Investigation of the Effects of Prehabilitation Education Delivered Through a Mobile Compatible Website on Quality of Life and Symptoms in Patients Undergoing Hematopoietic Stem Cell Transplantation

Hematopoietic Stem Cell Transplantation (HSCT) is an intensive treatment with the potential to cure hematologic malignancies and other highly morbid diseases. However, it is also associated with significant risks of morbidity and mortality. Many HSCT patients experience a variety of physical, emotional, and cognitive symptoms, particularly during the acute recovery phase following transplantation. Gastrointestinal symptoms such as nausea, vomiting, loss of appetite, mucositis, and changes in taste often emerge during the pre-transplant conditioning period and may persist for an extended period after the transplant.

Loss of strength and pain are among the most common and severe symptoms during the acute recovery phase. Other frequently encountered symptoms include anorexia, loss of muscle mass, and fatigue. During hospitalization, HSCT patients may also experience clinically significant emotional symptoms such as anxiety, depression, or adjustment disorders. These symptoms can negatively impact patients' subjective symptom burden, treatment adherence, and length of hospital stay.

Therefore, accurate assessment and management of symptoms and risks during hospitalization are essential to minimize the symptom burden in HSCT patients. Since HSCT involves high-dose chemotherapy, prolonged hospital stays, and strict isolation protocols, transplant-specific quality of life (QoL) assessment is crucial. Evaluating QoL in transplant patients can help healthcare professionals understand patients' physical, psychological, and social well-being and identify their rehabilitation needs.

Numerous symptoms caused by the disease and HSCT, as well as transplant-specific complications, significantly reduce patients' quality of life and adversely affect long-term transplant outcomes. For this reason, it is important to prepare patients adequately before undergoing HSCT. In such cases, the concept of prehabilitation is considered essential. Prehabilitation is a clinical model that introduces rehabilitation components to patients before intensive medical interventions, aiming to optimize functionality and improve tolerance to treatment.

Cancer prehabilitation is a part of the cancer rehabilitation care process. It occurs between the time of cancer diagnosis and the start of acute treatment. It includes physical and psychological assessments to establish a baseline functional level, identify impairments, and provide interventions that promote psychological health and physical improvement to reduce the incidence and/or severity of future impairments.

The aim of this study is to investigate the effect of prehabilitation education provided via a mobile-compatible website on the quality of life and symptom evaluation of patients undergoing HSCT. Patients will be randomly assigned to two groups: one group will receive prehabilitation education via a mobile-compatible website, while the other group will receive standard education procedures.

Both groups will be assessed using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) and the Edmonton Symptom Assessment Scale (ESAS) on the day of hospital admission, the day of transplantation, and the day of discharge.

The web-based educational content consists of 9 sections:

What is stem cell transplantation? Pre-transplant preparation period Stem cell transplantation procedure and engraftment What is oral mucositis (mouth sores)? How to perform oral care? What is the risk of infection? How to protect yourself from infection? Side effects of transplant treatment Nutrition and food preparation after transplantation Returning home after stem cell transplantation and home exercise suggestions before transplant At the end of the study, the test results of the patient groups will be compared both within and between groups. The study aims to determine whether the group receiving prehabilitation education through a mobile-compatible website differs significantly from the group receiving standard education and to evaluate the impact of the educational intervention on patient outcomes.