Physical activity counseling during and following stem cell transplantation – patients' versus advisors' perspectives

ABSTRACT

Background:

People receiving hematopoietic stem cell transplantation (HSCT) endure long phases of therapy and immobility, which diminish their physical activity (PA) level leading to physical deconditioning. One of the reasons is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. Therefore, our study investigates reported physical activity counseling behavior of health care professionals (HCPs) and the patient perspective on this topic.

Methods:

Physicians (N = 52), nurses (N = 52) physical therapists (N = 26), and patients receiving HSCT (N = 62) participated in a nationwide cross-sectional online-survey. Patients‘ preferred source of information concerning PA was determined. We examined HCPs self-assessed PA counseling behavior and patients‘ PA recall by assessing the use of the 5As (Ask, Advice, Agree, Assist, Arrange). Analysis of survey responses was descriptive. Univariate multinomial logistic regression examined whether sociodemographic factors and patient characteristics influence the response behavior.

Results:

Physicians and PA specialists were patients‘ preferred source of information regarding PA. A large discrepancy between HCPs’ perception and the degree to which HSCT patients recall advice became apparent; profound counseling steps like making referrals were less often recalled in our patient sample. Inactive patients reported to receive less basic PA counseling by physicians.

Conclusion:

Future research should identify the requirements to increase patients’ recall concerning PA counseling in the setting of HSCT. Important messages about PA need to be made more salient to those who are less active and less engaged.

KEYWORDS:

• Physical activity counseling
• recall
• hematopoietic stem cell transplantation
• exercise
• health promotion
• medical staff
• communication

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Medical Ethic Committee of the University of Heidelberg (reference number:S-150/2018).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

C. Meyer-Schwickerath

Corinna Meyer-Schwickerath, MSc, is a doctoral student at Heidelberg University, and part of the working group “Exercise Oncology”.

M. Köppel

Max Köppel, MSc, is a doctoral student at Heidelberg University, and part of the working group “Exercise Oncology”.

R. Kühl

Rea Kühl, PhD, is post-doctoral researcher at the National Center for Tumor Disease (NCT) Heidelberg, and part of the working group “Exercise Oncology”.

G. Huber

Gerhard Huber holds a PhD and is a professor of sport science at Heidelberg University. His research primarily focuses on evaluation of exercise programs in prevention and rehabilitation.

J. Wiskemann

Joachim Wiskemann holds a PhD and is habilitated in sports and exercise science with an additional academic education in sports psychology. He is employed at the National Center for Tumor Diseases and head of the working group "Exercise Oncology" (Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital).