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Maleki M, Dehghan Nayeri N, Hamidieh AA, Pouraboli B, Mardani A. Harmony in hardship: Unveiling parental coping strategies with the challenges of child's hematopoietic stem cell transplantation. J Pediatr Nurs 2024; 77:e202-e210. [PMID: 38616142 DOI: 10.1016/j.pedn.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/21/2024] [Accepted: 04/06/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Pediatric Hematopoietic Stem Cell Transplant (HSCT) profoundly affects various dimensions of parents' lives. Effective coping strategies are essential for improving psychological well-being and overall quality of life. Therefore, this study aimed to explore parental coping strategies with their child's HSCT challenges. DESIGN AND METHODS This qualitative study was conducted in Iran from February to November 2023, utilizing conventional content analysis with purposive sampling. For data collection, unstructured interviews were conducted, followed by in-depth semi-structured interviews with open-ended questions. Saturation was reached after analyzing qualitative data from 20 participants. RESULTS Data analysis unveiled a main theme labeled "harmony in hardship". This overarching concept encapsulates the participants' endeavors to cope with the various hurdles and complexities stemming from their child's HSCT. This theme consisted of five categories: "emotional release", "positive coping", "avoidance coping", "spiritual coping", and "seeking support". CONCLUSION Parents utilized multifaceted coping strategies to manage the complexities of their child's HSCT journey. Understanding these mechanisms is crucial as they can positively influence parents' psychological well-being and improve their overall quality of life. IMPLICATIONS FOR CLINICAL PRACTICE Healthcare professionals should recognize the diverse coping strategies employed by parents of children undergoing HSCT and provide tailored interventions and support. Furthermore, implementing structured support programs and training initiatives for healthcare professionals can enhance their capacity to meet the diverse needs of parents during this challenging journey.
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Affiliation(s)
- Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amir Ali Hamidieh
- Pediatric Cell and Gene Therapy Research Centre, Gene, Cell & Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Batool Pouraboli
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Mardani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
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Maleki M, Dehghan Nayeri N, Hamidieh AA, Pouraboli B. Parents' experiences of living with a child with cancer undergoing hematopoietic stem cell transplantation: a qualitative content analysis study. Front Psychol 2024; 15:1359978. [PMID: 38533218 PMCID: PMC10963479 DOI: 10.3389/fpsyg.2024.1359978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Objectives Pediatric Hematopoietic Stem Cell Transplant (HSCT) profoundly impacts the physical, psychological, and social aspects of parents' lives. Thus, this study aimed to explore the experiences of parents living with a child with cancer who undergoes HSCT. Methods This qualitative study involved 20 parents of children with cancer who were undergoing HSCT at a referral hospital in Iran. Purposive sampling was used to select the participants from February 2023 to November 2023. In-depth semi-structured interviews, featuring open-ended questions, were utilized for data collection. Data analysis was performed using conventional content analysis. Results Data analysis revealed two main themes. "Surrounded by hardships" and "Self-actualization." The first theme encompassed participants' experiences of facing difficulties in life after being aware of their child's need for HSCT. This theme consisted of four categories: "uncertainty about the child's future," "exhaustion from the child's treatment process," "worrying about the healthy child(ren)," and "helplessness." The second theme "self-actualization" included with two categories: "transformation in life's philosophy" and "acquisition of new capabilities." These categories highlighted the positive outcomes experienced by the participants following their child's HSCT. Conclusion Our findings underscore the importance of healthcare providers being attuned to parents' experiences throughout their child's HSCT trajectory. It is crucial for healthcare providers to encourage parents to articulate their concerns and feelings and seek support from healthcare providers, family, and friends. The development of psychological support services in healthcare settings can facilitate tailored interventions to alleviate parents' difficulties.
