Author(s): VEJBY, S., HENRIKSSON, A., JOHANSSON, B., ROBELIUS, A., WETTERGREN, L., Institution: DISCIPLINARY DOMAIN OF MEDICINE AND PHARMACY, Country: SWEDEN, Abstract-ID: 2095

INTRODUCTION:
Hematopoietic stem cell transplantation (HSCT) is a well-established procedure with the potential to cure a variety of conditions. As patients are hospitalized for a long time, special considerations regarding physical activity (PA) and nutrition are required. Malnutrition during HSCT may impact on relapse rate, fatigue, infection rate, engraftment and survival. In a previous study, we found that it is possible to increase PA levels using behavior change techniques such as individualized goal-setting, daily follow up and a self-monitoring PA diary. The present study aimed to investigate the feasibility and acceptability of a nurse-led combined physical activity and nutrition support program directed to patients undergoing HSCT at a Swedish university hospital.
METHODS:
In this single arm longitudinal intervention study, 20 adults planned for HSCT (14 males, mean age 56 (SD 13.2)) participated in an individualized intervention regarding PA and nutrition. The intervention started pretransplant with a nurse led information and encouragement about PA, web-based diet diary and a dietitian consultation. During hospitalization, intervention included PA goal-setting (walking, bicycling, rubber bands), activity diary, energy/protein intake monitoring, dietitian consultation, daily follow-ups by the study nurse and a PA prescription at discharge. After discharge, the study nurse had additional follow-up by phone. Six minutes walking test was assessed pretransplant, at admission and at discharge. Feasibility and acceptability were assessed by the number of patients participating, adherence to the intervention and retention. Semi-structured interviews were conducted with a sub sample of participants (n=14) two weeks after discharge. Interviews were transcribed and analyzed using qualitative content analysis.
RESULTS:
Twenty eight of 52 eligible patients were approached, 22 patients consented to participate in the study. As for adherence; 95% completed the diet diary pretransplant (30% during hospitalization), 100% formulated PA goals, 97% completed the activity diary daily, 70% met their PA endurance goals, 75% reached calculated energy intake and 10% reached calculated protein intake (they reached 76% of their calculated intake on a group level). All participants completed the 6MWT and no one terminated their participation prematurely. The qualitative analysis resulted in three main categories: Intervention factors (follow-ups, visible goal-setting, positive effects e.g.), individual factors (coping, previous experiences e.g.) and context factors (environment and routines). Generally, participants described the intervention as helpful and that they became motivated to achieve their personal PA goals.
CONCLUSION:
The intervention appears to be feasible as most patients fulfilled both the PA and nutrition parts and no adverse effects were reported. A revised version of the intervention will be implemented in clinical care.