African-American, Latino and Caucasian Patients' Experience before, during and after Stem Cell Transplantation: A Phenomenological Study

Topic Significance & Study Purpose/Background/Rationale:   Patient with refractory hematological malignancies are frequently candidates for life saving but potentially life threatening treatment such as stem cell transplantation (SCT).  The purpose of this study was to describe the meaning of the experience of SCT for African-American, Latino, and Caucasian patients before during and after SCT.

Methods, Intervention, & Analysis: Hermeneutic phenomenological method was used to complete analysis of data from interviews of 60 SCT patients that were conducted before treatment began, at the time of blood count recovery, and day 30, 60 and 100 after treatment. 

Findings & Interpretation: Like a bridge I never crossed before captured the meaning the experience had for participants at all times.  Three overlapping themes emerged: Facing the Fear, Getting Through and Going Beyond, primarily after the SCT.  Contextual factors of life threatening disease and treatment, lack of experience or knowledge, emotional/coping, culture, symptom burden, and financial burden influenced the transition between the phases of SCT. While the themes were common across all ethnicities differences in emphasis were found.

Discussion & Implications:  There is a need to determine the meaning of SCT, it's related education, and the experience of being post treatment for patients and their families of all ethnicities. Implications for practice include modifying care, education, and planning to ensure patient centered care that is responsive to the patient and family meanings. Research that assesses such care and the related outcomes is essential.