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Affiliation(s)
- Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ali Hamidieh
- Pediatric Cell and Gene Therapy Research Centre, Gene, Cell & Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Batool Pouraboli
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Bekar P, Altuntaş D, Efe E. Home experiences of parents of children undergoing hematopoietic stem cell transplantation: A qualitative study. J Pediatr Nurs 2023; 73:e541-e548. [PMID: 37923613 DOI: 10.1016/j.pedn.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE This study aimed to describe the home experiences of parents of children undergoing hematopoietic stem cell transplantation. DESIGN AND METHODS This study was conducted using a descriptive qualitative research design. The study sample consisted of 12 parents with a child treated with hematopoietic stem cell transplantation (HSCT) at a university hospital in Turkey. Semi-structured individual interviews and researcher observations were used for data collection. The interview transcripts of the study were analyzed using content analysis. RESULTS Five main themes were obtained, each of which had associated sub-themes: difficulties faced in home experiences, changes in family life, feelings about home experiences, parents' ways of coping with difficulties, and parents' suggestions. CONCLUSIONS Parents faced various difficulties in their own home experiences, and they felt fear, anxiety and stress during this period. Following the child's HSCT, there were changes in health, physical, psychological and social aspects of family life. Some parents used distraction techniques, and the support of their spouses and health professionals to cope with difficulties. PRACTICE IMPLICATIONS For pediatric nurses to comprehensively assess and support the home care needs of the child and parents, they should understand the difficulties parents face in home experiences, as well as their feelings, changes in their lives, suggestions regarding home experiences, and ways of coping. Regular health screening and psychosocial support can be provided for parents of children after HSCT, and regular training can be given for parents' management of care-related problems and increasing their self-efficacy for this management.
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Affiliation(s)
- Pınar Bekar
- Burdur Mehmet Akif Ersoy University, Bucak School of Health, Department of Child Development, Bucak/Burdur, Turkey.
| | - Duygu Altuntaş
- Akdeniz University, Nursing Faculty, Department of Child Health Nursing, 07058, Campus, Antalya, Turkey.
| | - Emine Efe
- Akdeniz University, Nursing Faculty, Department of Child Health Nursing, 07058, Campus, Antalya, Turkey.
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Chen J, Yu J, Xie M, Wu Y, Hu R. Understanding the symptom experience and self-management strategies of adult hematopoietic stem cell transplantation patients during hospitalization: findings from a qualitative longitudinal study. Support Care Cancer 2022; 30:10137-10147. [PMID: 36350378 PMCID: PMC9643937 DOI: 10.1007/s00520-022-07428-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022]
Abstract
Purpose The aim of this study was to explore the symptom experience and self-management strategies of adult hematopoietic stem cell transplantation patients during hospitalization. Methods This was a qualitative descriptive study. A heterogeneous sample of 19 patients who underwent hematopoietic stem cell transplantation from May to October 2021 were enrolled in the study. Semi-structured interviews were conducted at four time points during hospitalization, providing a total of 64 interview datasets. Results Four themes and 11 subthemes reflecting the symptom experience and self-management strategies of adult hematopoietic stem cell transplantation patients during hospitalization were observed. The four themes were (1) unexpected symptom burden: dynamic, disturbing, co-occurring, and correlative; (2) emotional complexity at different periods; (3) internal predicament: ineffectiveness of symptom management; and (4) external strength: desire for support from multiple sources. Hematopoietic stem cell transplantation patients experienced a complex and dynamic array of symptoms from admission to discharge, and they experienced the dual forces of internal predicament and external strength in symptom self-management during hospitalization. Conclusion The findings of this study emphasize the need for a deeper understanding and precise management of the symptom experience of adult hematopoietic stem cell transplantation patients during hospitalization. Hematopoietic stem cell transplantation nurses need to assess symptoms on an ongoing basis; educate patients on ways to perceive, express, and self-manage multiple symptoms; and develop patients’ self-symptom management skills to enhance their symptom relief and quality of life.
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Affiliation(s)
- Jingyi Chen
- The School of Nursing, Fujian Medical University, Shangjie Town, Minhou County, No.1 of Xueyuan Road, Fuzhou City, Fujian Province, China
| | - Jiejie Yu
- The School of Nursing, Fujian Medical University, Shangjie Town, Minhou County, No.1 of Xueyuan Road, Fuzhou City, Fujian Province, China
| | - Mengting Xie
- The School of Nursing, Fujian Medical University, Shangjie Town, Minhou County, No.1 of Xueyuan Road, Fuzhou City, Fujian Province, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, No.29 of Xinquan Road, Fuzhou City, Fujian Province, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Shangjie Town, Minhou County, No.1 of Xueyuan Road, Fuzhou City, Fujian Province, China.
