title: Patients' experiences of different care settings and a new life situation after allogeneic haematopoietic stem cell transplantation.
abstract: Over the past 20 years, considerable healthcare resources have shifted from an inpatient to an outpatient setting. To be in an outpatient setting or at home after allogeneic haematopoietic stem cell transplantation (allo-HSCT) has been shown to be medically safe and beneficial to the patient. In this study we describe patients' experiences of different care settings (hospital or home) and a new life situation during the acute post-transplant phase after HSCT. Semi-structured interviews were conducted with 15 patients (six women and nine men) 29-120 days after HSCT. An inductive qualitative content analysis was performed to analyse the data. The analysis resulted in four categories: To be in a safe place, To have a supportive network, My way of taking control, and My uncertain return to normality. The findings showed that patients undergoing HSCT felt medically safe regardless of the care setting. The importance of a supportive network (i.e. the healthcare team, family and friends) was evident for all patients. Both emotional and problem-focused strategies were used to cope with an uncertain future. Being at home had some positive advantages, including freedom, having the potential for more physical activity, and being with family members. The study highlights some key areas thought to provide more personalised care after HSCT.
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: K
authors.identifier: http://orcid.org/0000-0002-6331-8599
authors.initials: K
authors.lastname: Bergkvist
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Fossum
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: U-B
authors.initials: UB
authors.lastname: Johansson
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden.|Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Mattsson
authors.affiliation: The Red Cross University College, Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Larsen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D026684:Personal Autonomy; D011788:Quality of Life; D012944:Social Support; D014184:Transplantation, Homologous
keywords: acute post-transplant phase; allogeneic stem cell transplantation; content analysis; home care; hospital care; patient experiences