Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, AB T2N 4N2, Canada.
Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
Curr Oncol. 2023 Sep 15;30(9):8477-8487. doi: 10.3390/curroncol30090617.
Recipients and caregivers of Hematopoietic Stem Cell Transplant (HCT) have extensive physical and psychosocial needs. HCT programs recognize the need to support psychosocial wellbeing. However, evidence-based guidance for pre-HCT psychosocial services is sparse. We conducted a qualitative environmental scan of programs across Canada to better understand how programs evaluate and support patients and caregivers prior to HCT.
HCT programs across Canada were contacted with a list of questions about their psychosocial assessment and preparation process with patients and caregivers. They could respond via email or participate in an interview over the phone. Descriptive qualitative content analysis was conducted, using steps outlined by Vaismoradi and colleagues (2013).
Most participants were social workers from hospitals (64%). Four qualitative themes arose: (a) Psychosocial Team Composition. Psychosocial assessment for HCT patients was often provided by social workers, with limited availability of psychologists and psychiatrists. (b) Criteria for assessing select HCT patients. Participants prioritized psychosocial assessments for patients with higher perceived psychosocial needs or risk, and/or according to transplant type. Limited time and high psychosocial staff demands also played into decision-making. (c) Components and Practices of Pre-HCT Psychosocial Assessment. Common components and differences of assessments were identified, as well as a lack of standardized tools. (d) Patient Education Sessions. Many sites provided adjunct patient education sessions, of varying depth.
Significant variation exists in the way programs across the country assess their patients' psychosocial pre-transplant needs and assist in preparing patients for the psychosocial aspects of HCT. This environmental scan identified several strategies used in diverse ways. Further in-depth research on program outcomes across Canada could help to identify which strategies are the most successful.
造血干细胞移植（HCT）的接受者和护理人员有广泛的身体和心理社会需求。HCT 项目认识到需要支持心理社会健康。然而，关于 HCT 前心理社会服务的循证指南很少。我们对加拿大各地的项目进行了定性环境扫描，以更好地了解项目在 HCT 前如何评估和支持患者和护理人员。
联系加拿大各地的 HCT 项目，询问他们对患者和护理人员进行心理社会评估和准备的过程。他们可以通过电子邮件回复或通过电话进行访谈。使用 Vaismoradi 及其同事（2013 年）概述的步骤进行描述性定性内容分析。
大多数参与者是来自医院的社会工作者（64%）。出现了四个定性主题：（a）心理社会团队组成。HCT 患者的心理社会评估通常由社会工作者提供，心理学家和精神科医生的可用性有限。（b）评估特定 HCT 患者的标准。参与者优先对感知到更高心理社会需求或风险的患者进行心理社会评估，或者根据移植类型进行评估。时间有限和高心理社会工作人员需求也影响了决策。（c）HCT 前心理社会评估的组成部分和实践。确定了常见的评估组成部分和差异，以及缺乏标准化工具。（d）患者教育课程。许多站点提供不同深度的附加患者教育课程。
全国范围内的项目在评估患者 HCT 前心理社会需求以及帮助患者为 HCT 的心理社会方面做好准备的方式上存在显著差异。这项环境扫描确定了几种以不同方式使用的策略。在加拿大各地进一步深入研究项目结果可以帮助确定哪些策略最成功。
