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Dimensions of Neutropenia in Adult Cancer Patients: Expanding Conceptualizations Beyond the Numerical Value of the Absolute Neutrophil Count

Crighton, Margaret H. MSN, RN

Articles: CE

Neutropenia is a common and dangerous toxicity of cancer therapy that profoundly affects patients' lives. Neutropenia is typically defined by the numerical value of the absolute neutrophil count. However, considering neutropenia exclusively as the numerical value of the absolute neutrophil count limits its conceptualizations to physiologically related aspects, minimizes its complexities, and neglects dimensions of human response and the patient experience. This article offers a dimensional analysis of neutropenia derived from 42 research and clinical articles. Schatzman's dimensional analysis methods were applied to the literature to identify aspects of this phenomenon lying beyond its numerical boundaries. Dimensions of neutropenia that emerged were sorted into categories of perspective, context, conditions, processes, and consequences. The presence of the same dimension in more than 1 category and the circuitous relationships among categories begin to explicate the complexity and gravity of neutropenia. Articulation of these dimensions is necessary to assemble the beginnings of a theoretical understanding of neutropenia, which is crucial for the development and application of knowledge to research and practice. Limitations evident in the literature illuminate the urgent need for research into the psychosocial as well as physiologic dimensions of neutropenia.

University of Pennsylvania School of Nursing, Philadelphia, Pa.

Corresponding author: Margaret H. Crighton, MSN, RN, University of Pennsylvania School of Nursing, 420 Guardian Dr, Philadelphia, PA 19104 (e-mail:

The author has no conflict of interest.

This work was supported by a NINR predoctoral training grant (5-T32NR07036-15), an American Cancer Society Doctoral Scholarship in Cancer Nursing (DSCN-02-212-01-CN), and a John A. Hartford Foundation Building Geriatric Nursing Capacity Scholarship.

Accepted for publication April 28, 2004.

© 2004 Lippincott Williams & Wilkins, Inc.