Objective: The study was conducted to understand the
emotional impact of multiple myeloma, as well as the impact of its
principle treatment, peripheral blood stem cell transplant (PBSCT). The
absence of psycho-oncology research literature on this population prompted
the need for a hypothesis-generating investigation. Thus, a qualitative
design was used to construct a theoretical model of the trauma relating to
diagnosis and treatment of myeloma. The study also incorporates the
important period of reflection and growth following treatment.Methods: The sample consisted of 3 women and 3 men treated
for myeloma at a New York City-based cancer treatment center. Data from
individual interviews were audiotaped and transcribed. After extensive
review, the data were categorized into groups of repeating ideas, themes
and broad theoretical constructs.Results: A five-construct model emerged from the data
analysis that integrated a model of trauma and growth presented in earlier
work (Auerbach et al., 2006). These constructs
roughly correspond with stages of illness, but do not necessarily imply a
linear process, as suggested by stage models. The first construct is
diagnosis. Patients receive the news that they have multiple myeloma.
Initial reactions are discussed and a treatment plan takes form. In the
second construct, treatment, patients highlight the physical and emotional
hurdles confronted throughout treatment. The third construct, network of
safety, presents social factors that play a role in comforting patients
throughout illness. Patients recognize the importance of a strong support
system during their experiences. In the fourth construct, recuperation,
physical energy is regained after an arduous recovery period. This
contributes to higher spirits and a motivation to reengage with life. The
fifth construct is reflection and new existence. Patients strive to
balance a new reality that relapse and death are inevitable, along with
their need to live a meaningful life. Many do not yet appreciate how their
disease has impacted them, but describe how their interpersonal lives and
perceptions have changed, both positively and negatively.Significance of results: Limitations of the study, future
directions for research and clinical implications are discussed.
Maintenance thalidomide following single cycle autologous peripheral blood stem cell transplant in patients with multiple myeloma
