| Autor: |
Mitchell SA; Nursing Research, Clinical Center, National Institutes of Health, Bethesda, MD 20852, USA. mitchlls@mail.nih.gov, Leidy NK, Mooney KH, Dudley WN, Beck SL, LaStayo PC, Cowen EW, Palit P, Comis LE, Krumlauf MC, Avila DN, Atlam N, Fowler DH, Pavletic SZ |
| Jazyk: |
angličtina |
| Zdroj: |
Bone marrow transplantation [Bone Marrow Transplant] 2010 Apr; Vol. 45 (4), pp. 762-9. Date of Electronic Publication: 2009 Sep 28. |
| DOI: |
10.1038/bmt.2009.238 |
| Abstrakt: |
This study examined factors accounting for functional performance limitations in 100 long-term survivors of allogeneic hematopoietic stem cell transplantation with chronic graft-versus-host disease (cGVHD). Functional performance, measured by the SF-36 physical component summary score, was substantially lower (mean=36.8+/-10.7) than the US population norm of 50 (P<0.001). The most severe decrements were in physical function (mean=38.8+/-10.9) and physical role function (mean=37.88+/-11.88); 68% of respondents exceeded the five-point threshold of minimum clinically important difference below the norm on these subscales. Controlling for age and gender, six variables explained 56% of the variance in functional performance: time since cGVHD diagnosis, cGVHD severity, intensity of immunosuppression, comorbidity, functional capacity (distance walked in 2 min, grip strength, and range of motion), and cGVHD symptom bother (F=11.26; P<0.001). Significant independent predictors of impaired performance were intensive systemic immunosuppression, reduced capacity for ambulation, and greater cGVHD symptom bother (P<0.05). Symptom bother had a direct effect on functional performance, as well as an indirect effect partially mediated by functional capacity (Sobel test, P=0.004). Results suggest two possible mechanisms underlying impaired functional performance in survivors with cGVHD and underscore the importance of testing interventions to enhance functional capacity and reduce symptom bother. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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