Psychosocial Care for Adolescent and Young Adult Hematopoietic Cell Transplant Patients

• Published in: Journal of psychosocial oncology Vol. 29; no. 4; pp. 394 - 414
• Main Authors: Cooke, Liz, Chung, Carol, Grant, Marcia
• Format: Journal Article
• Language: English
• Published: New York, NY Taylor & Francis Group 01-07-2011; Haworth Press; Taylor & Francis LLC
• Subjects: Adaptation, Psychological; Adolescent; Adolescents; AYA; Biological and medical sciences; Certainty; Coping; Depression (Economics); Female; Fundamental and applied biological sciences. Psychology; Graft vs Host Disease - psychology; HCT; Hematologic Neoplasms - psychology; Hematologic Neoplasms - rehabilitation; Hematologic Neoplasms - surgery; Hematopoietic Stem Cell Transplantation - psychology; Humans; Illness and personality; Illness, stress and coping; Intervention; Male; Medical sciences; Needs Assessment; Oncology; Patient Compliance - psychology; Patient Education as Topic; Patients; Psychological aspects; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Qualitative research; Quality of Life; Social Adjustment; Stem cells; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Technology; transplant; Transplants & implants; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Young Adult; Young Adults; Human; Subjective experience; Hematopoietic cell; Homograft; AYA; Psychosocial factor; Recommendation; Quality of life; Case study; Treatment; Psychological distress; Follow up study; Surgery; Adolescent; Young adult; HCT; Graft; transplant; Application method; Cancer
• ISSN: 0734-7332; 1540-7586
• DOI: 10.1080/07347332.2011.582636

Psychological issues following hematopoietic cell transplantation (HCT) are unfortunately common. Literature specific to the transplant experience for the needs of adolescents and young adults (AYA) is lacking. The purpose of this article is to (1) describe the allogeneic transplant experience for AYA transplant patients during the first year following transplantation including demographic and treatment characteristics, (2) present AYA data obtained during and following a six-part posttransplant discharge study, (3) illustrate typical AYA experiences using case studies, and (4) propose AYA intervention strategies within Erickson's stages of psychosocial development. A quality of life model provided the research conceptual framework, and the content analysis framework for the qualitative research. Themes that emerged within each domain were the following: sexuality/fertility, fatigue, depression/poor coping/habits, adherence issues, use of technology, dependency issues, changes in roles/relationships, issues with school/education, financial issues, family problems/issues, miscellaneous, religion/spirituality, fear of future, uncertainty, life, death, more life appreciation. These data guide us for providing targeted interventions for the needs of this AYA population. This paper has presented literature and developmental theory, qualitative and qualitative data from an intervention study, and clinical cases in order to propose a developmental treatment model for AYA transplant patients. A coordinated and multidisciplinary approach is needed for the HCT patient who is an AYA.