bone Marrow Transplantation, 28, 503-509. doi: 10.1038/sj.bmt.1703158
    Heinonen, H., Volin, L., Uutela, A., Zevon, M., Barrick, C., & Ruutu, T. (2001b). Quality of life and factors related to perceived satisfaction with quality of life after allogeneic bone marrow transplantation. Annals of Hematology, 80, 137-143.
    Katz, N., Karpin, H., Lak, A., Furman, T., & Hartman-Maeir, A. (2003). Participation in occupational performance: Reliability and validity of the Activity Card Sort. OTJR: Occupation, Participation, and Health, 23, 10-17.
    Kirchhoff, A. C., Leisenring, W., & Syrjala, K. L. (2010). Prospective predictors of return to work in the 5 years after hematopoietic cell transplantation. Journal of Cancer Survivorship, 4(1), 33-44. doi: 10.1007/s11764-009-0105-2
    Kopp, M., Holzner, B., Meraner, V., Sperner-Unterweger, B., Kemmler, G., Nguyen-Van-Tam, D. P., & Nachbaur, D. (2005). Quality of life in adult hematopoietic cell transplant patients at least 5 yr after treatment: A comparison with healthy controls. European Journal of Haematology, 74, 304-308. doi: 10.1111/j.1600-0609.2004.00402.x
    Larsen, J., Nordstrom, G., Ljungman, P., & Gardulf, A. (2007). Factors associated with poor general health after stem-cell transplantation. Supportive Care in Cancer, 15, 849-857. doi: 10.1007/s00520-006-0200-0
    Lee, S. J., Fairclough, D., Parsons, S. K., Soiffer, R. J., Fisher, D. C., Schlossman, R. L., … Weeks, J. C. (2001). Recovery after stem-cell transplantation for hematologic diseases. Journal of Clinical Oncology, 19, 242-252.
    Lyons, K. D., Li, Z., Tosteson, T. D., Meehan, K., & Ahles, T. A. (2010). Consistency and construct validity of the Activity Card Sort (modified) in measuring activity resumption after stem cell transplantation. American Journal of Occupational Therapy, 64, 562-569. doi: 10.5014/ajot.2010.09033
    Lyons, K. D., Root, L. D., Kimtis, E., Schaal, A. D., Stearns, D. M., Williams, I. C., … Ahles, T. A. (2010). Activity resumption after stem cell transplantation. OTJR: Occupation, Participation and Health, 30, 20-28. doi: 10.3928/15394492-20091214-04
    Mosher, C. E., Redd, W. H., Rini, C. M., Burkhalter, J. E., & DuHamel, K. N. (2009). Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: A review of the literature. Psycho-Oncology, 18, 113-127. doi: 10.1002/pon.1399
    Pidala, J., Anasetti, C., & Jim, H. (2009). Quality of life after allogeneic hematopoietic cell transplantation. Blood, 114, 7-19. doi: 10.1182/blood-2008-10-182592
    Sachs, D., & Josman, N. (2003). The Activity Card Sort: A factor analysis. OTJR: Occupation, Participation and Health, 23, 165-176.
    Sherman, R. S., Cooke, E., & Grant, M. (2005). Dialogue among survivors of hematopoietic cell transplantation: Support-group themes. Journal of Psychosocial Oncology, 23, 1-24. doi: 10.1300/J077v23n01_01
    Socie, G., Mary, J. Y., Esperou, H., Robert, D. V., Aractingi, S., Ribaud, P., … Vexiau, P. (2001). Health and functional status of adult recipients 1 year after allogeneic haematopoietic stem cell transplantation. British Journal of Haematology, 113, 194-201.
    Syrjala, K. L., Langer, S. L., Abrams, J. R., Storer, B., Sanders, J. E., Flowers, M. E. D., & Martin, P. J. (2004). Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. JAMA, 291, 2335-2343. doi: 10.1001/jama.291.19.2335 291/19/2335
    Tierney, K., Facione, N., Padilla, G., & Dodd, M. (2007). Response shift—A theoretical exploration of quality of life following hematopoietic cell transplantation. Cancer Nursing, 30, 125-138.
    Wettergren, L., Sprangers, M., Bjorkholm, M., & Langius-Eklof, A. (2008). Quality of life before and one year following stem cell transplantation using an individualized and a standardized instrument. Psycho-Oncology, 17, 338-346. doi: 10.1002/pon.1240