Distress, problems and unmet rehabilitation needs after haematopoietic stem cell transplantation for haematologic...

Haematopoietic stem cell transplantation (HSCT) is an intensive treatment potentially resulting in distress, physical and psychosocial problems, and need for rehabilitation services. The purpose of this study was to assess the prevalence of distress, problems, and unmet rehabilitation needs among patients with haematological malignancies treated with HSCT, and to identify demographic and clinical factors associated with being distressed.

A cross-sectional questionnaire-based study among patients with a haematological malignancy was conducted 3-24 months post HSCT. Distress and problems were assessed by the National Comprehensive Network (NCCN) Distress Thermometer (DT) and Problem List (PL), and problems with physical endurance and muscle strength by 11-point scales. Unmet rehabilitation needs were assessed by a questionnaire constructed by the authors.

Among 130 invited patients, 98 (75%) were included. Mean observation time since HSCT was 8 months, mean age at survey was 54 years and 61% were male. About half (51%) of the participants reported distress. The most common problems reported on the PL were fatigue (56%), tingling in hands/feet (49%), and worry (47%). Impaired physical endurance and muscle strength were reported by 65% and 59 %, respectively. Thirty-seven percent reported unmet rehabilitation needs. Distressed participants reported more problems included in the PL [mean 10.3 (SD 5.1) vs 4.8 (SD 2.9), p<0.001] and more unmet rehabilitation needs (52% vs 21%, p=0.003) compared to non-distressed participants.

The high prevalence of distress, problems and unmet rehabilitation needs emphasize the importance of regular screening and tailored rehabilitation programs in this population.