看護とケアのジャーナル

Patients′ Subjective Experiences of Outpatient− and Inpatient Care during Autologous Hematopoietic Stem Cell Transplantation − A Quantitative Questionnaire Study

Abstract

Anncarin Svanberg* and Alexandra Eilegård Wallin

Background: As early as 1997 it was stated that the outpatient model when patients are cared for in their homes (outpatient care) in connection with hematopoietic stemcell transplantation (hSCT), gave positive results regarding safety and effectiveness. But in the year of 2022, in many countries, it is still an offer and not a standard treatment. Despite long international and national experience of outpatient treatment at hSCT, many patients are still fully cared for in hospitals.

Purpose: To describe the patients’ subjective experiences of outpatient (OP)- and inpatient (IP) care during autologous hematopoietic stem cell transplantation and to ensure the quality of care outside hospital environment as a form of care in order to improve the patient's experience of safety and security at autologous hematopoietic stem cell transplantation at a University Hospital in Sweden. And, to evaluate physicians' and nurses’ assessment using a standardized assessment form of the patient's self-care ability when cared for outside the hospital.

Methods: A quantitative questionnaire study with pre-selected response alternatives and open-ended questions.

Results: Most patients, regardless of the form of care, OP or IP care, felt satisfied with the information given by the care provider. Nearly all of the patients who were cared for in hospital and who responded to the questionnaire, experienced anxiety during the care period compared with patients who were cared for in a home environment responding to the questionnaire, where the vast majority did not experience any anxiety during the care period.

Conclusion: Most patients indicate, as shown in other studies, that they felt satisfied with the care and information they received in connection with hematopoietic stem cell transplantation but patients in IP care felt more anxiety than patients in OP care. Regarding evaluating physicians' and nurses’ assessment using a standardized assessment form of the patient's self-care ability when cared for outside the hospital, there were no notable differences in the assessment.

Clinical relevance: A questionnaire provides the healthcare provider with a basis for developing and improving in clinical care for patients receiving hSCT. Regarding attention to the mental well-being equated with the physical well-being it is a clinical task for healthcare providers. A well-developed basis for assessing the patient's level of care can ensure the best care.