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Trunk AD, Guo M, Budvytyte L, Islam NS, Khera N, Hamilton BK, Amonoo HL. Hematopoietic Stem-Cell Transplantation: Exploring the Latest Advances and Gaps in Disparities, Psychosocial and Symptom Management Interventions, and Chronic Graft-Versus-Host Disease Care. Am Soc Clin Oncol Educ Book 2024; 44:e432186. [PMID: 38754066 DOI: 10.1200/edbk_432186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Although allogeneic hematopoietic cell transplantation (HCT) offers a potential for cure for many patients with advanced hematologic malignancies and bone marrow failure or immunodeficiency syndromes, it is an intensive treatment and accompanied by short- and long-term physical and psychological symptoms requiring specialized care. With substantial advances in therapeutic approaches for HCT and supportive care, HCT survivors experience less morbidity and mortality. However, disparities in both HCT access and outcomes persist, and HCT survivors and their caregivers often lack access to much-needed psychosocial care. Additionally, more medical and psychosocial resources are needed to holistically care for HCT survivors with chronic graft-versus-host disease (GVHD). Hence, this chapter focuses on three areas pertaining to advances and gaps in HCT care: disparities in access to and outcomes of HCT, psychosocial and physical symptom management with supportive care interventions, and GVHD prevention and management.
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Affiliation(s)
- Andrew D Trunk
- Blood and Marrow Transplant Program, Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Michelle Guo
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | | | | | | | - Betty K Hamilton
- Blood and Marrow Transplant Program, Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Hermioni L Amonoo
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
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Corman M, Dambrun M, Rubio MT, Cabrespine A, Brindel I, Bay JO, Peffault de La Tour R. The Prospective Effects of Coping Strategies on Mental Health and Resilience at Five Months after HSCT. Healthcare (Basel) 2023; 11:1975. [PMID: 37444809 DOI: 10.3390/healthcare11131975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES Hematopoietic stem cell transplantation (HSCT) is a stressful event that engenders psychological distress. This study examines the prospective effects of coping strategies during hospitalization on resilience and on various mental-health dimensions at five months after transplantation. METHODS One hundred and seventy patients (Mage = 52.24, SD = 13.25) completed a questionnaire assessing adjustment strategies during hospitalization, and 91 filled out a questionnaire five months after HSCT (Mage = 51.61, SD = 12.93). RESULTS Multiple regression analyses showed that a fighting spirit strategy positively predicted resilience (p < 0.05), whereas anxious preoccupations predicted anxiety (p < 0.05), poorer mental QoL (p < 0.01), and were associated with an increased risk of developing PTSD (OR = 3.27, p < 0.01; 95% CI: 1.36, 7.84) at five months after transplantation. Hopelessness, avoidance, and denial coping strategies were not predictive of any of the mental health outcomes. Finally, the number of transplantations was negatively related to a fighting spirit (p < 0.01) and positively related to hopelessness-helplessness (p < 0.001): Conclusions: These results highlight the importance of developing psychological interventions focused on coping to alleviate the negative psychological consequences of HSCT.
