Exercise and Hospitalized Leukemia Patients
Anne Delengowski, RN, MSN, AOCN; Justine O'Connor RN, MSN, OCN; Megan Stinsman, RN, BSN, OCN, Kate McHenry, RN, BSN, OCN, Kaitlin Mostak, RN, BSN; JoAnn Silcox, RN, MSN; Colleen Sweeney, RN, Christine Muldoon, RN, BSN, OCN, Lauren Gilbride, RN, BSN, Department of Nursing, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
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To determine if patients in a structured, monitored walking program experience less symptom distress than patients receiving the usual standard of care.
Cancer and its treatments are associated with numerous physical and emotional symptoms that can present with adverse effects such as fatigue, weakness, pain and sleep disturbances. On average, the initial treatment of acute leukemia necessitates in-patient hospitalization for an average of 4-6 weeks, leaving little time to adjust to the diagnosis and potential distress it may cause. This treatment carries the potential for significant physical and psychological distress. Previous research has suggested exercise might be a promising strategy for some of this symptom distress.
The sample of patients consisted of a convenience sample of 30 adult (18 and over) patients (15 control/standard of care, 15 walking program) admitted to the oncology unit for induction or re-induction chemotherapy for the treatment of leukemia. Patients were randomized to a control group/current standard of care or the intervention/walking program group. After consenting, both groups were asked to complete the NCCN symptom distress tool on day one of admission and weekly thereafter until discharge. The control group received the present standard of care, which consisted of ambulation/activity as tolerated and is independently performed by patient. This group also received a plain calendar to track their motivation. The walking program/intervention group received educational materials about the importance of exercise during cancer treatment and a motivational calendar to track distances walked. In addition, the intervention group received pedometers to be used in conjunction with the motivational calendar indicating “historical milestones.” Patients in the walking program were encouraged to increase distance weekly by 50%, with week 1 beginning at ¼ mile (virtually to the Reading Terminal Market), concluding with a maximum of 2 miles, which could be divided over 24 hours. Initial, midpoint, and final distress scores were compared for all patients (average patient length of stay is 4-6 weeks).
Motivation (F = 8.52, p = 0.003) and distress levels changed significantly over time. Average motivation levels stayed relatively constant in the intervention group and varied in the control group over time. Distress levels improved significantly in both groups (F = 10.76, p = 0.001). However, neither motivation (F = 2.31, p = 0.13) nor distress (F = 0.344, p = 0.714) differed between the two groups.
Implications for Practice:
The intent for this research study is to implement an exercise program for patients with leukemia. Education of the staff will occur with all staff through the unit council. The researchers on the project would like to expand this study to include additional oncology populations and to delve into factors that affect patient distress.
|Review Type||Peer-review: Single Blind|
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