Hospital care or home care after allogeneic hematopoietic stem cell transplantation--patients' experiences of care and support.
OBJECTIVE
Treatment at home during the pancytopenic phase after allogeneic hematopoietic stem cell transplantation (HSCT) has been an option for patients at our center since 1998. Earlier studies have shown that home care is safe and has medical advantages. In this study, we present patients' experiences of care and support while being treated in hospital or at home during the acute post-transplantation phase.


METHODS
Patients (n = 41, 22 in hospital care and 19 in home care) answered the SAUC questionnaire at discharge (when home, or from hospital). Both statistical analysis and deductive content analysis were used.


RESULTS
The patients were highly satisfied with the care and support during the acute post-transplantation phase. Patients in home care were found to be more satisfied with care in general than patients in hospital care. The importance of safety, empathy, and encouragement from healthcare staff were expressed regardless of where care was given. Patients also felt that receipt of continuous, updated information during treatment was important and they had a strong belief in HSCT but were uncertain of the future regarding recovery.


CONCLUSIONS
The main findings of this study were that in comparison to hospital care, home care does not appear to have a significant negative effect on patients' experiences of care and support during the acute post-transplantation phase. In addition patients in home care felt safe, seen as a person and encouragement seem to empower the patients at home. Thus, this study may encourage other transplantation centers to provide home care if the patients want it.
Department of Laboratory Medicine, Therapeutical Immunology, Karolinska Institutet, Stockholm, Sweden. karin.bergkvist@shh.se
Karin
K
Bergkvist
Joacim
J
Larsen
Unn-Britt
UB
Johansson
Jonas
J
Mattsson
Britt-Marie
BM
Svahn
D000328:Adult; D000359:Aftercare / Q000379:methods*; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000451:nursing*; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000451:nursing* / Q000534:rehabilitation; D010351:Patient Discharge; D017060:Patient Satisfaction; D036301:Qualitative Research; D012944:Social Support; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires