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Everyday life following hematopoietic stem cell transplantation: decline in physical symptoms within the first month and change-related predictors

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      Lower quality of life, especially in the physical domain (Physical-QOL), is common in patients after hematopoietic stem cell transplantation (HSCT). However, few studies explore changes in the Physical-QOL, i.e., physical symptoms, in everyday life of patients following HSCT. The present study addresses this gap by examining patient daily physical symptoms and their predictors in terms of demographic and clinical characteristics.


      Physical symptoms were reported by 188 patients (56.9% men; aged 47.6 ± 13.4 years) for 28 consecutive days after post-HSCT hospital discharge. Multilevel modeling was used to investigate fixed and random effects for physical symptom changes over time.


      The results indicated that the initial level of physical symptoms (immediately after hospital discharge) systematically decreased over 28 days. Treatment toxicity (WHO scale; β = 0.09, p < .01) and baseline depressive symptoms (CES-D scale; β = 0.06, p < .01) were associated with the initial level of physical symptoms. Patients with more depressive symptoms before HSCT and with more adverse treatment effects presented with more physical symptoms immediately after hospital discharge. The type of transplant, diagnosis, and conditioning regimen differentiated the course of physical symptoms. Patients with leukemias and other myeloid neoplasms ( β = 0.05, p < .01), after allogeneic HSCT ( β = −0.06, p < .01), and with non-myeloablative conditioning ( β = −0.09, p < .01) showed a significant lower decrease in symptoms over time. Patients with multiple myeloma presented with the most rapid improvement ( β = −.03, p < .05).


      The findings suggest a heterogeneous and rather positive response to HSCT. Treatment-related conditions occurred to be a significant predictor of the intensity of change in physical functioning after HSCT.

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          In diary studies, people provide frequent reports on the events and experiences of their daily lives. These reports capture the particulars of experience in a way that is not possible using traditional designs. We review the types of research questions that diary methods are best equipped to answer, the main designs that can be used, current technology for obtaining diary reports, and appropriate data analysis strategies. Major recent developments include the use of electronic forms of data collection and multilevel models in data analysis. We identify several areas of research opportunities: 1. in technology, combining electronic diary reports with collateral measures such as ambulatory heart rate; 2. in measurement, switching from measures based on between-person differences to those based on within-person changes; and 3. in research questions, using diaries to (a) explain why people differ in variability rather than mean level, (b) study change processes during major events and transitions, and (c) study interpersonal processes using dyadic and group diary methods.

            Author and article information

            [1 ]ISNI 0000 0001 2184 0541, GRID grid.433893.6, Department of Psychology, , SWPS University of Social Sciences and Humanities, ; Chodakowska Street 19/31, 03-815 Warsaw, Poland
            [2 ]Maria Sklodowska-Curie—Oncology Center, Gliwice Branch, Gliwice, Poland
            [3 ]ISNI 0000 0001 2184 0541, GRID grid.433893.6, Department of Psychology, , SWPS University of Social Sciences and Humanities, ; Warsaw, Poland
            ORCID:, +48 22 517 98 24 ,
            Qual Life Res
            Qual Life Res
            Quality of Life Research
            Springer International Publishing (Cham )
            12 September 2017
            12 September 2017
            : 27
            : 1
            : 125-135
            © The Author(s) 2017

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

            Funded by: FundRef, Narodowe Centrum Nauki;
            Award ID: 2013/10/E/HS6/00189
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            © Springer International Publishing AG, part of Springer Nature 2018


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