Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

Paul B. Jacobsen, Ph.D.

Co-Major Professor

Vicky Phares, Ph.D.

Committee Member

Margaret Booth-Jones, Ph.D.

Committee Member

Jack Darkes, Ph.D.

Committee Member

Kristen Salomon, Ph.D.

Committee Member

Brent Small, Ph.D.


actigraphy, activity, cancer, fatigue, sleep, stem cell transplantation


Background: Fatigue is a prominent quality of life concern among cancer patients who have undergone allogeneic hematopoietic cell transplantation (HCT). The high percentage of HCT patients reporting fatigue concerns warrants investigation into factors that may contribute to or alleviate fatigue. The present study sought to elucidate relationships among fatigue and behavioral factors including sleep disruption and sedentary activity.

Method: Allogeneic HCT recipients who were one to five years post-transplant were invited to participate in the present study. Participants wore an actigraph assessing sleep efficiency and sedentary behavior for one week, completed daily assessments of fatigue and sleep during the same period, and completed self-report questionnaires of fatigue (summary fatigue), sleep, and sedentary behavior on day seven of the study.

Results: Eighty-two allogeneic HCT recipients (age M = 56, 52% female) were enrolled and provided complete data. Forty-five percent of participants met criteria for clinically significant fatigue. Summary fatigue, but not aggregated daily fatigue, predicted sleep efficiency; neither summary nor momentary fatigue predicted sedentary behavior. Sleep disruption during the previous night and sedentary behavior during the day were related to evening reports of daily average fatigue but not daily momentary fatigue.

Conclusion: Results from the present study suggest that nearly half of HCT recipients continue to experience clinically significant fatigue one to five years post-transplant. Results from the daily analysis suggest that patients who sleep better the previous night and are less sedentary that day report less fatigue at the end of the day, which is a finding that warrants replication and further study. Finally, findings suggest that a daily assessment methodology may be more useful under circumstances in which there is greater daily variability in fatigue.

Included in

Psychology Commons