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Affiliation(s)
- Maya Corman
- LAPSCO UMR CNRS 6024, Université Clermont Auvergne (UCA), 34 Avenue Carnot, 63000 Clermont-Ferrand, France
| | - Michael Dambrun
- LAPSCO UMR CNRS 6024, Université Clermont Auvergne (UCA), 34 Avenue Carnot, 63000 Clermont-Ferrand, France
| | - Marie-Thérèse Rubio
- Service D'Hématologie, CHRU Nancy-Hôpitaux de Brabois, 54511 Vandoeuvre-les-Nancy, France
| | - Aurélie Cabrespine
- CHU de Clermont-Ferrand, Site Estaing, Service de Thérapie Cellulaire et D'hématologie Clinique Adulte, 63000 Clermont-Ferrand, France
| | - Isabelle Brindel
- Service D'Hématologie, Hôpital Saint-Louis, Greffe de Moelle, 75010 Paris, France
| | - Jacques-Olivier Bay
- CHU de Clermont-Ferrand, Site Estaing, Service de Thérapie Cellulaire et D'hématologie Clinique Adulte, 63000 Clermont-Ferrand, France
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Alsulami FJ, Shaheed SU. Oral cryotherapy for management of chemotherapy-induced oral mucositis in haematopoietic cell transplantation: a systematic review. BMC Cancer 2022; 22:442. [PMID: 35459129 PMCID: PMC9027418 DOI: 10.1186/s12885-022-09539-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Oral mucositis (OM) is known to be the most common and challenging side effect of conditioning chemotherapy in haematopoietic cell transplant (HCT). This side effect causes significant morbidity and may delay the treatment plan, as well as increase therapeutic expenses. There are few clinical trials in the literature that indicate any kind of treatment or prevention methods are effective. Therefore, the aim of this study is to perform a systematic review of literature and examine the effectiveness of oral cryotherapy (OC) in management of chemotherapy-induced OM in patients with haematological malignancies undergoing a HCT. Methods A systematic literature search was conducted, using the electronic databases PubMed, Embase, MEDLINE and Scopus. A total of 322 papers were identified and 9 papers were analysed based on defined inclusion and exclusion criteria. The quality of the chosen primary studies was appraised using the COCHRANE risk of bias assessment tool. Results Nine randomized controlled trials, analysing 658 participants; control group (n = 289, age mean ± SD; 41.15 ± 21) and treatment group (n = 369, age mean ± SD; 39.15 ± 20), were included in this systematic review. Seven studies had significantly addressed the effectiveness of OC (p value < 0.05), in reducing the incidence of developing severe OM in the adult population undergoing HCT, especially when the conditioning regimen protocols included high dose of alkylating agent such as melphalan. Conclusion This review supports the use of OC for prevention of OM in patients undergoing HCT, with high-dose of melphalan conditioning protocols. It is recommended that more studies be conducted to compare efficacy and duration of OC with other chemotherapeutic agents with relatively short plasma half-lives. The heterogeneity of the trials demonstrated the need to regulate the validated assessment tools and similar interventions that would enable comparisons and analyses of treatment effects based on well-designed RCTs.
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Affiliation(s)
- Faizah Jabr Alsulami
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | - Sadr Ul Shaheed
- Nuffield Department of Surgical Sciences and Biomedical Research Centre, University of Oxford, Oxford, UK.
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Bishop E, Miller C, Miller S, McKellar C. How staying in a single room affects the experiences of haematology inpatients in an Australian cancer hospital. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S22-S29. [PMID: 35271362 DOI: 10.12968/bjon.2022.31.5.s22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND It has been suggested that single rooms for patients improve patient dignity and privacy and reduce infection transmission, but they can be socially isolating. It is not well understood how single rooms affect long-stay patients. AIMS To understand the experience of being an inpatient in a ward with single-room design. METHODS A qualitative, phenomenological study was conducted using semi-structured interviews with patients (n=10) in a newly built cancer hospital with a 100% single-room haematology ward. Interviews were analysed using Colaizzi's (1978) seven-step analysis. FINDINGS Patients described their experiences of their acute stay using the concepts of privacy, isolation and independence, as well as enabling sleep. Privacy enabled patients to have their own toilet, was perceived to aid infection control and provided silence. Privacy came at a cost of isolation, but patients re-framed this as expected and necessary for self-preservation. Furthermore, they were unsure as to whether other patients would reciprocate social contact and instead relied on the healthcare team. Patients sought independence during their acute stay as it enabled them to control the environment and create a space for healing. The ability to sleep and be rested was also a critical feature of patients' stay. CONCLUSION The research highlighted that haematology patients prefer single rooms. However, because they experienced isolation, it also highlighted the importance of facilitating and enabling peer support within the haematology setting.
