Main Article Content
therapeutic patient education, allogeneic hematopoietic stem cell transplantation, quality of life, psychological support, patient engagement
Physical and psychological factors, like wrong attitudes and behaviours, can negatively influence health outcomes of the patients receiving allogeneic hematopoietic stem cell transplantation (AHSCT). Educational interventions aiming to improve knowledge on side effects, risks, complications and preventive behaviour can reduce psychological distress, and improve quality of life (QoL). We aimed to compare a standard approach with therapeutic patient education (TPE) to analyse the impact on AHSCT patients’ QoL, psychological distress and knowledge of AHSCT side effects, risks complications and preventive behaviour.
Material and methods
A prospective interventional study was conducted analysing data of 36 patients who received one of two different educational approaches, which were a standard approach (not-exposed) or TPE (exposed).
In the exposed group QoL improved 14 days after transplantation (42.2 vs 25.6; p<0.03) and at time of discharge (36.6 vs 54.4; p<0.005). Anxiety and depression was better controlled in the exposed group, both at hospitalization and discharge (anxiety: 48.1 vs 53.2; 46.4 vs 51.6. p<0.04; depression: 49 vs 55.3; 48 vs 54.3 , p<0.03). Knowledge of AHSCT risks and complications improved in exposed patients, both at admission (10.1/15 vs 8/15 correct answers; p<0.01) and discharge (10.7/15 vs 8.8/15 correct answer; p<0.03).
The TPE for AHSCT patients improved knowledge, reduced anxiety and depression, which consequently increasing QoL. Therefore, we recommend our approach to further engage patients in the treatment plan, which should specifically take place prior to AHSCT initiation.
PDF Downloads 523
HTML Downloads 159
2 Tanaka Y, Kurosawa S, Tajima K, Tanaka T, Ito R, Inoue Y, Okinaka K, Inamoto Y, Fuji S, Kim SW, Tanosaki R, Yamashita T, Fukuda T. Analysis of non-relapse mortality and causes of death over 15 years following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplantation. 2016;51:553–559.
3 Mosesso K. Adverse Late and Long- Term Treatment Effects in Adult Allogeneic Hematopoietic Stem Cell Transplant Survivors. American Jurnal of Nursing. 2015;115(11):22-34.
4 Cioce M, Moroni R, Gifuni MC, Botti S, Orlando L, Soave S, Serra I, Zega M, Gargiulo G. Relevance of NANDA-I diagnoses in patients undergoing haematopoietic stem cell transplantation: a Delphi study. Professioni Infermieristiche. 2019;72(2):120-128.
5 Kim I, Koh Y, Shin D, Hong J, Jae Do H, Kwon SH, Sik Seo K. Importance of Monitoring Physical Function for Quality of Life Assessments in Hematopoietic Stem Cell Transplantation Patients: A Prospective Cohort Study. In vivo;34:771-777.
6 Holland JC. Psychological Care of Patients. Psycho-Oncology’s Contribution. J Clin Oncol, 2003;21:253s-265s.
7 Akechi T, Nakano T, Okamura H, Ueda S, Akizuki N, Nakanishi T, Uchitomi Y. Psychiatric disorders in cancer patients: Descriptive analysis of 1721 psychiatric referrals at two Japanese cancer center hospitals. Japanese Journal of Clinical Oncology. 2001;31:188 – 194.
8 Kugaya A, Akechi T, Okuyama T, Nakano T, Mikami I, Okamura H, Uchitomi Y. Prevalence, predictive factors, and screening for psychologic distress in patients with newly diagnosed head and neck cancer. Cancer. 2000;88:2817-2823.
9 Okamura H, Watanabe T, Narabayashi M, Katsumata N, Ando M, Adachi I, Uchitomi Y. Psychological distress following ? rst recurrence of disease in patientswith breast cancer: Prevalence and risk factors. Breast Cancer Research and Treatment. 2000;61:131 – 137.
10 Bukberg J, Penman D, Holland JC. Depression in hospitalized cancer patients. Psychosomatic Medicine. 1984;46:199 – 212.
11 Longobardi Y, Savoia V, Bussu F, Morra L, Mari G, Nesci DA, Parrilla C, D’Alatri L. Integrated rehabilitation after total laringectomy: a pilot trial study. Support Care Cancer. 2019;27(9):3537-3544.
12 Carlson LE. Screening alone is not enough: The importance of appropriate triage, referral, and evidence-based treatment of distress and common problems. J Clin Oncol, 2013;31:3616–3617.
13 Assal JP, Golay A. Patient education in Switzerland: from diabetes to chronic diseases. Patient Educ Couns. 2001;44(1):65-9.
14 Bevans M, Castro K, Prince P, Shelburne N, Prachenko O, Loscalzo M, Zabora J. An Individualized Dyadic Problem-Solving Education Intervention for Patients and Family Caregivers During Allogeneic HSCT: A Feasibility Study. Cancer nursing. 2010;33(2):24-33.
15 Foltz A, Sullivan J. Reading level, learning presentation preference, and desire for information among cancer patients. Journal of Cancer Education. 1996;11:32-38.
16 World Health Organization. Europe Report Therapeutic Patient Education – Continuing Education Programmes for Health Care Providers in the Field of Chronic Disease. Copenhagen, Denmark: WHO; 1998. [Google Scholar]
17 Fain AJ. La ricerca infermieristica: leggerla, comprenderla e applicarla. 2 Ed., Milano: McGraw-Hill. 2004;125.
18 Moscato U, Poscia A, Gargaruti R, Capelli G, Cavaliere F. Normal values of exhaled carbon monoxide in healthy subjects: comparison between two methods of assessment. BMC Pulm Med. 2014;16(14):204.
19 Friedman AJ, Cosby R, Boyko S, Hatton-Bauer J, Turnbull G. Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations. J Cancer Educ. 2011; 26(1):12-21.
20 Bennett S, Pigott A, Beller EM, Haines T, Meredith P, Delaney C. Educational interventions for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews. 2016;11: Art. No.: CD008144.
21 Fawzy FI, Fawzy NW, Hyun CS, Elashoff R, Guthrie D, Fahey J, Morton DL. Malignant melanoma: Effects of an early structural psychiatric intervention, coping and affective state on recurrence and survival 6 years later. Archives of General Psychiatry. 1993;50:681–689.
22 Donker T, Griffiths KM, Cuijpers P, Christensen H. Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC Medicine. 2009;7:79.
23 Pidala J, Anasetti C, Jim H. Health-related quality of life following haematopoietic cell transplantation: patient education, evaluation and intervention. British Journal of Haematology. 2009;148:373–385.
24 Kirsch, M., Crombez, P., Calza, S., Eeltink, C. & Johansson E. (2012). Patient information in stem cell transplantation from the perspective of health care professionals: A survey from the Nurses Group of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplantation 47, 1131-1133.
25 Marques ADCB, Szczepanik AP, Machado CAM, Santos PND, Guimarães PRB, Kalinke LP. Hematopoietic stem cell transplantation and quality of life during the first year of treatment. Rev Lat Am Enfermagem. 2018; 25(26):e3065.
26 Grulke N, Albani C, BailerH. Quality of life in patients before and after haematopoietic stem cell transplantation measured with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire QLQ-C30. Bone Marrow Transplantation. 2012;47:473–482.