Abstracts / Biol Blood Marrow Transplant 20 (2014) S297eS315S300

to the OPD setting. Further long term analysis is needed todetermine success of this transition to practice model.

474The Lived Experience of an Autologous HematopoieticStem Cell Transplantation: a Qualitative StudyJessica Driscoll 1, Kristin Geary 2. 1Massachusetts GeneralHospital, Boston, Massachusetts; 2 Simmons College, Boston,Massachusetts

Topic Significance & Study Purpose/Background/Rationale:The U.S. Department of Health and Human Services estimatesthat 18,900 hematopoietic stem cell transplants (HSCTs) wereperformed in 2011. Autologous transplants are the mostcommon type of HSCT worldwide. The use of autologousHSCT has increased because of its effectiveness in treatingcertain hematologic malignancies specifically lymphomasand multiple myeloma. Despite the fact that autologoustransplants have surpassed the number of allogeneic trans-plants, the studies that focus exclusively on the lived expe-rience of autologous transplantation patients are limited. Thepurpose of this study was to understand the lived experienceof patients undergoing an autologous HSCT.Methods, Intervention, & Analysis: This was a qualitativephenomenological study. Four patients in an outpatient bonemarrow transplant clinic were invited to participate in aninterview to reflect on their experiences as an autologousHSCT recipient. The participants were targeted six to twelvemonths post transplant to allow time for reflection andattribution of meaning of this experience in their own lives.The use of the open-ended question, “Please describe yourexperience as an autologous HSCT recipient” allowed par-ticipants to expand on issues of importance to them. Theinterviews were audiotaped and transcribed by the nurseresearchers. They were analyzed using hermeneutic phe-nomenology as described by van Manen (1997) in order tomore fully understand their experiences.Findings & Interpretation: Analysis of the four interviewsrevealed a number of themes. The six major themes thatemerged are: (1) worry and fear; (2) trusting and relation-ship building with caregivers; (3) isolation and contempla-tion; (4) significant life changes; (5) new identity based onself-reflection; and (6) challenges and coping.Discussion & Implications: The objective of this study wasto explore the phenomenon of experiencing an autologousHSCT and gain insight for nursing practice. The interviewsrevealed that while each participant has a unique experiencewith autologous HSCT, elements of the experiences areshared. The themes will help inform the understanding ofand nursing care provided for this population in the future.

475Amyloid Treatment Pearls: Standardizing an Approach toPatient CareCatherine Featherstone, Heather Hylton. MemorialSloan-Kettering Cancer Center, New York, New York

Topic Significance & Study Purpose/Background/Rationale:There are approximately 3000 new cases of Amyloidosisdiagnosed each year. While this is a relatively uncommondisease, an increasing number of cancer centers are trans-planting patients for disease control. The unique clinical fea-tures of Amyloid coupledwith the complications from therapyrequire knowledgeable staff to assess and manage thesecomplicated patients. As an experienced Amyloid treatmentcenter,wehave established standardized treatment guidelines

specific to this patient population. These guidelines offerhealth care providers at the bedside the basic tools to providethe best care possible to improvepatientoutcomes for patientsundergoing high-dose chemotherapyand autologous stemcelltransplant for Amyloid.Methods, Intervention, & Analysis: A standardized ap-proach for management of patients with Amyloid undergo-ing high-dose chemotherapy and autologous stem celltransplant (ASCT) was implemented based upon our clinicalexperience with this disease as an established Amyloidtreatment center. Defined patient care interventions withinthis approach are directed toward minimizing transplant-related morbidity, particularly in patients with cardiac orautonomic nervous system involvement of Amyloid.Findings & Interpretation: By incorporating standardizedinterventions in the Amyloid patient population undergoingASCT, we have been able to minimize peri-transplant compli-cations through maintenance of strict euvolemia, preventivecardiology practices, and promotion of patient conditioning.Discussion & Implications: Transplant-associated morbi-dity in the Amyloid patient population is often correlatedwith disease-related organ damage. Our guidelines weredesigned and implemented based upon our experiencetreating this disease and are focused on preventive strategiesand supportive measures. These interventions minimizetransplant-related complications in this unique patientpopulation and provide practical guidance for day-to-daymanagement.

476Bridging the Exercise Gap in BMT SurvivorsEleanor Flores, Grace Ku, Lindsay Kozicz, Clarinda Henning,Catherine Printz. UCSD, La Jolla, California

Topic Significance & Study Purpose/Background/Rationale:In an effort to address long term health risks in patients whohave undergone allogeneic BMT, a collaborative team at UCSan Diego started a BMT Survivorship Clinic that is spear-headed by one of our nurses. The clinic focuses on riskassessment, screening and prevention with the goal to im-prove quality of life and survival with a low morbidity postBMT.

As part of the visits, patients complete a questionnaire.We analyzed the data and identified exercise as a needamong our survivors. In reviewing the research, exercise hasbeen shown to reduce fatigue and improve physical func-tioning among transplant patients. We wanted to determineif this was true among our patient population and thenformulate a feasible intervention for those patients in need.Methods, Intervention, & Analysis: Of the 32 patients whocompleted the questionnaire, we found that 44% are notexercising. Of the non-exercisers, 64% reported fatiguecompared to 22% of exercisers. 86% of the non-exercisersreported joint stiffness compared to 22% of exercisers.Finally, 43% of non-exercisers reported difficulty with per-forming ADLs compared to 6% from the exercise group.

In accordance with the research, our findings demon-strate that those who lack physical exercise may also suffermore from fatigue, joint stiffness, and dificulty performingADLs.Findings & Interpretation: In response, we developed a"Prescription for Exercise." This "prescription" is a 1-pageinformation tool that introduces BMT patients to safe exer-cise pre- and post transplant. It gives concrete guidelines forstrength training and cardiovascular exercises. Since thenurses play an integral role as educators throughout thetransplant process, we asked them to take an active role in