Articles

Life in Limbo: Experiences of Iranian Hematopoietic Stem Cell Transplantation Recipient Patients and Nurses in a Qualitative Study

Abstract

Background: This study explored the state of hematopoietic stem cell transplantation (HSCT) recipient patients and problems experienced by them and nurse about these state and problems, in Iran.
Methods: Qualitative content analysis was used for analyzing semi-structured interviews with 12 HSCT recipient patients and 18 nurses.
Results: Three main categories described the HSCT state and problems: shadow of death, living with uncertainty, and immersion in problems. Patients treated with risk variety in continuity with probability of death. The patients lived with uncertainty. Consequently these resulted immersion in problems with four sub-categories including: (a) Physical problems, (b) money worries, (c) life disturbances, and (d) emotional strain.
Conclusion: HSCT patients live in a state of limbo between life and death with multidimensional problems. Establish centers for supporting and educating of patients and their families, education of health care providers, enhancement of public knowledge about HSCT along with allocating more budgets to take care of these patients can help patients for passing from this limbo.

Appelbaum FR. The current status of hematopoietic cell transplantation. Annu Rev Med; 2003. 54(1): 491-512.

De la Morena MT, Gatti RA. A history of bone marrow transplantation. Immunol Allergy Clin North Am; 2010. 30(1): 1-15

Kächele H, Grulke N. Psychoanalytic aspects of bone marrow transplantation. Int Congr Ser; 2006. 1286: 95-100.

Prieto JM, Blanch J, Atala J, Carreras E, Rovira M, Cirera E et al. Psychiatric Morbidity and Impact on Hospital Length of Stay Among Hematologic Cancer Patients Receiving Stem-Cell Transplantation. J Clin Oncol; 2002. 20(7): 1907-17.

Cooke L, Gemmill R, Kravits K, Grant M. Psychological Issues of Stem Cell Transplant. Semin Oncol Nurs;2009. 25(2): 139-150.

Fife BL, Huster GA, Cornetta KG, Kennedy VN, Akard LP, Broun ER. Longitudinal Study of Adaptation to the Stress of Bone Marrow Transplantation. J Clin Oncol; 2000. 18(7): 1539-49.

Mosher CE, Redd WH, Rini CM, Burkhalter JE, DuHamel KN. Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology; 2009. 18(2): 113-27.

Buchsel PC. Survivorship issues in hematopoietic stem cell transplantation. Semin Oncol Nurs ; 2009. 25(2): 159-69.

Mishel MH, Braden CJ. Finding meaning: Antecedents of uncertainty in illness. Nurs Res; 1988. 37(2): 98-103, 127.

Ghavamzadeh A, Alimogaddam K, Jahani M, Hamidieh A, Mousavi SA, Iravani M et al. Hematopoietic Stem Cell Transplantation in Iran: 1991 through 2010. IJHOSCR; 2010. 4(4): 1-9.

Ramzi M. Hematopoietic stem cell transplantation in Southern Iran: History, current status and future direction. Iran Red Crescent Med J; 2009. 11(4): 364-70.

Hansen BS, RØRtveit K, Leiknes I, Morken I, Testad I, Joa I et al. Patient experiences of uncertainty – a synthesis to guide nursing practice and research. J Nurs Manag; 2012. 20(2): 266-77.

McCormick KM. A Concept Analysis of Uncertainty in Illness. J Nurs Scholarsh; 2002. 34(2): 127-31.

Munakata W, Sawada T, Kobayashi T, Kakihana K, Yamashita T, Ohashi K et al. Mortality and medical morbidity beyond 2 years after allogeneic hematopoietic stem cell transplantation: experience at a single institution. Int J Hematol; 2011. 93(4): 517-22.

Ramzi M. Hematopoietic Stem Cell Transplantation in Southern Iran: History, Current Status and Future Direction. Iran Red Crescent Med J; 2009. 11(4): 364-70.

Ghavamzadeh A, Alimoghaddam K, Jahani M, Mousavi SA, Iravani M, Bahar B et al. Stem cell transplantation; Iranian experience. Arch Iran Med; 2009.12(1): 69-72.

Hutspardol S, Shaw PJ. Relapse and Mortality in Young Survivors 2.5 Years After Autologous and Allogeneic Hematopoietic Stem Cell Transplantation for Solid Organ Tumors and Malignant Blood Disorders. Biol Blood Marrow Transplant; 2009. 15(2): 20.

Pavletic SZ, Kumar S, Mohty M, de Lima M, Foran JM, Pasquini M et al. NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation: Report from the Committee on the Epidemiology and Natural History of Relapse following Allogeneic Cell Transplantation. Biol Blood Marrow Transplant; 2010.16(7): 871-90.

