Does quality of life improve for clients with autoimmune or neuromuscular disorders who received stem cell replacement?
Série IV – n.º 19 – OUT./NOV./DEZ. 2018Revista de Enfermagem Referência
pp. 29 – 36
ISSNe: 2182.2883 | ISSNp: 0874.0283 Available: https://doi.org/10.12707/RIV18055
Coping strategies used during treatment by patients submitted to hematopoietic stem cell transplantation Estratégias de enfrentamento utilizadas durante o tratamento por pacientes submetidos ao transplante de células-tronco hematopoiéticas Estrategias de afrontamiento utilizadas durante el tratamiento por pacientes sometidos a trasplante de células madre hematopoyéticas Ana Paula Szczepanik* ; Angela da Costa Barcellos Marques** ; Mariluci Alves Maftum*** ; Rosibeth Del Carmen Muños Palm**** ; Maria de Fátima Mantovani***** ; Luciana Puchalski Kalinke******
Abstract Background: Coping strategies in the process of treatment with hematopoeitic stem cell transplantation are crucial to the improvement of the quality of life of these patients. Objective: To describe coping strategies used during treatment by patients submitted to hematopoietic stem cell transplantation. Methodology: Qualitative, descriptive, and exploratory research, with 5 participants, conducted from July to November 2017, in a hospital of reference for this treatment in Brazil. Data were collected by means of semi-structured and self-applied video interview and analysed by the content analysis technique. Results: Coping strategies such as family support and spirituality were the most used, present in every stage of transplant, followed by the increase of feeling of appreciation of life after overcoming this experience. Conclusion: Patients develop coping strategies to endure therapy effects. The knowledge of the strategies can contribute to the enlightenment and stimulation of future patients regarding coping with treatment, as well as to the assistance of health professionals, especially nursing teams in care practice. Keywords: hematopoietic stem cell transplantation; bone marrow transplantation; adaptation, psychological; oncology nursing
Resumo Enquadramento: Estratégias de enfrentamento no processo de tratamento do transplante de células-tronco hematopoiéticas são determinantes para uma melhor recuperação dos pacientes. Objetivo: Descrever estratégias de enfrentamento utilizadas durante tratamento por pacientes submetidos ao transplante de células-tronco hematopoiéticas. Metodologia: Pesquisa qualitativa, descritiva e exploratória, com 5 participantes, de julho a novembro de 2017, em hospital referência para este tratamento no Brasil. Os dados foram obtidos por vídeo-entrevista semiestruturada, auto aplicada, e analisados pela técnica análise de conteúdo. Resultados: Estratégias de enfrentamento como o apoio fami- liar e a espiritualidade foram as mais utilizadas, estando presente em todas as etapas do transplante, seguido do aumento do senso de valorização da vida após a vivência desta experiência. Conclusão: Pacientes desenvolvem estratégias de enfrentamen- to para suportar os efeitos da terapêutica. O conhecimento destas estratégias pode contribuir para a elucidação e estimu- lação de futuros pacientes relativamente ao enfrentamento do tratamento, assim como, para a subsidiação dos profissionais de saúde, em especial, das equipas de enfermagem na prática do cuidado. Palavras-chave: transplante de células-tronco hematopoé- ticas; transplante de medula óssea; adaptação psicológica; enfermagem oncológica
Resumen Marco Contextual: Estratégias de enfrentamiento em el proceso de laterapéutica del Trasplante de Células-Madre Hematopoyéticas son determinantes para una mejor recu- peración de los pacientes. Objetivo: Describir estrategias de enfrentamiento utilizadas em el tratamiento por pacientes sometidos al trasplante de células madre hematopoyéticas. Metodología: La investigación cualitativa, descriptiva y exploratoria, realizada con 5 participantes, de julio a no- viembre de 2017, en hospital referencia para este tratamiento en Brasil. Los datos fueron obtenidos por video-entrevista semiestructurada, auto aplicada, y analizados por la técnica análisis de contenido. Resultados: Estrategias de enfrentamiento como el apoyo familiar y la espiritualidad fueron las más utilizadas, estan- do presente en todas las etapas del trasplante seguido del aumento del sentido de valoración de la vida después de la vivencia de esta experiencia. Conclusión: Los pacientes desarrollan estrategias de en- frentamiento para soportar los efectos de la terapéutica. El conocimiento de estas estratégias puede contribuir com elucidación de cómo el paciente vive el tratamiento y como estímulo para los pacientes futuros, así como subsidios para profesionales de salud, en especial, el equipo de enfermería em la práctica del cuidado. Palabras clave: trasplante de células madre hematopoyéticas; trasplante de médulaósea; adaptación psicológica; enfermería oncológica.
