The present study conducted at Hacettepe University in Turkey. Patients who treated with HSCT and previously consulted to physical therapy were included. Data were collected by interviewing with the patients on the phone. Exclusion criteria were patients who were not available by phone, who stay in the hospital when called, who were not willing to participate, who were not able to cooperate, who had seriously chronic disease other than cancer, and who were being diagnosed with COVID-19. The Hacettepe University Ethical Committee approved the present study. The informed consent was read to the participants on the phone and their consent was obtained.
Demographic and Medical Information
Age, gender, height, body weight, educational status, profession, current working status, and marital status of the participants were recorded. The medical data were recorded including diagnosis, duration after diagnosis, HSCT type, duration after HSCT, and complications associated with HSCT.
The Eastern Cooperative Oncology Group Performance Score (ECOG) was used to evaluate the overall performance of the participants. The ECOG evaluates globally patients’ performance and is scored between 0 and 4 points. Higher scores indicate lower performance level (6).
Supportive Care Needs
The Supportive Care Needs Survey-Short Form 29TR (SCNS-SF29) was used to identify supportive care needs of participants . The SCNS-SF29 asks four different aspects of supportive care needs including healthcare and information (14 items), daily life (5 items) sexuality (3 items), and psychological needs (7 items). Each item is scored between 1 and 5 points (1=Not suitable for me, 2=Sufficient for me, 3=I need a little, 4=I need quite, and 5=I need very much). Higher scores indicate higher supportive care need in that aspect. As an alternative use, the questionnaire can also be used to determine the number of the perceived unmet needs (3 or higher scoring is considered unmet need) . In addition, participants were asked how much they needed to be informed regarding COVID-19 (no need - a little needed - quite needed - very much needed).
Compliance to the Exercise Program
Among the participants who previously prescribed with a home exercise program (n=61) were asked on phone regarding the compliance to the program. Home exercise program was consisted of brisk walking, strengthening, and stretching exercises which were adjusted to the individual needs and performance level. Individuals were interviewed regarding their compliance to exercise prescription on phone. Compliance to brisk walking program that how much minute/week did they walk during the last week when compared to the recommended duration was recorded (0% compliance to 100% compliance).
Quality of Life Level
The European Cancer Research and Treatment Organization Quality of Life Questionnaire-Cancer30 (EORTC QLQ-C30) was used to assess health-related QOL. The questionnaire includes a total of 30 items which are scored between 1 (not at all) and 4 (too much) points. Three different scores are calculated for general health, functionality, and symptoms as a result of the questionnaire. Higher scores represent higher general health and functional scores. On the other hand, higher scores indicate higher symptom severity . The Turkish version of the EORTC QLQ-C30 was conducted and it was found to be valid and reliable .
The State-Treat Anxiety Inventory-I (STAI-I) was used to determine anxiety level of the participants. The emotions or behaviors expressed in the 20 items are scored 1 (none) to 4 points (completely). The total score is between 20 and 80 points. Higher scores indicate higher anxiety level. The STAI-I was adapted to Turkish language and was found valid and reliable (9,10). The cutoff value was determined as 39 points for STAI-I . Besides the STAI-I, a question of how worried individuals regarding COVID-19 was asked by using Visual Analogue Scale (0: not at all worried to 10: too much worried).
Statistical analysis was performed by using the Statistical Program for Social Sciences (SPSS) Version 23. The level of significance was set at 0.05 for all statistical analyses and the results were expressed as percentage (%) or Mean ± Standard Deviation. The Kolmogorov–Smirnov test was used to determine normality of distribution. Since data did not meet parametric assumptions, the Mann Whitney U test was used to compare numerical data. The Spearman correlation coefficient test was used to assess associations between the recorded outcomes.