Hastings Brooklyn, Patil Crystal, Gallo Agatha M
University of Illinois at Chicago College of Nursing, Chicago, IL, USA.
West J Nurs Res. 2019 Dec;41(12):1829-1844. doi: 10.1177/0193945919870828. Epub 2019 Aug 18.
Haploidentical hematopoietic stem cell transplantation (HSCT) from partially matched first-degree relatives (e.g., parent, sibling, child) is the newest therapy available to reverse symptoms of adults with sickle cell disease. Because of this innovation, little is known about the recipients' transplant experiences and how this type of transplant affects their quality of life. We describe the experiences and health-related quality of life (HRQOL) of five (3 female, 2 male) of nine eligible adults with sickle cell disease who received HSCT. Participants completed a brief demographics form, an HRQOL survey, and a 90-minute audio-recorded interview. We produced a series of matrices and summaries for our content analysis in addition to descriptive statistics. We report on recipients' perspectives about the process, outcomes, personal life goals, and how their experience relates to their HRQOL scores. Participants' impressions of their experience varied, but their HRQOL scores paralleled their complications. Those with successful transplants and minimal complications scored highest. Those with successful transplants but significant complications scored in the middle and the individual with an unsuccessful transplant scored the lowest. The four with successful transplants remarked that their health had improved and expressed optimism. We identified three themes: (a) the relief of being pain free, (b) new availability of opportunities, and (c) no regrets about undergoing the transplant. These results delve into the complex factors affecting health and the success of adults with SCD who have a haploidentical HSCT.
来自部分匹配的一级亲属(如父母、兄弟姐妹、子女)的单倍体相合造血干细胞移植(HSCT)是目前可用于逆转成年镰状细胞病患者症状的最新疗法。由于这一创新疗法,对于接受移植者的移植经历以及这种类型的移植如何影响他们的生活质量,人们了解甚少。我们描述了9名符合条件的成年镰状细胞病患者中5名(3名女性,2名男性)接受HSCT后的经历和与健康相关的生活质量(HRQOL)。参与者填写了一份简短的人口统计学表格、一份HRQOL调查问卷,并进行了一次90分钟的录音访谈。除了描述性统计外,我们还制作了一系列矩阵和总结用于内容分析。我们报告接受移植者对移植过程、结果、个人生活目标的看法,以及他们的经历与HRQOL评分之间的关系。参与者对自己经历的印象各不相同,但他们的HRQOL评分与并发症情况相符。移植成功且并发症最少的参与者评分最高。移植成功但有严重并发症的参与者评分中等,移植失败的参与者评分最低。4名移植成功的参与者表示他们的健康状况有所改善,并表达了乐观情绪。我们确定了三个主题:(a)摆脱疼痛,(b)有了新的机会,(c)对接受移植不后悔。这些结果深入探讨了影响成年镰状细胞病患者健康和单倍体相合HSCT成功的复杂因素。