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Distress prior to undergoing hematopoietic stem cell transplantation: demographic and symptom correlations and establishing a baseline

Authors Smith S, Hobson L, Haig A

Received 5 April 2016

Accepted for publication 18 July 2016

Published 15 September 2016 Volume 2016:7 Pages 137—144


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Robert Howland

Sean Robinson Smith,1 Mary Elizabeth Hobson,2 Andrew J Haig1

1Department of Physical Medicine & Rehabilitation, 2Adult Blood and Marrow Transplantation Program, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA

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.
Objectives: 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.
Conclusion: 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.

Keywords: Distress Thermometer, bone marrow transplant, cancer rehabilitation, BMT rehabilitation, symptom management, patient-reported outcomes

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