Keywords

Adolescents and young adults, Bone marrow transplantation, Grounded theory, Hematopoietic stem cell transplantation, Pediatric, Self-management

 

Authors

  1. Morrison, Caroline F. PhD, RN
  2. Martsolf, Donna PhD, RN, FAAN
  3. Borich, Annamarie MSN, RN
  4. Coleman, Kristen BSN, RN
  5. Ramirez, Patricia BSN, RN
  6. Wehrkamp, Nicole BSN, RN
  7. Tehan, Rebecca BA
  8. Woebkenberg, Katherine BS
  9. Pai, Ahna L.H. PhD

Abstract

Background: Stem cell transplant (SCT) is a major life event that can have long-term psychosocial consequences for the entire family. It is unknown the degree to which the psychosocial characteristics associated with SCT influence self-management behaviors and health outcomes in adolescents and young adults (AYAs).

 

Objective: The study had the following aims: (1) to describe how AYAs manage their care regimen post-SCT and (2) to explore self-management facilitators, barriers, processes, and behaviors within individual, family, community, and healthcare system domains.

 

Interventions/Methods: A grounded theory study was conducted to understand the process AYAs use to manage their care after SCT. Semistructured individual interviews were conducted, digitally recorded, and transcribed verbatim. Data were coded to consensus and analyzed using constant comparison methods.

 

Results: A sample of 17 AYAs (13-25 years old at transplant) and 13 caregivers (dyads) participated in the study. Initially, the participants experienced a tornado of activities, information, and emotions. Support from family, friends, and healthcare providers empowered families to manage their care, maintain a positive attitude, and approach a "normal" life.

 

Conclusions: Monotony, managing symptoms, and isolation were the hardest obstacles for AYAs throughout the process. Families discussed managing their care activities by developing routines that got easier with time.

 

Implications for Practice: Nurses play an instrumental role in AYA self-management practices by providing information, education, and social support. Psychosocial issues were prominent in the self-management process and should be addressed in future research and interventions with AYAs and caregivers.