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Isolation Method for Long-Term and Short-Term Hematopoietic Stem Cells
Published on: May 19, 2023
Family Adjustment to Pediatric Hematopoietic Stem Cell Transplant During COVID-19
Marie L Chardon1, Kimberly L Klages1, Naomi E Joffe1,2,3
1Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Families with children undergoing hematopoietic stem cell transplant (HCT) adapted well to COVID-19, often due to HCT preparedness. However, isolation and germ fears posed challenges, highlighting the need for psychosocial support.
Area of Science:
- Pediatric Hematology/Oncology
- Family Psychology
- Infectious Disease Epidemiology
Background:
- The COVID-19 pandemic presented unique challenges for families globally, including increased infection risk and social isolation.
- Families with children undergoing pediatric hematopoietic stem cell transplant (HCT) faced heightened vulnerability due to the child's immunocompromised status.
- Understanding the impact of the pandemic on these families is crucial for providing targeted clinical support.
Purpose of the Study:
- To qualitatively explore the experiences and adjustment of families with children undergoing HCT during the COVID-19 pandemic.
- To identify factors influencing family adjustment during this unprecedented public health crisis.
- To inform clinical practice and psychosocial support strategies for pediatric HCT families.
Main Methods:
- Conducted semi-structured qualitative interviews with 29 caregivers of children (≤12 years) who had undergone HCT within the past two years.
- Interviews were completed within the first four months following initial COVID-19 quarantine measures.
- Grounded theory methodology was employed to analyze the interview data and identify emergent themes.
Main Results:
- Twenty-two distinct themes related to family adjustment during the pandemic were identified.
- While nearly half of caregivers reported COVID-19 as a stressor, 69% indicated adequate adjustment.
- Positive adjustment was often attributed to HCT preparedness, whereas increased isolation and germ fears contributed to difficulties.
Conclusions:
- Families with pediatric HCT experience demonstrated a unique capacity to cope with pandemic-related stressors, often leveraging prior HCT-related coping mechanisms.
- Specific risk factors, including recent transplant status, limited social support, and reduced access to coping resources, were associated with poorer adjustment.
- Enhanced psychosocial support from healthcare teams is recommended for families facing increased vulnerability during pandemics.
Objective:
The COVID-19 pandemic has been difficult for families across the world due to fears about infection risk, increased social isolation, and significant changes in family roles and routines. Families with a child undergoing pediatric hematopoietic stem cell transplant (HCT) may be at even greater risk for poor adjustment during COVID-19 given their child's increased risk for infection. The purpose of the current study was to qualitatively examine the impact of COVID-19 on family adjustment during pediatric HCT to inform clinical care.
Methods:
Twenty-nine caregivers of children (≤12 years) who underwent an HCT within the past 2 years completed semi-structured qualitative interviews and demographic questionnaires in the first 4 months following initial COVID-19 quarantine.
Results:
Twenty-two themes emerged from the interviews using grounded theory methodology. Although nearly half of caregivers described COVID-19 as a stressor, 69% of caregivers reported adequate adjustment to COVID-19. Caregivers generally attributed their positive adjustment to HCT preparing the family for COVID-19 and more difficult adjustment to increased physical or social isolation and COVID-19 amplifying germ fears. The child's HCT treatment status also had important implications on family adjustment to COVID-19.
Conclusions:
Results suggest that families undergoing pediatric HCT are uniquely prepared to cope with the impacts of a global pandemic; however, families experiencing certain risk factors (e.g., more recent transplant, impaired access to social support, reduced access to coping tools) may experience poorer adjustment during pandemics such as COVID-19 and may benefit from increased psychosocial support from their healthcare team.
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