{
    "abstract": "This study aims to measure activity participation and describe barriers and goals for participation in older adults post-HCT.\nIn a convergent mixed methods design, we quantitatively assessed four domains of participation (instrumental, low demand leisure, high demand leisure, and social) using the modified Activity Card Sort (ACSm) and described cognitive, physical, and psychosocial function using validated measures. Semi-structured interviews were used to describe barriers and goals for participation.\nEighteen participants with the median age of 66 years (range 60-75 years) completed the ACSm and interview. Seventeen of the 18 participants were >\u20096 months post-HCT and 44% of the total participants were >\u200912 months out from transplant. Overall, participants returned to 80% of their total activities. Mean retention was the highest in low-demand leisure activities (89%), followed by instrumental (85%), social (77%), and high-demand leisure activities (59%). Fatigue and impaired physical function were barriers for all activity domains. Participants discussed cognitive function as a barrier for many instrumental and low-demand leisure activities. Side effects, complications (i.e., osteoporosis and GVHD) and immune suppression were barriers to high-demand leisure activities. Participants talked about the meaning and purpose behind activity participation, highlighting the centrality of returning to life activities despite ongoing symptoms. There were multiple goals discussed related to activity participation.\nOlder adults undergoing HCT have diminished functional reserve and need more time to recover from activities that require sustained energy. Physical activity promotion programs targeting activity limitations and participation restrictions in cancer survivors are particularly salient for older adults undergoing HCT.",
    "authors": [
        {
            "affiliation": "Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center Omaha, NE 68198 -\u20096155, Omaha, NE, USA.",
            "firstname": "Natalie",
            "initials": "N",
            "lastname": "von Oldenburg"
        },
        {
            "affiliation": "Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center Omaha, NE 68198 -\u20096155, Omaha, NE, USA.",
            "firstname": "Noelle",
            "initials": "N",
            "lastname": "Pick"
        },
        {
            "affiliation": "Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center Omaha, NE 68198 -\u20096155, Omaha, NE, USA.",
            "firstname": "Jessica N",
            "initials": "JN",
            "lastname": "Semin"
        },
        {
            "affiliation": "Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center Omaha, NE 68198 -\u20096155, Omaha, NE, USA.",
            "firstname": "Marcia",
            "initials": "M",
            "lastname": "Free"
        },
        {
            "affiliation": "Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center Omaha, NE 68198 -\u20096155, Omaha, NE, USA.",
            "firstname": "Weston",
            "initials": "W",
            "lastname": "Ernst"
        },
        {
            "affiliation": "Blood and Marrow Transplantation Program, Nebraska Medicine, Omaha, NE, USA.",
            "firstname": "Diane M",
            "initials": "DM",
            "lastname": "Hill-Polerecky"
        },
        {
            "affiliation": "Blood and Marrow Transplantation Program, Nebraska Medicine, Omaha, NE, USA.",
            "firstname": "Kimberly A",
            "initials": "KA",
            "lastname": "Miller"
        },
        {
            "affiliation": "Division of Hematology Oncology, Department of Internal Medicine, University of Nebraska Medical Center, Fred & Pamela Buffett Cancer Center, Omaha, NE, USA.",
            "firstname": "Vijaya R",
            "initials": "VR",
            "lastname": "Bhatt"
        },
        {
            "affiliation": "Division of Hematology Oncology, Department of Internal Medicine, University of Nebraska Medical Center, Fred & Pamela Buffett Cancer Center, Omaha, NE, USA.",
            "firstname": "Tanya M",
            "initials": "TM",
            "lastname": "Wildes"
        },
        {
            "affiliation": "Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.",
            "firstname": "Paul A",
            "initials": "PA",
            "lastname": "Estabrooks"
        },
        {
            "affiliation": "Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center Omaha, NE 68198 -\u20096155, Omaha, NE, USA.",
            "firstname": "Alfred L",
            "initials": "AL",
            "lastname": "Fisher"
        },
        {
            "affiliation": "Nebraska Coalition for Patient Safety, Omaha, NE, USA.\nCollege of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.",
            "firstname": "Katherine J",
            "initials": "KJ",
            "lastname": "Jones"
        },
        {
            "affiliation": "Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center Omaha, NE 68198 -\u20096155, Omaha, NE, USA. thuy.koll@unmc.edu.",
            "firstname": "Thuy T",
            "initials": "TT",
            "lastname": "Koll"
        }
    ],
    "conclusions": "Older adults undergoing HCT have diminished functional reserve and need more time to recover from activities that require sustained energy. Physical activity promotion programs targeting activity limitations and participation restrictions in cancer survivors are particularly salient for older adults undergoing HCT.",
    "copyrights": "\u00a9 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",
    "doi": "10.1007/s00520-025-09399-5\n10.1016/j.bbmt.2020.04.013\n10.1016/j.jgo.2019.11.008\n10.1371/journal.pone.0213263\n10.1007/s00520-023-07672-z\n10.1007/s00520-015-2744-3\n10.1177/1539449219844749\n10.1016/j.jgo.2021.09.010\n10.1188/11.onf.75-83\n10.5014/ajot.2010.09033\n10.1093/gerona/56.3.M146\n10.1093/geronj/49.2.M85\n10.1093/gerona/56.6.M366\n10.1300/J018v01n01_06\n10.1001/archinte.166.10.1092\n10.1016/0277-9536(91)90150-B\n10.1016/s0140-6736(19)31785-4\n10.1001/jamaoncol.2016.0855\n10.1002/cncr.33313\n10.1016/j.jgo.2023.101623\n10.1016/j.jtct.2023.03.010\n10.11124/jbisrir-2017-003551\n10.1007/s00508-019-1484-7\n10.1016/j.mcna.2011.02.008\n10.14336/AD.2014.0500183\n10.1186/s12877-023-04080-0\n10.1016/j.exger.2022.111698",
    "journal": "Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer",
    "keywords": [
        "Hematopoietic cell transplant",
        "Lived experience",
        "Physical activity",
        "Quality of life",
        "Survivorship"
    ],
    "methods": null,
    "publication_date": "2025-04-17",
    "pubmed_id": "40244442\n30849098\n31046601\n21186163\n11253156\n8126356\n11382797\n16717171\n2035047\n31609229\n27254472\n33206383\n36921916\n29521871\n30941525\n21549870\n24900941\n37328797",
    "results": "Eighteen participants with the median age of 66 years (range 60-75 years) completed the ACSm and interview. Seventeen of the 18 participants were >\u20096 months post-HCT and 44% of the total participants were >\u200912 months out from transplant. Overall, participants returned to 80% of their total activities. Mean retention was the highest in low-demand leisure activities (89%), followed by instrumental (85%), social (77%), and high-demand leisure activities (59%). Fatigue and impaired physical function were barriers for all activity domains. Participants discussed cognitive function as a barrier for many instrumental and low-demand leisure activities. Side effects, complications (i.e., osteoporosis and GVHD) and immune suppression were barriers to high-demand leisure activities. Participants talked about the meaning and purpose behind activity participation, highlighting the centrality of returning to life activities despite ongoing symptoms. There were multiple goals discussed related to activity participation.",
    "title": "Participation in life activities after hematopoietic cell transplantation in older adults.",
    "xml": "<Element 'PubmedArticle' at 0x788502c07ec0>"
}