Exploring the everyday world of the patient in isolation.

PURPOSE/OBJECTIVES: To explore the phenomenon of isolation from the perspective of patients cared for in reverse isolation for bone marrow transplant (BMT).

DESIGN

Interpretive, phenomenologic.

SETTING

Hematology and bone marrow transplant unit of a large teaching hospital in Brisbane, Australia.

SAMPLE

Seven patients undergoing BMT.

METHODS

Phenomenologic interviews and thematic analysis of transcribed data.

MAIN RESEARCH VARIABLE

Patient's day-to-day experiences of reverse isolation.

FINDINGS

Although appreciative of the physical care and attention given to them, participants did not convey a sense that healthcare professionals understood the experience of the BMT recipient's isolation or illness from their perspective. Major themes elicited from analysis of the transcripts included (a) striving to take charge, which refers to participants' attempts to maintain control in a seemingly out-of-control situation. (b) intellectualizing the need for isolation, and (c) being in touch: contact with family and staff.

CONCLUSIONS

Elements of caring for the patient appeared to dominate the comments associated with staff contact. Other forms of care (e.g., caring about) emphasize the importance of nurses understanding and connecting with peoples' meanings and experiences of their illness and treatment.

IMPLICATIONS FOR NURSING PRACTICE

Although all participants were aware that they could ask for information about their diagnosis and treatment at any time, most had not been offered the opportunity to describe their feelings or experiences before. Unless nurses take more initiative to gain insight and a greater appreciation of the patient's understanding of his or her situation, they will continue to focus on unidimensional aspects of care and neglect the multidimensional or holistic nature of nursing care.