Finding new bearings: a qualitative study on the transition from inpatient to ambulatory care of patients with acute myeloid leukemia.
OBJECTIVE
Treatment of adult acute myeloid leukemia (AML) is intensive, with induction treatment initiated in an inpatient setting and subsequent consolidation therapy often conducted in an outpatient setting. The purpose of the present qualitative paper is to provide insight into the experience of patients in the transition from inpatient to ambulatory care.


METHODS
Participants were 35 AML patients who were interviewed about their experience of the illness and treatment. Utilizing the grounded theory method, we describe the adjustment of participants to the transition to ambulatory care.


RESULTS
As outpatients, participants described adjusting to the intensity of ambulatory treatment and to the need to assume greater responsibility for their care. They also expressed a growing desire to understand their long-term care plan, compared to their preference to focus on the present prior to discharge, and they were struggling to construct a new sense of identity.


CONCLUSIONS
AML patients are now leaving acute care settings sicker and earlier. Considering their perceptions can inform interventions to facilitate adjustment during the transition to outpatient care.
Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, 610 University Ave, Toronto, ON, Canada, rinat.nissim@uhn.ca.
Rinat
R
Nissim
Gary
G
Rodin
Aaron
A
Schimmer
Mark
M
Minden
Anne
A
Rydall
Dora
D
Yuen
Ashley
A
Mischitelle
Peter
P
Fitzgerald
Christopher
C
Lo
Lucia
L
Gagliese
Camilla
C
Zimmermann
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D003266:Continuity of Patient Care / Q000458:organization & administration / Q000592:standards; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010351:Patient Discharge / Q000592:standards; D011787:Quality of Health Care