Life after Transplant: The Use of Group in Preparation for Transition Home

Life after Transplant: The Use of a Group Modality in Preparation for Transition Home

Becky Dame, RN, BMT-CN, Moffitt Cancer Center, Tampa, FL and Lynda Cook Gannon, LCSW, Moffitt Cancer Center, Tampa, FL , Alix Beaupierre, RN, BSN, OCN, Moffitt Cancer Center, Tampa, FL, Ashur-Dee Brown, RN, BS, CHTC, Moffitt Cancer Center, Tampa, FL, and Jolene Rowe, LCSW, Moffitt Cancer Center, Tampa, FL.

Topic Significance & Study Purpose/Background/Rationale

The transition from transplant center to local oncologist and from local housing to home demands both practical and emotional consideration. Transplant Nurse Coordinators (TNCs) and Clinical Social Workers (CSWs) are in a unique position to help patients and caregivers in this transition. With proper education, patients and caregivers are better equipped to handle discharge.  The use of a group modality allows patients and caregivers the opportunity to learn from one another.

Methods, Intervention, & Analysis

TNCs and CSWs met to develop a program to address the transition from transplant center care to home.  Content input  was secured from other nurses, social workers, and physicians in the outpatient BMT program based on the perceived need for support of patients during this critical time. A group modality was chosen in an effort to utilize peer learning and support.

All patients who underwent an allogeneic transplant were scheduled to attend the program prior to discharge from the transplant center, between day +60 and day +90. A slide presentation was developed and focused on the following areas: communication between the transplant center and the local oncologist, necessary precautions, recommended follow-up care, practical aspects of insurance, employment, finances and emotional concerns including managing anxiety, depression, and adjusting to the "new normal."   Group discussions and reflection of the transplant experience and future goals were facilitated by the TNCs and CSWs.  Evaluations were obtained from each participant at their next clinic visit.

Findings & Interpretations

Overall, patients and caregivers rated the group experience and information provided as informative and thought provoking.  97% of participants “strongly agreed/agreed” that the topics presented assisted them in planning their discharge from both a practical and emotional perspective.  93% reported feeling comfortable participating in the group discussions.

Discussion & Implications

The benefit of an interdisciplinary model between TNCs and CSWs provides a broad perspective relative to BMT patients transitioning home. The use of discussion, as well as slide presentation, helps to individualize education for participants, creates an environment for discussing questions and concerns, and allows patients and caregivers to share experiences and receive support.  Another class relative to the period of post-transplant days +30 to +45 is under consideration.