Bjorklund A, Aschan J, Labopin M, Remberger M, Ringden O, Winiarski J et al. Risk factors for fatal infectious complications developing late after allogeneic stem cell transplantation. Bone Marrow Transplant; 2007. 40(11): 1055-62.

Shlomchik WD ,Lee SJ, Couriel D, Pavletic SZ. Transplantation’s Greatest Challenges: Advances in Chronic Graft-versus-Host Disease. Biol Blood Marrow Transplant; 2007. 13: 2-10.

Grimsbø GH, Finset A, Ruland CM. Left Hanging in the Air: Experiences of Living with Cancer as Expressed Through E-mail Communications with Oncology Nurses. Cancer Nurs; 2011. 34(2): 107-16.

Shaha M, Cox CL, Talman K ,Kelly D. Uncertainty in Breast, Prostate, and Colorectal Cancer: Implications for Supportive Care. J Nurs Scholarsh; 2008. 40(1): 60-67.

Bailey DE, Wallace M, Mishel MH. Watching, waiting and uncertainty in prostate cancer. J Clin Nurs; 2007. 16(4): 734-41.

Mattsson M, Möller B, Stamm T, Gard G, Boström C. Uncertainty and Opportunities in Patients with Established Systemic Lupus Erythematosus: A Qualitative Study. Musculoskeletal Care; 2012. 10(1): 1-12.

Jiang X ,He G. Effects of an uncertainty management intervention on uncertainty, anxiety, depression, and quality of life of chronic obstructive pulmonary disease outpatients. Res Nurs Health; 2012. 35(4): 409-18.

Mishel MH. The measurement of uncertainty in illness. Nurs Res; 1981. 30(5): 258-63.

Neville KL. Uncertainty in Illness: An Integrative Review. Orthop Nurs; 2003. 22(3): 206-14.

Niscola P, Romani C, Scaramucci L, Dentamaro T, Cupelli L, Tendas A et al. Pain syndromes in the setting of haematopoietic stem cell transplantation for haematological malignancies. Bone Marrow Transplant; 2008. 41(9): 757-64.

Copelan EA. Hematopoietic Stem-Cell Transplantation. N Engl J Med; 2006. 354(17): 1813-26.

Barr RD. The importance of lowering the costs of stem cell transplantation in developing countries. Int J Hematol; 2002. 76: 365-67.

Ghavamzadeh A, Alimogaddam K, Jahani M, Mousavi S, Iravani M, Bahar B et al. Hematopoietic stem cell transplantation in Iran: 1991 to 2008. Hematol Oncol Stem Cell Ther; 2008. 1(4): 231-8.

Mishra V, Andresen S, Brinch L, Kvaloy S, Ernst P, Lonset MK et al. Cost of autologous peripheral blood stem cell transplantation: the Norwegian experience from a multicenter cost study. Bone Marrow Transplant; 2005. 35(12): 1149-53.

Langer S, Abrams J, Syrjala K. Caregiver and patient marital satisfaction and affect following hematopoietic stem cell transplantation: a prospective, longitudinal investigation. Psychooncology; 2003. 12(3): 239-53.

Hengeveld MW, Houtman RB, Zwaan FE. Psychological aspects of bone marrow transplantation: a retrospective study of 17 long-term survivors. Bone marrow transplant; 1988. 3(1): 69-75.

Broers S, Kaptein AA, Le Cessie S, Fibbe W, Hengeveld MW. Psychological functioning and quality of life following bone marrow transplantation: A 3-year follow-up study. J Psychosom Res; 2000. 48(1): 11-21.

Refsgaard B, Frederiksen K. Illness-Related Emotional Experiences of Patients Living With Incurable Lung Cancer: A Qualitative Metasynthesis. Cancer Nurs; 2012. 00(0): 1-8.

Chapple A, Ziebland S, McPherson A. Stigma, shame, and blame experienced by patients with lung cancer: qualitative study. BMJ; 2004. 328(7454): 1470.

Gregurek R, Braš M, Đorđevid V, Ratkovid AS, Brajkovid L. Psychological problems of patients with cancer. PSYCHIAT DANUB; 2010. 22(2): 227-30.

Maguire P. Improving the detection of psychiatric problems in cancer patients. Soc Sci Med; 1985. 20(8): 819-23.

Baker F, Zabora J, Polland A, Wingard J. Reintegration After Bone Marrow Transplantation. Cancer Practice; 1999. 7(4): 190-19

Files
IssueVol 7, No 3 (2013) QRcode
SectionArticles
Keywords
Hematopoietic stem cell transplantation Limbo Uncertainty

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Zamanzadeh V, Valizadeh L, Sayadi L, Taleghani F, Jeddian A. Life in Limbo: Experiences of Iranian Hematopoietic Stem Cell Transplantation Recipient Patients and Nurses in a Qualitative Study. Int J Hematol Oncol Stem Cell Res. 1;7(3):25-33.