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General health, symptom occurrence, and self-efficacy in adult survivors after allogeneic hematopoietic stem cell transplantation: a cross-sectional comparison between hospital care and home care

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Abstract

Purpose

Earlier studies have shown that home care during the neutropenic phase after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is medically safe, with positive outcomes. However, there have been few results on long-term outcomes after home care. The aims of this study were to compare general health, symptom occurrence, and self-efficacy in adult survivors who received either home care or hospital care during the early neutropenic phase after allo-HSCT and to investigate whether demographic or medical variables were associated with general health or symptom occurrence in this patient population.

Methods

In a cross-sectional survey, 117 patients (hospital care: n = 78; home care: n = 39) rated their general health (SF-36), symptom occurrence (SFID-SCT, HADS), and self-efficacy (GSE) at a median of 5 (1–11) years post-HSCT.

Results

No differences were found regarding general health, symptom occurrence, or self-efficacy between groups. The majority of patients in both hospital care (77 %) and home care (78 %) rated their general health as “good” with a median of 14 (0–36) current symptoms. Symptoms of fatigue and sexual problems were among the most common. Poor general health was associated with acute graft-versus-host disease (GVHD), low self-efficacy, and cord blood stem cells. A high symptom occurrence was associated with female gender, acute GVHD, and low self-efficacy.

Conclusions

No long-term differences in general health and symptom occurrence were observed between home care and hospital care. Thus, home care is an alternative treatment method for patients who for various reasons prefer this treatment option. We therefore encourage other centers to offer home care to patients.

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Acknowledgments

We are grateful to all patients who participated in the study. This study was funded and supported by grants from the Swedish Cancer Society, the Swedish Blood Cancer Society, and Sophiahemmet University.

Conflict of interest

The authors declare that they have no conflicts of interests.

Author information

Authors and Affiliations

  1. Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden

    Karin Bergkvist, Mats Remberger, Jonas Mattsson & Joacim Larsen

  2. Sophiahemmet University, Stockholm, Sweden

    Karin Bergkvist & Unn-Britt Johansson

  3. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

    Jeanette Winterling & Eva Johansson

  4. Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden

    Eva Johansson

  5. Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Unn-Britt Johansson

  6. Center for Allogeneic Stem Cells Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden

    Britt-Marie Svahn, Mats Remberger & Jonas Mattsson

  7. The Swedish Red Cross University College, Stockholm, Sweden

    Joacim Larsen

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  1. Karin Bergkvist
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Correspondence to Karin Bergkvist.

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Bergkvist, K., Winterling, J., Johansson, E. et al. General health, symptom occurrence, and self-efficacy in adult survivors after allogeneic hematopoietic stem cell transplantation: a cross-sectional comparison between hospital care and home care. Support Care Cancer 23, 1273–1283 (2015). https://doi.org/10.1007/s00520-014-2476-9

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