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Beckmann NB, Dietrich MS, Hooke MC, Gilmer MJ, Akard TF. Parental Posttraumatic Growth After Pediatric Hematopoietic Stem Cell Transplant. J Hosp Palliat Nurs 2021; 23:331-338. [PMID: 34185727 DOI: 10.1097/njh.0000000000000759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Little is known about the development of posttraumatic growth among parents of children with serious advanced disease. The purpose of this study is to describe parental posttraumatic growth 100 days after pediatric stem cell transplant. This is a cross-sectional, descriptive study of 24 parents, approximately 100 days after their children received stem cell transplant. Participants reported environmental, personal, and disease characteristics and completed measures of distress, coping, rumination, and posttraumatic growth. Evidence of parental posttraumatic growth was described in each of 5 dimensions (relating to others, new possibilities, personal strength, spiritual change, and appreciation of life). Posttraumatic growth was positively associated with parental distress, disengagement coping, and rumination measures (r = 0.44-0.47, P < .05). Appreciation of life demonstrated the strongest associations with distress and rumination (r = 0.53-0.61, P < .01). Curvilinear relationships were observed for the association of distress, disengagement coping, and involuntary engagement with posttraumatic growth (P < .05). Study results highlight opportunities for palliative care nurses and clinicians to facilitate opportunities to support parent posttraumatic growth during treatment for children's advanced disease.
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Chardon ML, Brammer C, Madan-Swain A, Kazak AE, Pai ALH. Caregiver Religious Coping and Posttraumatic Responses in Pediatric Hematopoietic Stem Cell Transplant. J Pediatr Psychol 2021; 46:465-473. [PMID: 33517435 DOI: 10.1093/jpepsy/jsaa126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Caregivers often experience their child's hematopoietic stem cell transplant (HCT) treatment as traumatic. Although many caregivers develop posttraumatic stress symptoms (PTSS) in response to supporting their child through HCT, other caregivers demonstrate posttraumatic growth (PTG). Religious coping may contribute to these different adjustment trajectories; however, more information is needed to clarify the unique associations of positive versus negative religious coping on caregiver PTSS and PTG in the context of pediatric HCT. This study aimed to examine the relationships between negative and positive religious coping on caregivers PTSS and PTG while controlling for caregiver sex, self-efficacy, and social support. METHODS Caregivers (N = 140) of youth admitted to the hospital for their first HCT were asked to complete self-report measures of their use of positive and negative religious coping, PTSS, PTG, social support, and self-efficacy. Two hierarchical linear regressions were conducted to test hypotheses. RESULTS Greater positive religious coping, but not negative religious coping, was associated with caregivers reporting more PTG in response to pediatric HCT. More negative religious coping, but not positive religious coping, was associated with caregivers experiencing greater PTSS. CONCLUSIONS Engaging in positive religious coping appears to promote better caregiver adjustment to pediatric HCT, whereas negative religious coping may increase caregiver risk for developing PTSS. Screening caregivers' religious beliefs, including the type of religious coping they employ, could inform providers regarding the best approach to supporting caregivers towards a growth trajectory and mitigate PTSS.
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Affiliation(s)
- Marie L Chardon
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Caitlin Brammer
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Avi Madan-Swain
- Division of Pediatric Hematology and Oncology, University of Alabama at Birmingham
| | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System.,Department of Pediatrics, Thomas Jefferson University
| | - Ahna L H Pai
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
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Abstract
PURPOSE OF REVIEW Discussing the currently available HSCT options for Hb SS patients highlighting advantages and disadvantages of each modality in the light of recently published data. RECENT FINDINGS When MSD is available, myeloablative regimen is the preferred approach for otherwise healthy children whereas the nonmyeloablative (NMA) regimen is of choice for adults as well as children with SCD-associated morbidities. Mixed chimerism is common especially with NMA conditioning and is usually enough for cure. Alternative donor HSCT outcomes are progressively improving especially with posttransplant cyclophosphamide for GVHD prophylaxis. SUMMARY Recent studies comparing HSCT and chronic transfusion in Hb SS patients increasingly come in favor of HSCT arm. Advances in HSCT field led to donor pool expansion and better tolerated regimens. It is easier now to tailor a personalized transplantation plan for almost every patient. A successful management plan should be sufficiently comprehensive addressing patients' and families' social and psychological concerns to ensure compliance and improve outcome.
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