Psychosocial factors that influence sibling donors during allogeneic bone marrow transplantation

[摘要] ENGLISH ABSTRACT: Haematopoietic stem cell transplantation has become an increasingly popular treatment option for persons with life-threatening blood related diseases such as leukemia, lymphoma, myeloma and certain forms of anaemia. Due to this new therapy the use of bone marrow from a healthy individual also called a living donor for transplantation is inevitable. These living donors can experience psychological and economic issues and these components needs to be addressed in the transplant protocol. The researcher described the psychosocial factors that influenced sibling donors during allogeneic bone marrow transplantation at a public sector hospital in Cape Town, whether the transplant team members explained the administrative process of the transplant in an understandable manner and language and the effect of the psychosocial factors and administrative process of the allogeneic bone marrow transplantation on the sibling donors.A quantitative research approach with a descriptive design was used in this study. The sample was selected by means of full population sampling. The final sample size of (n=64) stem cell sibling donors over 18 years of age participated in the study. A self-reporting questionnaire was used to gather data, inclusive of four open-ended questions to establish an in depth sense of what the donor experiences during the bone marrow donation process. Descriptive statistics used to describe the variables included frequency distributions in the form of histograms and frequency tables. The Pearson chi-square statistical analysis test was used to test for relationships amongst groups.The study drew on the Roy Adaptation Model (RAM) as the theoretical framework to explain the phenomena surrounding the psychosocial and administrative effect of the transplantation process on the sibling donor. Based on the findings the haematopoietic stem cell donors coped with the psychosocial impact of the donation process by making use of their coping mechanism to adapt to their situation according to the Roy Adaptation Model. This model also offers guidance to the nurses to apply this model to nursing practice.Results revealed that sibling donors developed feelings of anxiety in relation to the invasive procedures that cause them to experience physical pain. Most respondents claimed that they were not psychologically affected by the donation process. The moral obligation the sibling donor has towards his sister or brother outweighed the physical pain or discomfort experienced during the donation process. Results revealed that the responding donors claimed they were well informed regarding the donation process and understood the treatment plan of the recipient. However, results revealed that there was a lack in visual donor information such as books, pamphlets as well as internet information. Results concerning the demographics revealed that (n=29) respondents had no schooling and some respondents had some schooling which can give an indication of how to bridge the knowledge and information gap between them and the donor in terms of language.Statistical significance results regarding the emotional state and economic situation of the donors was found. Some of the respondents were responsible for their own transport and their own accommodation, some of those that are employed were responsible for leave without pay. An organ donation policy needs to be developed to prevent live organ donors from losing valuable working hours that could result in loss of salary and should provide other financial incentives. Furthermore, a lack in a post-donation follow-up medical to alleviate and detect post-donation complications was identified.Further nursing research can help nurses to understand living donation for transplantation, also how the nurses that practice in organ transplant units experience and deal with the psychosocial factors that influence them particularly.

[发布机构] Stellenbosch University