Lived experience of State-sponsored intra-national overseas therapeutic mobility for stem cell transplantation

Consenting rather than choosing. A qualitative study on overseas patients' decision to undergo hematopoietic stem cell transplantation

OBJECTIVE

Reasons for patients' acceptance of the allogeneic hematopoietic stem cell transplantation (allo-HSCT) proposed and how their decision may be affected by the long distances involved have not been sufficiently investigated so far. We therefore conducted a qualitative study to identify the factors involved in overseas patients' decision to accept allo-HSCT.

METHODS

In-depth semi-directive interviews were conducted with overseas allo-grafted patients (n = 22), as well as one non-consenting patient and their caregivers (n = 24). Interviews were analyzed taking an inductive thematic approach.

RESULTS

Respondents stated that their decision to undergo the transplantation was constrained by their feeling of being in a therapeutic impasse, the need for a survival strategy, the need to survive for their family's sake, family and doctors' pressures, and the feeling of being managed. The following factors favoring patients' acceptance were the medical information received, their faith, having a family donor, peer testimonies, and positive representations of the transplantation. Factors against patients' acceptance were geographical distance from home to the transplant center, apprehension of protective isolation, fear of dying, and representations of the graft.

CONCLUSIONS

These factors, such as patient's personal values and representations, need to be weighed up in order to adapt the information exchanged accordingly. Efforts are required to relieve patients' social isolation and improve the means of providing family support.

Can imaginary mobilities be conducive to mental health?

Despite the growing interest in the relationship between physical mobility and mental health in health geography, there has been less attention to mobility in the non-physical imaginary realm and its effects on health. This study attempts to explore whether and how 'imaginary mobilities' can be conducive to mental health. It conceptualised imaginary mobilities and designed 'Imaginary Travels' as a type of imaginary mobility. To verify the research questions, 50 young unemployed people living in Seoul, South Korea, were examined (experimental group: n = 25; control group: n = 25). The results demonstrate the immediate and long-term therapeutic effects of Imaginary Travels as imaginary mobility using three psychological questionnaires in the quantitative analysis and data derived from interviews and diary entries in the qualitative analysis. The quantitative statistical analysis revealed significant effects in the experimental group in contrast to the control group. The qualitative analysis indicated that imaginary mobilities are conducive to mental health through immersing, exploring, and practising inner geographies. These findings have implications for understanding mobilities and their associated therapeutic qualities in the imaginary realm beyond the physical realm.