Pain in adult recipients of blood or marrow transplant

Severe pain is a problem for most bone marrow transplant (BMT) recipients. The purpose of this descriptive study was to describe the pain experience of adults undergoing autologous BMT, allogeneic BMT, or peripheral blood stem cell transplant. The sample consisted of 20 adults, 21 to 54 years of age. Using investigator-developed structured interview guides, investigators interviewed each participant four times: on the day of transplant, then at 3-weekly intervals. Investigators used a content analysis approach when analyzing data. During the first interview, 18 participants said that they were told to expect mouth sores during BMT, yet only six said that they actually expected to experience mouth sores during BMT. During successive interviews, 13 reported mouth sores. Eight other pain sites were reported. Participants reported that their tolerance of mild, moderate, and severe pain decreased over 2 weeks, and they named a wide variety of factors that caused or relieved pain. Ten said that they used nonpharmacologic techniques to feel more comfortable. Seven said that their BMT pain was worse or more difficult than they had expected. Overall pain ratings ranged from 0 to 8 on a 0 to 10 scale, M = 4.5. Five said the side effects of analgesics bothered them more than their pain. Most of them said a pain-rating scale was useful. Three weeks post-BMT, seven said they still experienced pain. Implications for clinical practice, research, and education are discussed.