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  • 1.
    Bergkvist, Karin
    et al.
    Division of Therapeutic Immunology, Department of Laboratory; Sophiahemmet University, Stockholm.
    Winterling, Jeanette
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Johansson, Eva
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm; Department of Medicine Solna, Karolinska Institutet, Stockholm.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm.
    Svahn, Britt-Marie
    Center for Allogeneic Stem Cells Transplantation, Karolinska University Hospital Huddinge, Stockholm.
    Remberger, Mats
    Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm; Center for Allogeneic Stem Cells Transplantation, Karolinska University Hospital Huddinge, Stockholm.
    Mattsson, Jonas
    Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm; Center for Allogeneic Stem Cells Transplantation, Karolinska University Hospital Huddinge, Stockholm.
    Larsen, Joacim
    The Swedish Red Cross University College. Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm.
    General health, symptom occurrence, and self-efficacy in adult survivors after allogeneic hematopoietic stemcell transplantation: a cross-sectional comparison between hospital care and home care2015In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 23, no 5, p. 1273-1283Article in journal (Refereed)
    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.

  • 2.
    Johansson, Eva
    et al.
    Red Cross University College of Nursing. Karolinska Institutet.
    Larsen, Joacim
    Red Cross University College of Nursing.
    Schempp, Thérèse
    Red Cross University College of Nursing.
    Jonsson, Linnea
    Red Cross University College of Nursing.
    Winterling, Jeanette
    Red Cross University College of Nursing. Karolinska Institutet.
    Patients' goals related to health and function in the first 13 months after allogeneic stem cell transplantation2012In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 20, no 9, p. 2025-2032Article in journal (Refereed)
    Abstract [en]

    Purpose: Patient participation in goal setting and decision making is a core component of the rehabilitation process, but there is little information on what patients want to achieve after allogeneic stem cell transplantation (allo-SCT). The aim of this study was to describe adult patients' perceptions of goals related to health and function, as well as self-perceived limitations and facilitating strategies in the first 13 months after allo-SCT. Methods: Fifteen patients with a median age of 44 years (range, 22-65 years) were interviewed on one occasion during the first year after allo-SCT. Data were analysed using qualitative content analysis. Results: Results showed that patients felt that time after allo-SCT largely concerned: "to be healthy" and "to participate in a normal life". Some patients felt it was easy to set goals while others found it difficult. Most described goals had a long-term character. Patients were faced with a wide variety of limitations of which a few did not link to a described goal. Several facilitating strategies were described that either had or could help patients to reach their goals. Conclusions: Our results indicate that assistance with setting achievable goals, including individualised strategies and support from health care professionals to realise the goals, may assist in the rehabilitation to restore health and function after allo-SCT.

  • 3.
    Larsen, Joacim
    et al.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23300, 141 83 Huddinge, Stockholm.
    Nordström, G
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23300, 141 83 Huddinge, Stockholm.
    Ljungman, P
    Haematology Centre, Karolinska University Hospital, Stockholm.
    Gardulf, A
    Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm.
    Factors associated with poor general health after stem-cell transplantation2007In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, ISSN 0941-4355, Vol. 15, no 7, p. 849-857Article in journal (Refereed)
    Abstract [en]

    Aims: 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. Material and Methods: 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. Results: 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". Conclusions: 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.

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