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Affiliation(s)
- Emma Bishop
- An Honours Student, Bachelor of Nursing, La Trobe University, Bundoora, Victoria, Australia, at the time of undertaking the research, and is now a registered nurse
| | - Charne Miller
- Site Director, Alfred Health Clinical School, La Trobe University, Victoria, Australia
| | - Sam Miller
- Co-ordinator, Masters of Nursing Programme, La Trobe University, Victoria, Australia
| | - Catherine McKellar
- Director of Nursing Education, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia, at the time of the research
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Shi Y, Zhao X, Wang Y. Exploring parents' experience in the decision-making process for children with haematological diseases receiving haematopoietic stem cell transplantation in China based on genograms. J Pediatr Nurs 2022; 63:e18-e26. [PMID: 34799205 DOI: 10.1016/j.pedn.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/31/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To explore parents' experience in the decision-making process for children with haematological diseases receiving haematopoietic stem cell transplantation (HSCT) based on genograms. DESIGN AND METHODS A qualitative study based on genogram was conducted. Seven pairs of parents completed their genogram and a semi-structured interview. Two related donors were interviewed to discuss their experiences in the decision-making process of donating bone marrow to their loved ones. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. RESULTS The genogram presents the complete family structure, family member relationships and incident-related conflicts. Two superordinate themes emerged from the data analysis. The first theme was transplantation decision motivations, including four subthemes: the values of life priority, empathy based on kinship, inheritance of family blood, trust in doctors and medical science. The second theme was transplantation decision conflicts, including four subthemes: decision-making conflicts among family members, related-donor decision-making conflicts, risk-benefit game, blind optimism and insufficient cognition conflict. CONCLUSIONS Genogram can show the hidden resources and conflicts of each family and help the care providers better understand parents' experience and the decision-making dilemmas in the decision-making process for children with haematological diseases receiving HSCT. The needs of transplant families for treatment-related information were not fully met. PRACTICE IMPLICATIONS It is necessary for medical staff to increase psychological and informational support for donors and their families when the parents of patients make bone marrow transplant decisions. Medical staff should engage in family-focused systematic interventions to reduce the psychological burden and conflicts of decision makers.
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Affiliation(s)
- Yan Shi
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China; Department of Clinical Psychology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China; Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Xudong Zhao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China; Department of Clinical Psychology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Yanbo Wang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China; Department of Clinical Psychology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
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Contribution of nurses to protective environment in haematopoietic cell transplant setting: an international survey by the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2021; 56:1433-1440. [PMID: 33514921 PMCID: PMC7844547 DOI: 10.1038/s41409-020-01194-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/03/2020] [Accepted: 12/08/2020] [Indexed: 11/09/2022]
Abstract
Infections are frequently experienced complications for patients undergoing haematopoietic cell transplant (HCT). To assess current infection prevention strategies, an international survey among HCT nurses was conducted by the Nurses Group and IDWP of the EBMT. Nurse representatives from all EBMT transplant centres were invited to complete an online questionnaire on protective environment in adult and paediatric HCT units. A total of 141 complete questionnaires were returned for the isolation section and 26 for the paediatric section, the majority of respondents (89.4%) being nurses. A small number of centres (7.1%) reported not allowing visitors, the rest have rules for entering patient rooms. Most HCT units (99.3%) indicated that nurses play a critical role in infection prevention and measures differed between bacterial infections and viral infections. Many of the paediatric units (57.7%) had a play area, applying rules of entry. To our knowledge, this is the first survey on protective environment directed at nurses within HCT centres. Despite having different practices, most HCT units tend to decrease isolation procedures and the use of PPE for multi-drug resistant organisms. This must concur with an increase of hand hygiene compliance, for which our data show that there is still room for improvement.
