Person-Centred Nursing in Allogeneic Stem Cell Transplantation Using a Conversation Tool: A Qualitative Study

Area of Science:

• Hematology
• Oncology Nursing
• Transplantation Medicine

Background:

• Allogeneic haematopoietic stem cell transplantation (allo-HCT) patients have complex recovery needs.
• Person-centred nursing (PCN) is crucial but underexplored in specialized allo-HCT care.
• The Assessment of Rehabilitation Needs Checklist (ARNC) is used in cancer care but its role in PCN for allo-HCT is uninvestigated.

Purpose of the Study:

• To investigate how the Assessment of Rehabilitation Needs Checklist (ARNC) promotes person-centred nursing (PCN) in the allogeneic haematopoietic stem cell transplantation (allo-HCT) context.
• To explore the ARNC's utility as a conversation tool in supporting PCN for allo-HCT patients.

Main Methods:

• Qualitative study at two Swedish allo-HCT centers.
• Semi-structured interviews with 16 patients and 16 registered nurses (RNs).
• Analysis of 30 RN-written memos using reflexive thematic analysis.

Main Results:

• The ARNC facilitated individualized conversations and identified unmet patient needs, including sensitive concerns.
• Identified themes: 'Letting the Story Emerge,' 'Unmet Needs,' and 'Structural Gaps in Practice.'
• Organizational constraints like time pressure and fragmented care limited shared care planning and sustained engagement.

Conclusions:

• The ARNC has potential to support PCN in allo-HCT through narrative-based, needs-driven conversations.
• Effectiveness is contingent upon structured follow-up processes.
• Optimizing ARNC use requires organizational conditions that foster relational care and address structural gaps.