Stress and coping strategies among allogeneic haematopoietic stem cell transplantation survivors: A qualitative study

Abstract

Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is one of the most aggressive treatments for haematological disorders. The procedure requires high doses of chemotherapy, and in some cases radiation, to eradicate the disease; this has a significant impact on patients' quality of life (Mosher, Redd, Rini, Burkhalter, and DuHamel, 2009). Despite the potentially curative effects of this treatment, psychosocial distress often results from regimen-related toxicities, long periods of isolation, lengthy in-hospital stays, a range of symptoms induced by graft-versus-host disease (GVHD) and long-lasting complications(Brice et al., 2017; Cooke, Gemmill, Kravits, & Grant, 2009). However, despite these stressors, there are limited evidence-based psychological interventions for allo-HSCT survivors (Baliousis, Rennoldson, & Snowden, 2016). To develop these interventions, specific information is needed regarding survivor appraisal of stressors and coping strategies. Thus, a qualitative analysis of survivors' views is appropriate and useful. We reviewed previous qualitative studies describing stress and coping among adult allo-HSCT survivors by using PubMed, Web of Science and Google Scholar; 'haematopoietic stem cell transplantation' 'stress' 'coping"' "qualitative"' were used as keywords; hand searching was also performed. Previous studies have categorised allo-HSCT survivors' stressors into the following three

“This Graft-vs.-Host Disease Determines My Life. That's It.”—A Qualitative Analysis of the Experiences and Needs of Allogenic Hematopoietic Stem Cells Transplantation Survivors in Germany

“…Conducting qualitative research can further help discover areas for improvement of care and inform the development of interventions to help survivors better cope with their symptoms (30,31). Yet, only few qualitative studies explored alloHSCT-survivors' experiences post-transplant (19,(32)(33)(34)(35)(36)(37), with many of them focusing on survivors of leukemia or lymphoma (33). Also, there is still a lack of research on how care in this area could be improved and, to our knowledge, very few qualitative studies have focused on the views and perceptions of European alloHSCT-survivors taking into account that findings from other contexts may not be generalizable due to differences in healthcare settings and services.…”

Survivorship Experiences of Chinese Hematopoietic Stem Cell Transplantation Survivors: A Qualitative Study

“…Similar ndings were made in studies from the UK 8 and Japan. 17 As reported in a study in the United States, up to 90% of 90 HSCT survivors did not adhere to a good quality diet, resulting in nutritional de ciencies. 30 One possible reason for poor diet found in our study was a "reduced sense of taste."…”

“…Researchers have investigated the impact of HSCT on quality of life, life experiences and long-term effects, living with GVHD, spirituality, coherence, self-management, stress and coping strategies, healthcare and nancial needs, and returning to work. [8][9][10][11][12][13][14][15][16][17][18] Findings from these studies included negative experiences and restrictions in survivorship, 8,11 job insecurity and decline in work capacity. 9,14 However, they also documented positive experiences including cognitive coping, 17 acknowledging the meaningfulness of the HSCT experience, 15,18 reliance on spiritual or religious resources, 10 progressively learning self-management, 16 as well as valuing the importance of participating in health decision-making.…”

“…[8][9][10][11][12][13][14][15][16][17][18] Findings from these studies included negative experiences and restrictions in survivorship, 8,11 job insecurity and decline in work capacity. 9,14 However, they also documented positive experiences including cognitive coping, 17 acknowledging the meaningfulness of the HSCT experience, 15,18 reliance on spiritual or religious resources, 10 progressively learning self-management, 16 as well as valuing the importance of participating in health decision-making. 12,13 Nevertheless, qualitative reports on the survivorship experiences of Chinese HSCT survivors are still lacking at present.…”

Psychosocial and financial issues after hematopoietic cell transplantation

“…7 Importantly, adap tive or maladaptive coping strat e gies play a cru cial role in the occur rence and impact of psy cho log i cal sequelae. 8,9 Estimates sug gest that 10% to 40% of HCT sur vi vors experi ence neurocognitive dys func tion when mea sured with neuro-psychological test ing; how ever, esti ma tes are higher when selfreported (40%-60%). 4 A pro por tion of HCT sur vi vors may experi ence per sis tent neurocognitive dys func tion, while other sur vi vors may expe ri ence improve ments over time.…”