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Biagioli V, Albanesi B, Belloni S, Piredda A, Caruso R. Living with cancer in the COVID-19 pandemic: An Italian survey on self-isolation at home. Eur J Cancer Care (Engl) 2020; 30:e13385. [PMID: 33289205 PMCID: PMC7883078 DOI: 10.1111/ecc.13385] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/23/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
Objective To investigate the perception of self‐isolation at home in patients with cancer during the lockdown period resulting from the COVID‐19 outbreak in Italy. Methods A cross‐sectional descriptive study was conducted through an online survey of patients with cancer who were sheltering at home from 29th March to 3rd May 2020. Perception of self‐isolation was assessed using the ISOLA scale, after evaluation of its psychometric properties. Content analysis was used to analyse two open‐ended questions. Results The participants were 195 adult patients with cancer (female = 76%; mean age = 50.3 ± 11.2; haematological malignancy = 51.3%). They reported moderate isolation‐related suffering (M = 2.64 ± 0.81), problems in their relationships with others (M = 3.31 ± 1.13) and difficulties in their relationships with themselves (M = 3.14 ± 1.06). Patients who experienced significantly more social problems were older, had less education and were living without minor children. Overall, four main categories emerged from the qualitative content analysis: (1) lack of freedom and social life, (2) uncertainty and worries, (3) feeling supported and (4) dealing with isolation. Conclusion Living with cancer in the COVID‐19 pandemic was often perceived as an isolating experience, primarily in terms of detachment from loved ones.
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Affiliation(s)
| | - Beatrice Albanesi
- Department of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Silvia Belloni
- School of Nursing, Faculty of Medicine, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Alessio Piredda
- Associazione Italiana degli Infermieri di Area Oncologica (AIIAO), European Institute of Oncology, Milan, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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Biagioli V, Piredda M, Annibali O, Tirindelli MC, Pignatelli A, Marchesi F, Mauroni MR, Soave S, Del Giudice E, Ponticelli E, Clari M, Cavallero S, Monni P, Ottani L, Sica S, Cioce M, Cappucciati L, Bonifazi F, Alvaro R, De Marinis MG, Gargiulo G. Factors influencing the perception of protective isolation in patients undergoing haematopoietic stem cell transplantation: A multicentre prospective study. Eur J Cancer Care (Engl) 2019; 28:e13148. [PMID: 31429155 DOI: 10.1111/ecc.13148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/04/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To identify which factors can influence the patients' perception of protective isolation following Haematopoietic Stem Cell Transplantation (HSCT). METHODS This is a prospective study conducted in 10 Italian centres, members of the Italian Group of stem cell transplant (GITMO). Patients' perception of protective isolation was assessed using the ISOLA scale between 7 and 9 days post-transplant. Statistical linear regression analysis was performed. RESULTS The participants were 182 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. Male sex (β = .152), education level (β = -.245), double room (β = .186), satisfaction with visiting hours (β = -.174) and emotional support from nurses (β = -.169) were independently associated with isolation-related suffering. Significant predictors of the relationship with oneself included body temperature (β = -.179), fatigue (β = -.192) and emotional support from nurses (β = -.292). Factors independently associated with the relationship with others were education (β = -.230), chemotherapy cycles (β = -.218), pain (β = .150) and satisfaction with visiting hours (β = -.162). CONCLUSION Healthcare providers should pay greater attention in caring for those patients who are at risk for a negative isolation experience. Nurses should provide emotional support.
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Affiliation(s)
- Valentina Biagioli
- Department of Biomedicine and Prevention, Faculty of Medicine, School of Nursing, Tor Vergata University, Rome, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | - Ombretta Annibali
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit, Campus Bio-Medico di Roma University, Rome, Italy
| | - Maria Cristina Tirindelli
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit, Campus Bio-Medico di Roma University, Rome, Italy
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Sonia Soave
- Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Elena Ponticelli
- Department of Oncology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Marco Clari
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | | | - Pierina Monni
