The Meaning of Self-efficacy for Symptom Management in the Acute Phase of Hematopoietic Stem Cell Transplantation

Abstract

Background Hematopoietic stem cell transplantation (HSCT) is an intensive treatment that offers the potential for longer life or cure for some types of cancer. Hematopoietic stem cell transplant is associated with decreased quality of life and functional status and distressing symptoms. Self-efficacy for symptom management (SESM) is a person's belief in his/her ability to implement behaviors to manage these symptoms. Presence of SESM can affect symptom distress, healthcare utilization, and posttransplantation outcomes. Objective The aim of this study was to explore the meaning of SESM in adults during the acute phase of HSCT. Methods Interviews were conducted before and at 30 days after transplantation. Descriptive thematic analysis was performed on verbatim interview transcripts. Results Themes of confidence, being responsible, and caring for mind, body, and spirit were identified, with subthemes of self-confidence, confidence in others, confidence and symptom level, vigilance, self-advocacy, and normalcy. Participants reported having high SESM before transplantation and having much less or no SESM when symptom distress was the most severe. Conclusions This is the first study to examine the patient's perspective of self-efficacy in the acute phase of HSCT. This contributes to existing literature on the concept of symptom management and expands nursing knowledge of SESM in patients undergoing HSCT. Implications for Practice Nurses can assess SESM before transplantation and implement interventions to enhance SESM when symptoms are at their most distressing after HSCT. The findings from this study can provide the basis for creating behavioral interventions to enhance self-efficacy for symptom management in HSCT patients.

Evaluation of a Nurse-Led Patient Navigation Intervention

“…Still, the additional value of the nurse-led patient navigation intervention, even in this group, is visible in this study, especially for the more practical and emotional domains of daily life. Cancer nurses should therefore be recognized as key members of the survivorship care team 30–32 …”

“…Cancer nurses should therefore be recognized as key members of the survivorship care team. [30][31][32] Despite the significant improvement of QoL over time in the IG, no differences in QoL were observed between the IG and the CG 1 year after transplantation. This improvement of QoL in the IG might be explained by a gradual improvement of the medical situation and the physical and psychosocial recovery after HSCT.…”

Associations Between Global Mental Health and Response to an App-Based Meditation Intervention in Myeloproliferative Neoplasm Patients

“…This practice of nonjudgmental present-moment awareness has been demonstrated to reduce stress, 33 increase selfefficacy, 34 and improve emotion regulation 35 all of which have been associated with reductions in anxiety and depression among cancer patients/survivors. [36][37][38] Khoury and colleagues 39 suggest that mindfulness-based therapies may be most effective in those with more severe mental illness (ie, depression). In a meta-analytic review, they found across multiple studies (n = 6) that those reporting a more severe level of baseline depression improved to a greater extent from pretreatment to posttreatment as compared with those reporting more mild or moderate depression at baseline.…”

A retrospective study of treatment and outcomes of patients with lymphoma undergoing hematopoietic stem cell transplantation

“…HSCT is among the treatment approaches that prolong the life of patients with lymphoma, improve their quality of life, achieve remission success and reduce the incidence of relapse [11,14]. Although SCT contributes positively to the recovery process of patients with lymphoma, it causes patients to face many social, economic, and psychological problems [15,16]. Patients experience many symptoms depending on the disease and treatment process, and in this case, their life processes are affected and the satisfaction from life is prevented [3,9].…”