Factors Associated with Physical Activity during Hospitalization for Hematopoietic Cell Transplantation and after Discharge: A Pilot Study

Abstract

Background The importance of physical activity to support health has been widely demonstrated. Hematopoietic cell transplantation (HCT) requires lengthy hospitalizations resulting in substantial decreases in physical activity. Understanding the factors associated with physical activity during hospitalization and immediately following hospital discharge is vital to support the transition from hospital to home. Objective To examine the associations among personal factors (exercise self-efficacy, physical and mental health, and symptom severity and interference) and physical activity immediately following HCT. Methods In this prospective observational pilot study, accelerometers measured physical activity during hospitalization on HCT days 0 to 4 (T1) and days 5 to 9 (T2), and in the first 7 days after hospital discharge (T3). Personal factors were assessed at T1, T2, and T3. Physical activity and personal factors were evaluated for change over time (Friedman test) and associations (Spearman correlations). Results Participants' (n = 26, 57% male; median age, 55 years [40-65.3]) accelerometer data revealed light and moderate to vigorous physical activity, and median steps decreased significantly as symptoms severity and interference increased from T1 to T2. Exercise self-efficacy was moderate to high from T1 to T3 and was correlated with increased steps at T2 (r = 0.57, P =.05) and increased light physical activity (r = 0.55, P =.05) and steps (r = 0.61, P =.01) at T3. Conclusions This pilot study provides preliminary evidence of the relationships between physical activity and symptoms, symptom severity, and exercise self-efficacy. Implications for Practice Maintaining high levels of physical activity during hospitalization for HCT may not be possible. Nurses can help patients set realistic expectations for physical activity during hospitalization and immediately after hospital discharge.