The life threat in hematopoietic allogeneic stem cell transplantation - an interview and focus group study on health care professionals’ perspectives

Understanding healthcare professionals’ (HCPs) experiences with patients undergoing hematopoietic allogeneic stem cell transplantation (allo-HSCT) is crucial, given its dual nature of offering a hope for cure which on the other hand is accompanied by a high risk for morbidity and mortality. Yet, how...

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Bibliographic Details
Published in:	Annals of hematology Vol. 103; no. 10; pp. 4251 - 4259
Main Authors:	Reimer, Alinda, Ley, Merle, Schepers, Carolin, Pralong, Anne, Schoerger, Berenike, Voltz, Raymond, Hallek, Michael, Herling, Marco, Holtick, Udo, Simon, Steffen T.
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2024 Springer Nature B.V
Subjects:	Adult Attitude of Health Personnel Female Focus Groups Health Personnel - psychology Hematology Hematopoietic Stem Cell Transplantation - psychology Humans Interviews as Topic Male Medicine Medicine & Public Health Middle Aged Oncology Palliative Care - psychology Professionals Qualitative Research Stem cell transplantation Transplantation, Homologous Health care professionals Allogeneic transplantation Moral distress Hematopoietic stem cell transplantation Supportive care, stem cell transplantation
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Summary:	Understanding healthcare professionals’ (HCPs) experiences with patients undergoing hematopoietic allogeneic stem cell transplantation (allo-HSCT) is crucial, given its dual nature of offering a hope for cure which on the other hand is accompanied by a high risk for morbidity and mortality. Yet, how HCPs experience their patients’ existential threats remains unexplored. Qualitative thematic content analysis was employed to comprehend these experiences. This involved conducting three focus groups and 11 individual in-depth interviews with nurses and hematologists. We found that HCPs struggled to balance curative goals and the therapy’s risks, while attempting to maintain their patients’ hopes. The unpredictability of patient trajectories and their suffering burdened HCPs. Despite occasional disagreements within the team, (inter-)professional exchanges remained a crucial ressource, especially in addressing the patients’ potential life threat. Team meetings and palliative care specialist supervisions were emphasized as vital for managing these challenges. HCPs sought support in communicating with patients about death-related issues and managing the transition from a curative to a palliative goal of care. Our research underscores the need for targeted support for HCPs and lays a groundwork for addressing their challenges. Trial registration number DRKS00027290 (German Clinical Trials Register). Date of trial registration January 10th, 2022.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0939-5555 1432-0584 1432-0584
DOI:	10.1007/s00277-024-05967-7