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Polomeni A, Bompoint C, Labopin M, Badoglio M, Battipaglia G, Eeltink C, Liptrott SJ, Babik A, Murray J, Stringer J. Hematopoietic cell transplant nurse coordinators' perceptions of related donor care: a European survey from the EBMT Nurses Group. Bone Marrow Transplant 2019; 55:623-632. [PMID: 31578465 DOI: 10.1038/s41409-019-0686-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 08/06/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022]
Abstract
Allogeneic haematopoietic cell transplantation (HCT) is a curative procedure for patients with haematological malignancies and immune deficiencies. A human leukocyte antigen (HLA) identical sibling is only available for 25-35% of patients in need. The improvement in haplo-identical transplantation has led to a marked increase in cell donation from relatives. Despite international recommendations, discrepancies in related-donors (RD) care exist between centres, particularly regarding medical suitability criteria, consenting procedures and donor follow-up. This European survey aimed to explore hematopoietic cell transplantation coordinators nurses' (HCT-CNs) perceptions of RD care, in particular the association with the presence or not of an independent unit (IU). Ninety-three HCT-CNs from seventy-six EBMT centres responded, representing 19 countries (response rate: 27%). Our results did not show a significant association between IU and HCT-CNs perceptions of related-donors care. The practices for RD care vary among centres regarding presence or not of an IU (48%), person caring for RD (haematologist in 54%, HCT physician in 17%, HCT-CNs in 20%), person to whom the results of HLA typing are communicated, use of a booklet for RD, follow-up or not and periodicity of follow-up. Qualitative data highlight the related-donation ethical issues and the need for improvement in RD care. HCT-CNs' main concerns were: the necessary confidentiality to insure the voluntary status of RD, the perceived conflict of interest felt by professionals when managing both patients and RD, plus the psychosocial aspects of related-donation. Even if there is a variety of a practice among centres, the presence of an IU is not significantly associated with an improvement in RD care.
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Affiliation(s)
- A Polomeni
- Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France.
| | - C Bompoint
- EBMT Nurses Group, Department of Hematology and Cell therapy, Saint Eloi Hospital, Montpellier, France
| | - M Labopin
- EBMT Paris Study Office/CEREST-TC, Department of Hematology and Cell Therapy, Saint-Antoine Hospital, INSERM UMR 938, Université Pierre et Marie Curie, Paris, France
| | - M Badoglio
- EBMT Paris Study Office/CEREST-TC, Department of Hematology and Cell Therapy, Saint-Antoine Hospital, INSERM UMR 938, Université Pierre et Marie Curie, Paris, France
| | - G Battipaglia
- Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France
| | - C Eeltink
- EBMT Nurses Group, Amsterdam UMC, VU University Medical Center Department of Hematology, Amsterdam, The Netherlands
| | - S J Liptrott
- EBMT Nurses Group, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Babik
- EBMT Nurses Group, JACIE QM Inspector, IOSI-Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - J Murray
- EBMT Nurses Group, Haematology and Transplant Unit, Christie Hospital NHS Foundation Trust Manchester, Manchester, UK
| | - J Stringer
- EBMT Nurses Group, The Christie NHS Tust, The University of Manchester, Manchester, UK
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Zomerdijk N, Turner J, Hill GR, Gottlieb D. Adult related haematopoietic stem cell donor care: Views of Transplant Nurses. Eur J Oncol Nurs 2019; 41:56-63. [PMID: 31358258 DOI: 10.1016/j.ejon.2019.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/08/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The objective of this mixed-methods study was to explore the experiences and perspectives of Transplant Nurses (TNs) in caring for related donors (RDs). METHOD In this mixed-methods study, both quantitative and qualitative data were collected from semi-structured interviews with seven TNs from two clinical hospitals. Closed and multiple-choice questions regarding the organisation of RD care were administered in addition to an in-depth exploration of TN experiences and perspectives of RD care. Interviews were audio-recorded, transcribed, and qualitative data was subjected to thematic analyses. RESULTS The analysis identified 5 themes relating to RD care: managing complex family dynamics and ambivalence; concerns about RD psychological adjustment; identifying and correcting RD misperceptions; limited guidelines and structured processes; limited training for the role and access to supervision. Five themes were identified describing the barriers to delivering RD care: RDs unwilling to express their concerns; language; time constraints; medical priority of clinicians; biomedical focus of TNs. All TNs agreed they would like additional training in the psychosocial management of RDs. TNs identified key areas for improvement, including psychosocial support and educational material. CONCLUSIONS Our results highlight the significant role of TNs in RD care, and underline issues specific to the current RD care environment. Lack of training for the role and limited guidelines addressing RD care management are key issues which may detrimentally affect RD care. The pivotal role of TNs must be acknowledged and supported by improving TN training and implementing clear guidelines for the management of RDs. The trial has been registered on the publicly accessible register: www.clinicaltrials.gov site with the identifier ACTRN12617000407392.
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Affiliation(s)
- Nienke Zomerdijk
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
| | - Geoffrey R Hill
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Fred Hutchinson Cancer Research Center, Sydney, NSW, Australia.
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