- Haematology/Oncology and Specialised Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Ottani
- Bone Marrow Transplant Centre, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Sica
- Institute of Haematology, Cattolica del Sacro Cuore University, Rome, Italy
| | - Marco Cioce
- Haematology Unit, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | | | - Francesca Bonifazi
- Institute of Hematology and Medical Oncology "Seràgnoli", S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, Faculty of Medicine, School of Nursing, Tor Vergata University, Rome, Italy
| | | | - Gianpaolo Gargiulo
- Haematology and Haematopoietic Stem Cell Transplantation Unit, Federico II University Hospital, Naples, Italy
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Quiñoa-Salanova C, Porta-Sales J, Monforte-Royo C, Edo-Gual M. The experiences and needs of primary family caregivers of patients with multiple myeloma: A qualitative analysis. Palliat Med 2019; 33:500-509. [PMID: 30761947 DOI: 10.1177/0269216319830017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Family caregivers play a key role in the lives of patients with multiple myeloma. However, very little is known about the impact that the disease (its diagnosis, course and prognosis) has on the main family caregiver. AIM To achieve a deeper understanding of the lived experience of individuals who are the primary caregiver of a relative with multiple myeloma and to shed light on their needs. DESIGN Interpretative phenomenological study. SETTING AND PARTICIPANTS A total of 12 individuals who were the main family caregivers of a relative with multiple myeloma who was under outpatient follow-up at a cancer unit in Barcelona were recruited via purposive sampling until data saturation was reached. In semi-structured in-depth interviews, participants described their experiences of caring for their relative with multiple myeloma. Interviews were recorded, transcribed and analysed using ATLAS.ti v7.2. The seven steps proposed by Colaizzi were used for data analysis, and the relationships among emerging themes were examined. FINDINGS Four main themes emerged: (a) a new life, adapting to the disease, (b) commitment to the patient, (c) the emotional sphere and (d) experiences in relation to the care and support received. The analysis also revealed a core overarching theme: uncertainty. CONCLUSION Primary family caregivers experienced intense uncertainty, and they described a strong need to air their feelings. Specific practical initiatives, targeting both health-related and logistical aspects of care, need to be developed in order to support family caregivers of myeloma patients.
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Affiliation(s)
- Carmen Quiñoa-Salanova
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,2 Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Josep Porta-Sales
- 3 Palliative Care Service, Institut Català d'Oncologia (ICO), Barcelona, Spain.,4 Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,5 Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Montserrat Edo-Gual
- 6 Department of Nursing, Escola Universitària d'Infermeria Gimbernat, Barcelona, Spain
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Proia-Lelouey N, Letrecher S. L’isolement en secteur protégé : une expérience extrême. Une revue de la littérature. PSYCHO-ONCOLOGIE 2019. [DOI: 10.3166/pson-2018-0045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Biagioli V, Piredda M, Annibali O, Tirindelli MC, Pignatelli A, Marchesi F, Mauroni MR, Soave S, Del Giudice E, Ponticelli E, Clari M, Cavallero S, Monni P, Ottani L, Sica S, Cioce M, Cappucciati L, Bonifazi F, Alvaro R, De Marinis MG, Gargiulo G. Development and initial validation of a questionnaire to assess patients’ perception of protective isolation following haematopoietic stem cell transplantation. Eur J Cancer Care (Engl) 2018; 28:e12955. [DOI: 10.1111/ecc.12955] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/22/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Valentina Biagioli
- Faculty of Medicine, Department of Biomedicine and Prevention, School of Nursing; Tor Vergata University; Rome Italy
| | - Michela Piredda
- Research Unit Nursing Science; Campus Bio-Medico di Roma University; Rome Italy
| | - Ombretta Annibali
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit; Campus Bio-Medico di Roma University; Rome Italy
| | - Maria Cristina Tirindelli
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit; Campus Bio-Medico di Roma University; Rome Italy
| | | | - Francesco Marchesi
- Haematology and Stem Cell Transplant Unit; Regina Elena National Cancer Institute; Rome Italy
| | | | - Sonia Soave
- Stem Cell Transplant Unit; Fondazione Policlinico Tor Vergata; Rome Italy
| | | | - Elena Ponticelli
- Department of Oncology; Città della Salute e della Scienza University Hospital; Turin Italy
| | - Marco Clari
- Department of Quality and Safety of Care; Città della Salute e della Scienza University Hospital; Turin Italy
