Facilitators and obstacles to couples’ intimacy after hematopoietic stem cell transplantation: a qualitative study

Abstract Background Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the only potentially curative treatment option for many patients with hematological disorders but it includes a significant risk of mortality and long-term morbidity. Many patients and their support persons feel overwhelmed when being informed about alloHSCT and may benefit from improvements in consultation style and timing. Aims To explore, qualitatively, in a sample of hematological cancer patients and their support persons, their preferences for receiving one longer consultation or two shorter consultations when being informed about alloHSCT. Participants’ perceptions of when and how different consultation styles should be offered were also examined. Methods Semi-structured face-to-face and phone interviews were conducted. A purposeful sampling frame was used. Data were analysed using framework analysis. Results Twenty patients and 13 support persons were recruited (consent rate: 96%, response rate: 91%). Most patients (60%) and support persons (62%) preferred two shorter consultations over one longer consultation. This helped them digest and recall the information provided, remember questions they had, involve significant others and search for additional information. Patients would have liked to be offered paper and pen to take notes, take a break after 30 min and have their understanding checked at the end of the first consultation, e.g. using question prompt lists. Some patients and support persons preferred both consultations to happen on the same day to reduce waiting times as well as travel times and costs. Others preferred having a few days in-between both consultations to better help them prepare the second consultation. Participants reported varying preferences for different consultation styles depending on personal and disease-related characteristics, such as age, health literacy level and previous treatment. Conclusion To our knowledge, this is the first qualitative study to explore patients’ and their support persons’ preferences for having one longer consultation or two shorter consultations when being informed about alloHSCT. Receiving two shorter consultations may help patients process and recall the information provided and more actively involve their support persons. Clinicians should consider offering patients and their support persons to take a break after 30 min, provide paper and pen as well as question prompt lists.

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Exercise barriers and facilitators during hematopoietic stem cell transplantation: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-037460 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037460

Author(s):

Mi-Seong Yu ◽

Ki-Yong An ◽

Jiyong Byeon ◽

Meeok CHOI ◽

June-Won Cheong ◽

...

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Qualitative Study ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Exercise Programme ◽

Barriers And Facilitators ◽

Hematopoietic Stem ◽

Exercise Barriers

ObjectiveAlthough exercise is beneficial in patients undergoing hematopoietic stem cell transplantation (HSCT), motivating patients to exercise is challenging. We aimed to understand exercise barriers and facilitators during HSCT treatment while participating in a daily unsupervised exercise programme.ParticipantsPatients scheduled to have HSCT.Study design6 participants were included in this descriptive qualitative study during HSCT treatment while participating in an exercise programme to identify perceived barriers and facilitators of the exercise. An average of three semi-structured interviews were conducted per patient.SettingExercise during HSCT treatment in an isolated immune room.InterventionDaily unsupervised exercise.ResultsA total of six patients completed a 6-week exercise programme as well as all scheduled interviews, whose compliance to the exercise programme ranged from 12% to 79%. Based on interview results, three themes were identified as barriers to exercise and four themes were identified as facilitators to exercise. Patients experienced physical and psychological barriers such as nausea, vomiting, sore throat, reduced appetite, decreased willpower and anxiety due to feelings of isolation. Environmental factors included negative opinions about exercise programmes and lack of encouragement from the haematologist. Facilitators of exercise included willpower, easy and simple exercise, convincing explanations from haematologists and supervised support from exercise specialists.ConclusionOur study has identified potential barriers and facilitators associated with exercise participation during HSCT. Supervised exercise recommended by a haematologist, convincing explanation on the benefit of exercise by medical personnel, positive feedback from other HSCT survivors and supervision by exercise specialists may increase compliance to the exercise programme during HSCT.Trial registration numberISRCTN61498391.

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