*MSc., RN, Complexo Hospital de Clínicas da Universidade Federal do Paraná, 80210-170, Curitiba, Brazil [anasau2012@gmail.com]. http://orcid.org/0000-0002-5103-5604. Contribution to the arti- cle: writing of the article, bibliographical research, data collection, data analysis, discussion. Address for correspondence: Rua General Carneiro, 181 – Alto da Glória, Curitiba – Pr. 80210-170, Curitiba, Brasil. **MSc., RN , Complexo Hospital de Clínicas da Universidade Federal do Paraná, 80210-170, Curitiba, Brazil [angebarenf@yahoo.com.br]. http://orcid.org/0000-0003-1442-0308. Contribution to the article: writing of the article, bibliographical research, formatting, substantial participation in discussion. ***Ph.D., Professor, Federal University of Paraná, 80210-170, Curitiba, Brazil [maftum@ufpr.br]. http://orcid.org/0000-0001-8706-7299. Contribution to the article: bibliographical research, data analysis and interpretation, substantial participation in discussion. ****Ph.D., Professor, Federal University of Paraná, 80210-170, Curitiba, Brazil [rosibethpalm@gmail. com]. http://orcid.org/0000-0001-7929-9620. Contribution to the article: bibliographical research, data analysis and interpretation, substantial participation in discussion. *****Ph.D., Professor, Federal University of Paraná, 80210-170, Curitiba, Brazil [mfatimamantovani@ ufpr.br]. http://orcid.org/0000-0001-7961-8273. Contribution to the article: writing of the article, bi- bliographical research, data analysis and interpretation, substantial participation in discussion. ******Ph.D., Professor, Federal University of Paraná, 80210-170, Curitiba, Brazil [lucianakalinke@ yahoo.com.br]. http://orcid.org/0000-0003-4868-8193. Contribution to the article: research Concep- tion and design, writing of the article, data analysis and interpretation, critical revision of manuscript regarding relevant intellectual content.
Received for publication: 14.07.18 Accepted for publication: 07.12.18
RESEARCH PAPER (ORIGINAL) ARTIGO DE INVESTIGAÇÃO (ORIGINAL)
http://orcid.org/0000-0002-5103-5604
http://orcid.org/0000-0003-1442-0308
http://orcid.org/0000-0001-8706-7299
http://orcid.org/0000-0001-7929-9620
http://orcid.org/0000-0001-7961-8273
http://orcid.org/0000-0003-4868-8193
http://orcid.org/0000-0002-5103-5604
http://orcid.org/0000-0003-1442-0308
http://orcid.org/0000-0001-8706-7299
http://orcid.org/0000-0001-7929-9620
http://orcid.org/0000-0001-7961-8273
http://orcid.org/0000-0003-4868-8193
30 Revista de Enfermagem Referência – IV – n.º 19 -2018
Coping strategies used during treatment by patients submitted to hematopoietic stem cell transplantation
Introduction
Hematopoietic stem cells transplantation (HSCT) is considered as one of the treatment options for patients with haematological diseas- es and is in continuous growth. It is a complex and hard procedure, which requires a long peri- od of hospitalization and exposes the patient to physical, emotional, and social changes, leading to the need to develop coping strategies to face these adversities. The global demographic and epidemiological transitions show a growing impact in cases of cancer and hematologic diseases in the next de- cades (Gratwol, Baldomero, & Passweg, 2013), with increasing incidence in Brazil and the world. According to data from the Ministry of Health (MH), in 2017 there were 2,794 HSCTs in Brazil, of which 1,668 were autolo- gous and 1,126 allogeneic, 46 autologous and 155 allogeneic occurring in Paraná (Associação Brasileira de Transplante de Órgãos, 2017). When the HSCT is performed, there is depres- sion of the immune system that triggers physical changes throughout the patient’s daily life. This can be considered as a critical moment in their life because, initially, the patient feels fear and little expectation in relation to the future. Sometimes, these reactions are reinforced by beliefs and fantasies related to this pathology, associating it with the end of life (Andrade, Castro, Soares, & Santos, 2012). Therefore, there is a need to seek coping alternatives and strategies to experience these changes. Coping strategy was defined by Lazarus and Folkman (1987) as an individual variable de- picted by the way people commonly react to stress, driven by personal factors, situational demands, and available resources. That is, they are ways and attempts to preserve life and/or physical and mental health in the face of a stressor moment that will bring consequences into their daily lives. Considering that studies addressing the coping strategies theme in the treatment can contribute to scientific production for transplant patients and those who, directly or indirectly, experience this process with them, such as family, friends, and health professionals, the patient can benefit from knowledge thereby improving their un- derstanding and, thus, engaging in treatment for a greater success. Family and friends will be
able to understand the situation experienced by the patient and help them with special care during hospitalization and at home and…
