Being in protective isolation following autologous haematopoietic stem cell transplantation: A phenomenological study

J Clin Nurs. 2017 Dec;26(23-24):4467-4478. doi: 10.1111/jocn.13777. Epub 2017 Apr 7.

Abstract

Aims and objectives: To explore the lived experiences of patients with haematological malignancies who had been in protective isolation during their hospital stay for autologous haematopoietic stem cell transplantation.

Background: Although protective isolation aims to benefit patients' health by preventing infection, it could also imply harmful psycho-social implications for patients, such as loneliness.

Design: A descriptive phenomenological study was conducted in an Italian university hospital.

Methods: Nine patients with haematological malignancies who had been in protective isolation for autologous haematopoietic stem cell transplantation were enrolled. They were interviewed during their weekly ambulatory visits, which are usually carried out up to 100 days post-transplant, and asked about their stay in isolation. Giorgi's method of analysis was used to describe the experience of protective isolation from the patient' perspective.

Results: Eight themes emerged: isolation is a defence, threats from which patients have to defend themselves, rules for defence, the burden of the defence, external strategies for defence, inner strengths for defence, defending loved ones and outcomes of the defence. The general structure was expressed as a defence from suffering.

Conclusions: While fighting a hard battle against cancer, informants largely accepted the strict isolation measure and represented it as a shield for an effective defence.

Relevance to clinical practice: Nurses should provide emotional and social support to help patients feel like active fighters and strengthen their strategies for an effective defence from suffering.

Keywords: haematopoietic stem cell transplantation; loneliness; patient isolation; social isolation.

MeSH terms

  • Aged
  • Female
  • Hematologic Neoplasms / psychology
  • Hematopoietic Stem Cell Transplantation / psychology*
  • Humans
  • Italy
  • Loneliness / psychology
  • Male
  • Middle Aged
  • Patient Isolation / psychology*
  • Qualitative Research
  • Social Support