The coping process in adults with acute leukemia undergoing hematopoietic stem cell transplantation

The increasing numbers of leukemia cancer survivors treated with hematopoietic stem cell transplantation (HSCT) face numerous challenges after their transplant procedure. Little information has been published regarding the coping process of this population. Understanding how they cope with this life-threatening disease can assist healthcare professionals to provide holistic care.

This study was designed to elicit the coping process of adults experiencing acute leukemia who underwent HSCT therapy.

This longitudinal qualitative study and grounded theory took place during 2009-2011. Ten adults with acute leukemia scheduled for HSCT were recruited from Shariati Hospital in Tehran, Iran. A series of pretransplant and posttransplant interviews were held in the hospital's HSCT units. Final interviews took place 2-6 months posttransplant in the hospital's outpatient clinic.

The five categories that emerged from the data included perceived threat, suspension between fear and hope, rebirth, contextual factors, and coping strategies. Although patients vacillated within the coping spectrum (i.e., the "buffer zone" between fighting and acquiescing), "finding meaning" was identified as the final outcome of their experience that indicated effective coping. CONCLUSIONS/IMPLICATION FOR PRACTICE: Each patient perceives leukemia and HSCT therapy uniquely. This life-threatening disease can significantly affect patient perception and change patient lives both temporarily and permanently. Nurses can apply effective interventions to help patients cope with their unique situation, find meaning and hope, and allay fear and stress.