 | Author(s) | | | Stephens M |
| Publication | | | European Journal of Oncology Nursing |
| Reference | | | Vol 9 : pages 204-215 |
| Publication Date | | | 2005 |
|  |  Relevant to nurses who care for patients post-HSCT
 | What is the problem and what is known about it so far? |
All nurses working in areas where haemopoietic stem cell transplant (HSCT) is undertaken will recognise the enormous physical and psychological impact it has on individuals. The effects of transplant may last from months to years or be permanent and although several researchers have attempted to measure quality of life post transplant this study is unique in exploring patient experiences, their concerns and the impact of HSCT on their lives. The author suggests that following transplant individuals’ may have a different outlook on life, their priorities, emotions and physical capabilities may change affecting their perceptions of wellbeing. Little is yet known about these aspects of individuals’ lives.
| Who was studied? |
This small study (n=5) provides insight into the experiences of patients post autologous transplant for a variety of haematological cancers. Three women and two men participated. Length of time post transplant ranged from six months to four years. Mean age of participants at the time of interview 53.8 years (50.4 years at time of transplant).
| How was the study done? |
The nature of the study allowed individuals to detail how their life is now, and how it has changed since undergoing autologous HSCT. A phenomenological research approach was used which aims to describe the participants’ experience as accurately as possible. Data were collected through an unstructured interview asking the question ‘can you tell me about your life since transplant’.
| What were the findings? |
Nine core themes were identified from the interviews:
 | changes on various levels (physical, psychological and spiritual) |
| fear (all participants feared relapse and described having to confront their own death) |
| isolation (sense of being alone and being different from others) |
| concern about others’ wellbeing and coping skills (particularly partner and close family) |
| adaptation, adjustment and recovery (recovery not to pretransplant self but adapting to an altered life post transplant) |
| changes in values, outlook and priorities |
| transplant as a separate and discrete experience from diagnosis and initial treatment |
| new life |
| bereavement (loss of life as it was) |
| What are the limitations? |
The small sample size is an obvious limitation of this study and the results cannot be generalised. The author suggests that data saturation (no new themes emerging from the data) may have been reached after five interviews. However, only one participant identified bereavement as a theme and it is possible that other themes may have emerged with a larger sample size. There may also be a sampling bias as all participants had indicated that they would like to discuss the experience of transplant before being approached to participate in the study. Findings may have differed had others who had not identified the need to speak about their experience been included in the sample. Additionally, participants were known to the researcher and this may have introduced some bias.
The study was undertaken in one major internationally renowned centre in the UK. Individuals treated in this centre may not have the same experience as those treated in other centres and further research would be useful across a number of different centres. It would also be interesting to compare the experiences of different age groups and those with different diseases who will have experienced different treatment regimens before their transplant.
| Implications for practice |
The study has important implications for nurses who should consider how they prepare and individuals for life after transplant and how continued support can be provided.
Comment by: Maggie Grundy, Senior Lecturer at the Robert Gordon University, Aberdeen
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