| | | | - Pierina Monni
- Haematology/Oncology and Specialised Medicine Unit; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Laura Ottani
- Bone Marrow Transplant Centre; Fondazione IRCCS Ca' Granda; Milan Italy
| | - Simona Sica
- Institute of Haematology; Cattolica del Sacro Cuore University; Rome Italy
| | - Marco Cioce
- Haematology Unit; Fondazione Policlinico Universitario Agostino Gemelli; Rome Italy
| | | | - Francesca Bonifazi
- Alma Mater Studiorum University of Bologna; Bologna Italy
- Institute of Hematology and Medical Oncology ‘Seràgnoli’; S. Orsola-Malpighi University Hospital; Bologna Italy
| | - Rosaria Alvaro
- Faculty of Medicine, Department of Biomedicine and Prevention, School of Nursing; Tor Vergata University; Rome Italy
| | | | - Gianpaolo Gargiulo
- Haematology and Haematopoietic Stem Cell Transplantation Unit; Federico II University Hospital; Naples Italy
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Styczynski J, Tridello G, Donnelly JP, Iacobelli S, Hoek J, Mikulska M, Aljurf M, Gil L, Cesaro S. Protective environment for hematopoietic cell transplant (HSCT) recipients: The Infectious Diseases Working Party EBMT analysis of global recommendations on health-care facilities. Bone Marrow Transplant 2018. [PMID: 29535381 DOI: 10.1038/s41409-018-0141-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
International guidelines on protective environment for HSCT recipients proposed a set of 10 global recommendations in 2009 on protective environment (GRPE) concerning hospital room design and ventilation. The EBMT Infectious Diseases Working Party undertook a survey on the status on protective environment for HSCT recipients with the aim of surveying current practices and their agreement with GRPE recommendations. The questionnaire consisted of 37 questions divided into 5 sections about filtration, air changes, maintenance, and the protective environment in rooms and the surrounding unit. Overall, 177 centres (response rate 33%) from 36 countries responded, indicating that 99.4% of patient rooms were equipped with HEPA filters, but only 48.6% of the centre's staff were aware of, and could confirm, regular replacement of filters based on manufacturers' recommendations. Well-sealed rooms were used in terms of windows (70.6%), ceilings (35%), and plumbing pipes (51.4%). The sensor monitors in the patient room used to determine when the HEPA filters require changing were installed only in 18.1% of centres. Only 1 centre fulfilled all 10 GRPE recommendations, while 62 centres fulfilled the 3 level "A" recommendations. In conclusion, HEPA-filtered rooms are available in almost all centres, while fewer centres fulfilled other requirements. Knowledge on the details and maintenance of protective environments in the HSCT setting was inadequate, reflecting a lack of communication between the health personnel involved, hospital infection control and the hospital maintenance services.
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Affiliation(s)
- Jan Styczynski
- Department of Pediatric Hematology and Oncology, Nicolaus Copernicus University Torun, Collegium Medicum, Bydgoszcz, Poland.
| | - Gloria Tridello
- Department of Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Policlinico G.B. Rossi, Verona, Italy
| | - J Peter Donnelly
- Department of Haematology, Radboud UMC, Nijmegen, The Netherlands
| | | | | | - Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences, University of Genova, Ospedale Policlinico San Martino, Genova, Italy
| | - Mahmoud Aljurf
- Oncology Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Lidia Gil
- Department of Hematology, Medical University, Poznan, Poland
| | - Simone Cesaro
- Department of Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Policlinico G.B. Rossi, Verona, Italy
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Biagioli V, Piredda M, Annibali O, Iacorossi L, D'Angelo D, Matarese M, Alvaro R, De Marinis MG. Being in protective isolation following autologous haematopoietic stem cell transplantation: A phenomenological study. J Clin Nurs 2017; 26:4467-4478. [DOI: 10.1111/jocn.13777] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Valentina Biagioli
- Department of Biomedicine and Prevention; Faculty of Medicine; School of Nursing; Tor Vergata University; Rome Italy
| | - Michela Piredda
- Research Unit Nursing Science; Campus Bio-Medico di Roma University; Rome Italy
| | - Ombretta Annibali
- Haematology, Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy Unit; Campus Bio-Medico di Roma University; Rome Italy
| | | | - Daniela D'Angelo
- Research Unit Nursing Science; Campus Bio-Medico di Roma University; Rome Italy
| | - Maria Matarese
- Research Unit Nursing Science; Campus Bio-Medico di Roma University; Rome Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention; Faculty of Medicine; School of Nursing; Tor Vergata University; Rome Italy
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