Factors associated with poor general health after stem-cell transplantation

• Published in: Supportive care in cancer Vol. 15; no. 7; pp. 849 - 857
• Main Authors: Larsen, Joacim, Nordström, Gun, Ljungman, Per, Gardulf, Ann
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01-07-2007
• Subjects: Adolescent; Adult; Attitude to Health; Female; functional status; general health; Health Status; Health Status Indicators; Health Surveys; hematopoietic stem-cell transplantation; Humans; Male; Medicin och hälsovetenskap; Middle Aged; multiple regression analysis; Neoplasms - therapy; Patients; Perception; questionnaires; Sickness Impact Profile; Stem Cell Transplantation - adverse effects; Stem Cell Transplantation - psychology; Stress, Psychological; Surveys and Questionnaires; symptom distress; Treatment Outcome
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-006-0200-0

To describe functional status (FS), general health (GH) and symptom distress (SD) from admission to 1 year post-SCT and to identify medical, demographic, and/or patient-reported outcome variables associated with patient-perceived GH.
Forty-one patients (27 women) with a median age of 44 (18-65) years answered three questionnaires (SIP, SWED-QUAL, and SFID-SCT) from admission to 1 year post-SCT.
At discharge, 59% of the patients reported poor FS and GH, and 24% reported > 10 simultaneous symptoms. After 1 year post-SCT, 22% still reported poor FS, 32% poor GH, and 12% > 10 simultaneous symptoms. Compared with admission, significantly larger proportions of the patients reported poor GH at discharge (20 vs 59%, p = .001), poor FS at 6 months (24 vs 59%, p = .004), and poor GH [The number of symptoms was found to be significantly associated with poor GH at discharge (OR 1.330, p = .009) and at 1 year post-SCT (OR 2.000, p = .010)]. Patients reporting "poor GH" at discharge and at 1 year post-SCT reported a median of 7 and 10 symptoms, respectively. Patients with "good GH" reported a median of three symptoms both at T1 and T4. "Tiredness", "anxiety", "mouth dryness", "loss of appetite", and "diarrhoea" were reported by a larger proportion of the patients reporting "poor GH".
The results confirm that some patients who have undergone a SCT have a negatively affected life situation. The study indicates that actively asking for symptoms and applying the best treatment for symptom alleviation are among the most important measures that SCT teams can take to help the patients perceive better general health and an improved life situation.