FACTORS ASSOCIATED WITH PHYSICAL FRAILTY AMONG JORDANIAN HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) RECIPIENTS: CROSS-SECTIONAL STUDY

Abstract

Background: Physical frailty among HSCT recipients can be defined as a serious health problem characterized by reduced muscle strength and slower physical performance, which together can increase treatment toxicity, non-relapse mortality (NRM), and decreased overall survival (OS). Despite this finding, there are a limited number of studies that have focused on physical frailty and its associations in this population, particularly in the Jordanian population.Objectives: This study aimed to examine the factors associated with physical activity and physical frailty outcomes among HSCT recipients. It also aimed to determine whether physical activity mediates the relationship between self-efficacy for exercise, social support, and physical frailty outcomes. Methods: A convenience sample of 136 HSCT recipients aged 18 years or older was recruited from a single medical center in Jordan. Questionnaires on self-efficacy for exercise, social support, and physical activity were administered. Physical frailty was assessed using the Fried Frailty Phenotype, including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Chi-square test, logistic regression, and mediation analyses were performed. Findings: The overall prevalence of physical frailty and prefrailty was 41.9% and 30.1%, respectively. The rate of physical frailty substantially increased with age and was higher among patients with graft-versus-host disease (70.2%). Lower physical activity levels were significantly associated with increased physical frailty among HSCT recipients (χ²= 85.95, p 0.05). Moreover, physical activity partially mediated the relationship between self-efficacy for exercise and physical frailty. Conclusion: This study showed that physical frailty is prevalent among HSCT recipients in Jordan. Early physical frailty screening and the development of a culturally sensitive self-management program can mitigate the adverse effects of physical frailty among this vulnerable population.