Support Care Cancer: Symptom experience and self-management strategies during hospitalization in adult hematopoietic stem cell transplant patients: results from a qualitative longitudinal study

Hematopoietic stem cell transplantation (HSCT) rebuilds the patient's hematopoietic and immune function
by replacing a patient's HSCs with healthy autologous (i.
e.
, the patient's own cells) or allogeneic (i.
e.
, cells from a donor) hematopoietic stem cells.
Only a few qualitative studies have compared and analysed changes in HSCT patients over time during hospital stay
.
To fill these gaps, a research team conducted this longitudinal descriptive phenomenological study aimed at exploring symptom experiences and self-management strategies
for adult HSCT patients during hospitalization.

This is a qualitative, descriptive study
.
The study included a heterogeneous sample
of 19 patients who underwent hematopoietic stem cell transplantation between May and October 2021.
Semi-structured interviews were conducted at four time points during hospitalization, providing a total of 64 interview datasets
.

Figure 1: Summary of topics and subtopics

Figure 2: Dynamic symptoms of hematopoietic stem cell transplant patients at four time points

4 themes and 11 sub-themes to observe symptom experiences and self-management
strategies during hospitalization in adult hematopoietic stem cell transplant patients.
The four themes are (1) unexpected symptom burden: dynamic, disturbing, co-occurring and related; (2) emotional complexity over time; (3) Internal dilemma: poor symptom management; (4) External forces: eager for multi-party support
.
Hematopoietic stem cell transplant patients experience a complex and dynamic set of symptoms from admission to discharge, experiencing the dual power
of symptomatic self-management and external forces during hospitalization.

In summary, the study highlights the need for a deeper understanding of symptom experiences and self-management strategies
during hospitalization in adult HSCT patients.
HSCT patients experience complex and dynamic symptoms
several times during hospitalization.
Healthcare providers should enhance routine assessment of symptoms, educate patients on how to perceive, express, and self-manage multiple symptoms, and develop self-symptom management skills to reduce physical and psychological symptoms associated with HSCT and thus improve their quality of life
.
In addition, HSCT patients often experience distressing symptoms
during transplantation.
Established support pathways from multiple sources are important
to promote person-centred symptom management and improve the general health of HSCT hospitalized patients.
Further research is needed to combine longitudinal quantitative and qualitative methods to explore symptom characteristics during HSCT, providing a unique perspective
for understanding symptom pathogenesis and better preventing and managing symptoms.

Original source:

Chen, J.
, Yu, J.
, Xie, M.
et al.
Understanding the symptom experience and self-management strategies of adult hematopoietic stem cell transplantation patients during hospitalization: findings from a qualitative longitudinal study.
Support Care Cancer(2022).
https://doi.
org/10.
1007/s00520-022-07428-1