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Five Phases of Recovery and Rehabilitation After Allogeneic Stem Cell Transplantation

A Qualitative Study

van der Lans, Mariska C.M. MSc, RN; Witkamp, Frederika E. PhD, RN; Oldenmenger, Wendy H. PhD, RN; Broers, Annoek E.C. MD, PhD

doi: 10.1097/NCC.0000000000000494
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Background: For patients with a hematological malignancy, allogeneic stem cell transplantation (alloSCT) is a treatment modality that may cause a wide range of problems. Little is known about the process of recovery and rehabilitation and the problems that alloSCT patients are confronted with during the first-year posttransplant.

Objective: This study explored the problems of patients during the first year after alloSCT, to better understand the process of recovery and rehabilitation.

Methods: In a qualitative study, hemato-oncology patients were interviewed 1-year posttransplant. The semistructured interviews were transcribed verbatim, coded, and analyzed using constant comparative analysis.

Results: Ten participants were included until saturation of data was reached. The patients had experienced various problems and had gone through an individual process of recovery and rehabilitation. Nevertheless, 5 phases could be distinguished: (1) survive, (2) on the receiving end, (3) bring under control, (4) start recuperation, and (5) retrospection. The duration of each phase varied between patients.

Conclusion: Although patients experienced individual problems after alloSCT, they all followed a common pathway. Posttransplant care might be improved by adjusting the care to the distinct phases that the patients pass through.

Implications for Practice: Nurses can play an important role in achieving improvements in posttransplant care by adjusting care to the individual needs of patients within the distinct phases.

Future nursing research should confirm and refine this process of recovery and rehabilitation and assess the effects of improvement measures in alloSCT patients and in other populations.

Author Affiliations: Department of Hematology (Ms van der Lans and Dr Broers), Department of Medical Oncology (Drs Oldenmenger and Witkamp), Erasmus MC Cancer Institute, Rotterdam; and Research Center Innovations in Care, Rotterdam University of Applied Sciences (Dr Witkamp), The Netherlands.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Mariska C.M. van der Lans, MSc, RN, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands (m.vanderlans@erasmusmc.nl).

Accepted for publication February 15, 2017.

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