Hospital care or home care after allogeneic hematopoietic stem cell transplantation – Patients' experiences of care and support

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society 2013-08, Vol.17 (4), p.389-395
• Main Authors: Bergkvist, Karin, Larsen, Joacim, Johansson, Unn-Britt, Mattsson, Jonas, Svahn, Britt-Marie
• Format: Article
• Language: English
• Subjects: Adult; Aftercare - methods; Aged; Allogeneic stem cell transplantation; Discharge; Female; Health care; Hematology, Oncology and Palliative Medicine; Hematopoietic Stem Cell Transplantation - nursing; Home care; Home Care Services; Hospital care; Hospitalization; Hospitals; Humans; Length of Stay; Longitudinal Studies; Male; Middle Aged; Mixed methods analysis; Nursing; Pancytopenia - nursing; Pancytopenia - rehabilitation; Pancytopenic phase; Patient care; Patient Discharge; Patient Satisfaction; Personal safety; Qualitative Research; Social Support; Statistical analysis; Statistics, Nonparametric; Stem cells; Surveys and Questionnaires; Transplants
• ISSN: 1462-3889; 1532-2122; 1532-2122
• DOI: 10.1016/j.ejon.2012.12.004

Abstract Purpose Treatment at home during the pancytopenic phase after allogeneic hematopoietic stem cell transplantation (HSCT) has been an option for patients at our center since 1998. Earlier studies have shown that home care is safe and has medical advantages. In this study, we present patients' experiences of care and support while being treated in hospital or at home during the acute post-transplantation phase. Method Patients ( n  = 41, 22 in hospital care and 19 in home care) answered the SAUC questionnaire at discharge (when home, or from hospital). Both statistical analysis and deductive content analysis were used. Results The patients were highly satisfied with the care and support during the acute post-transplantation phase. Patients in home care were found to be more satisfied with care in general than patients in hospital care. The importance of safety, empathy, and encouragement from healthcare staff were expressed regardless of where care was given. Patients also felt that receipt of continuous, updated information during treatment was important and they had a strong belief in HSCT but were uncertain of the future regarding recovery. Conclusions The main findings of this study were that in comparison to hospital care, home care does not appear to have a significant negative effect on patients' experiences of care and support during the acute post-transplantation phase. In addition patients in home care felt safe, seen as a person and encouragement seem to empower the patients at home. Thus, this study may encourage other transplantation centers to provide home care if the patients want it.