The psychosocial impact of bone marrow transplantation: Research and clinical social work perspectives

Abstract

Bone marrow transplantation (BMT) has been under-studied from a social work perspective. This article reports on a cross-institutional study into the psychological and social preparation for bone marrow transplantation. The data presented was collected from all consenting BMT recipients treated over a preceding three year period at four teaching hospitals. The key findings included demographic issues which had an influence on post transplant adjustment, lack of rehabilitation services, ongoing physical incapacity, disappointment at the slow rate of recovery, lack of counselling resources, difficulties in the way information was presented, difficulties with the transition from hospital to home and a perceived lack of interest by hospital staff of the needs of carers. These results were presented to the social workers in each BMT unit. They considered the extent to which the findings matched their clinical experience, and the relevance of the research to their social work practice. This discussion suggested the need for social work involvement on a number of levels beyond case-work, particularly in promoting organisational change.Bone marrow transplantation (BMT) is a treatment for malignant disease which involves the extraction of marrow from the recipient or from a matched donor. The recipient then undergoes high dose chemotherapy which destroys the malignant cells but also renders the body incapable of producing normal blood cells. This would normally lead to increasing immune deficiency until death by opportunistic infections. However, the infusion of marrow effects a repair of the body's ability to produce blood cells. It usually takes three to five weeks until the Desmond J. Perry, recipient is considered to be out of danger of succumbing to these infections. BMT recipients go through a number of worrying stages in their treatment which include periods of isolation, side-effects of chemotherapy, and high dependency on others to meet their daily needs.A number of psychosocial difficulties have been isolated in the literature, which suggests the need to look at access to community-based services, and that empowering BMT recipients to have more control over their own preparation might have an impact on their post-transplant adjustment. The literature also suggests that social workers are best situated to address some of these difficulties because of their focus not only on the needs of the individual, but also their grasp of the impact of social factors of adjustment to cancer. This article uses both the qualitative and quantitative data collected in this study to address these issues.

Social Work in Health Care

“…Social work in health care was faced with numerous challenges during this period. Like other professionals in the health field, social workers have had to deal with the ramifications of epidemics of new diseases, such as AIDS, the reappearance of old diseases, like tuberculosis, the occurrence of environmental catastrophes and man-made disasters around the world (Brooks, 1996: Jackson et al, 1996Sewpaul and Rollins, 1999;Black and Bruce, 1998;Cwikel and Rozovski, 1998;Soskolne et al, 1996) as well as the continued development of new technologies (Barr and Botha, 1995;Perry et al, 1998). The worldwide escalation in the costs of health care have also taken a toll on social work.…”