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General health, symptom occurrence, and self-efficacy in adult survivors after allogeneic hematopoietic stemcell transplantation: a cross-sectional comparison between hospital care and home care
Division of Therapeutic Immunology, Department of Laboratory; Sophiahemmet University, Stockholm.
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm; Department of Medicine Solna, Karolinska Institutet, Stockholm.
Sophiahemmet University, Stockholm, Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm.
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2015 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 23, no 5, 1273-1283 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Earlier studies have shown that home care during the neutropenic phase after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is medically safe, with positive outcomes. However, there have been few results on long-term outcomes after home care. The aims of this study were to compare general health, symptom occurrence, and self-efficacy in adult survivors who received either home care or hospital care during the early neutropenic phase after allo-HSCT and to investigate whether demographic or medical variables were associated with general health or symptom occurrence in this patient population.

METHODS: In a cross-sectional survey, 117 patients (hospital care: n = 78; home care: n = 39) rated their general health (SF-36), symptom occurrence (SFID-SCT, HADS), and self-efficacy (GSE) at a median of 5 (1-11) years post-HSCT.

RESULTS: No differences were found regarding general health, symptom occurrence, or self-efficacy between groups. The majority of patients in both hospital care (77 %) and home care (78 %) rated their general health as "good" with a median of 14 (0-36) current symptoms. Symptoms of fatigue and sexual problems were among the most common. Poor general health was associated with acute graft-versus-host disease (GVHD), low self-efficacy, and cord blood stem cells. A high symptom occurrence was associated with female gender, acute GVHD, and low self-efficacy.

CONCLUSIONS: No long-term differences in general health and symptom occurrence were observed between home care and hospital care. Thus, home care is an alternative treatment method for patients who for various reasons prefer this treatment option. We therefore encourage other centers to offer home care to patients.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2015. Vol. 23, no 5, 1273-1283 p.
Keyword [en]
Allogeneic hematopoietic stem cell transplantation, General health, Symptom occurrence, Self-efficacy, Home care, Hospital care
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Nursing
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URN: urn:nbn:se:rkh:diva-1411DOI: 10.1007/s00520-014-2476-9PubMedID: 25322970OAI: oai:DiVA.org:rkh-1411DiVA: diva2:784417
Available from: 2015-01-29 Created: 2015-01-29 Last updated: 2017-12-05Bibliographically approved

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Larsen, Joacim

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