Dimensions of neutropenia in adult cancer patients: expanding conceptualizations beyond the numerical value of the absolute neutrophil count.
Neutropenia is a common and dangerous toxicity of cancer therapy that profoundly affects patients' lives. Neutropenia is typically defined by the numerical value of the absolute neutrophil count. However, considering neutropenia exclusively as the numerical value of the absolute neutrophil count limits its conceptualizations to physiologically related aspects, minimizes its complexities, and neglects dimensions of human response and the patient experience. This article offers a dimensional analysis of neutropenia derived from 42 research and clinical articles. Schatzman's dimensional analysis methods were applied to the literature to identify aspects of this phenomenon lying beyond its numerical boundaries. Dimensions of neutropenia that emerged were sorted into categories of perspective, context, conditions, processes, and consequences. The presence of the same dimension in more than 1 category and the circuitous relationships among categories begin to explicate the complexity and gravity of neutropenia. Articulation of these dimensions is necessary to assemble the beginnings of a theoretical understanding of neutropenia, which is crucial for the development and application of knowledge to research and practice. Limitations evident in the literature illuminate the urgent need for research into the psychosocial as well as physiologic dimensions of neutropenia.
University of Pennsylvania School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104, USA. crighton@nursing.upenn.edu
Margaret H
MH
Crighton
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D017281:Cost of Illness; D005334:Fever / Q000209:etiology; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000209:etiology; D007958:Leukocyte Count; D020380:Needs Assessment; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012107:Research Design; D012307:Risk Factors