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Symptom Management and Successful Outpatient Transplantation for Patients With Multiple Myeloma

Coleman, Elizabeth Ann PhD, RNP, AOCN; Coon, Sharon K. PhD(c), RN, AOCN; Mattox, Sandra G. MNSc, RNP; O’Sullivan, Patricia PhD


This retrospective descriptive study compared symptoms and symptom management in patients who completed autologous peripheral blood stem cell transplantation without hospital admission with those of patients who required unplanned hospital admission during the transplantation period. The sample consisted of 87 patients with multiple myeloma treated as outpatients during a 16-month period. Medical records and electronic database records review for each patient provided data on patient characteristics, medical factors, and symptoms/symptom management. Neither age, gender, religion, payer source, treatment on or off protocol, nor positive blood culture made a difference in hospital admission. The percentage of outpatient visits that included documented teaching on self-care made a significant difference (P = .008). Longitudinal analyses of patients’ documented symptoms before admission compared with nonadmitted patients captured changes over time in symptoms/symptoms management. Overall, the patients’ symptoms were managed well. Significant differences were fatigue, measured as the percentage of usual energy (P = .017), and the amount of oral hydration in a 24-hour period (P < .001). Results call attention to the role that fatigue and the amount of oral hydration may have in unplanned hospital admissions and to the importance of teaching on self-care.

From University of Arkansas for Medical Sciences, Little Rock (Drs Coleman and Coon and Ms O’Sullivan), and St. Jude Children’s Hospital, Memphis, Tenn (Ms Mattox).

Supported in part by the Oncology Nursing Foundation/Smith Kline Beecham Research Grant and the American Cancer Society Institutional Research Grant #IRG-91-021-06.

Corresponding author: Elizabeth Ann Coleman, PhD, RNP, AOCN, College of Nursing, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 529, Little Rock, AR 72205 (e-mail:

Accepted for publication August 13, 2002.

© 2002 Lippincott Williams & Wilkins, Inc.