“Whatever It Takes:” A Photovoice Exploration of Isolated Allogenic Hematopoietic Stem Cell Transplantation Patients

Brown, Caroline E.

Friday, 3 August 2012: 9:10 AM

Caroline E. Brown, DEd, CNS
Nursing, University of California San Diego Health System, San Diego, CA
Kathryn R. Siebert, RN, OCN
Nursing, University of California, San Diego Health System, San Diego, CA
Ellen R. Carr, RN, MSN, AOCN
Nursing, University of California San Diego Health system, San Diego, CA

Learning Objective 1: The learner will be able to discuss isolated allogenic hematologic stem cell transplantation (HSCT)patients’ perceptions and experiences of isolation.

Learning Objective 2: The learner will be able to identify interventions to mediate the experience of isolation in HSCT patients.

Purpose: Protective isolation is a common practice among hematopoietic stem cell transplantation (HSCT) patients. Psychological intolerance of protective isolation was identified as a problem leading to discontinuation of isolation in between 2-42% of patients in a recent systematic review. The purpose of this qualitative study was to explore isolated HCST patients’ perceptions of isolation and elicit suggestions for interventions to mediate the experience of isolation.

Methods: Participants were recruited from isolated patients on the inpatient Bone Marrow Transplantation (BMT) unit after at least one week of isolation. In-depth interview was the primary research method used; in addition photo voice was used with a small subset of participants. Data sources included transcripts from in-depth interviews, field notes, demographic survey responses and participant generated photographs. Data analysis proceeded as an iterative process utilizing comparative analysis methodology. Themes were identified from the data and refined by the researchers and confirmed with participants as the process unfolded.

Results: Ten participants ranging in age from 22-57 undergoing Allogenic HSCT participated in this study. The core concept that emerged from the data was that participants would do “Whatever it Takes”. Sub categories include: Getting Through; Protecting Self; Attitude; Daily Routine; Connections; Environment and Information.

Conclusion: This project is unique in that it engages isolated allogenic HSCT patients in active participation to elicit suggestions and selection of an intervention to mediate the experience of isolation. Participants voiced ways to mediate the experience including enhancing exercise opportunities, reducing restrictions on internet access and increasing communication about what the experience would entail. The use of photovoice created a unique view of the participants experiences.

Study funded by STTI Zeta Mu Chapter Small Qualitative Research Grant 2009 and Daisy Foundation Grant 2009.

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