Graduation Date

Spring 5-4-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Nursing

First Advisor

Windy W. Alonso

Second Advisor

Ann M. Berger

Abstract

Purpose: Physical activity may decrease inactivity-related complications associated with hematopoietic stem cell transplantation (HSCT). Factors associated with objectively measured sedentary behavior and physical activity during HSCT have not been studied adequately. This study aimed to describe the clinical and personal factors associated with sedentary behavior and physical activity starting with the day of hematopoietic stem cell transplantation, for 10 days during hospitalization, and the first 7 days after discharge.

Methods: This longitudinal, observational study measured sedentary behavior and physical activity with accelerometers on HSCT days 0-4 (T1), days 5-9 (T2), and the first 7 days after hospital discharge (T3). Clinical factors (demographics, HSCT type, time to engraftment, length of hospitalization) and personal factors (exercise self-efficacy, physical and mental health, and symptom severity and interference) were assessed at T1, T2, and T3. Physical activity and clinical and personal factors were described and evaluated for change over time (Friedman test), differences in physical activity between clinical and personal factors (Mann-Whitney U and Kruskal-Wallis tests), and associations with clinical and personal factors (Spearman correlations).

Results: Participants’ (n=26, 57% male, median age 55 years [40-65.3]) accelerometer data revealed participants were sedentary ³87% of the time with no change over time. The sample’s median metabolic equivalent values corresponded to lying, sitting, or standing from T1-T3. Light and moderate-vigorous physical activity and median number of steps decreased significantly as symptom severity and interference increased from T1 to T2. Patient-reported exercise self-efficacy was moderate to high at all time points and was correlated with an increased number of steps at T2 (r=.57, p=.05) and increased light physical activity (r=.55, p=.05) and number of steps (r=.61, p=.01) at T3.

Conclusion: Accelerometers recorded low minutes of light and moderate-to-vigorous physical activity per day, with metabolic equivalent levels corresponding with sedentary activities, despite reporting moderate to high exercise self-efficacy. Symptom severity and interference were associated with lower levels of physical activity in patients hospitalized for HSCT. Oncology nurses can educate patients hospitalized for HSCT on the benefits of reducing sedentary time, increasing physical activity, and managing symptoms during hospitalization and early recovery.

Comments

2024 Copyright, the authors

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Available for download on Thursday, April 23, 2026

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