Interventions Improving Coping Strategies and Promoting Compliance in Adolescents Undergoing Hematopoietic Stem Cell...

Hematopoietic stem cell transplantation (HSCT) during adolescence is complex and may compromise psychosocial development, mental health, and treatment adherence. Evidence remains limited on how adolescents experience HSCT and which interventions support coping and self-management.

To describe interventions that strengthen coping strategies and promote compliance in adolescents, and to synthesize their transplant and posttransplant experiences.

A mixed-method systematic review with a convergent integrated design was conducted (PROSPERO CRD42023405294) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles published between 2013 and 2023 were searched in major databases.

Thirteen studies including adolescents aged 10-18 years were retained and appraised using established criteria, with assignment of levels of evidence. Adolescents reported negative impacts on mental health, isolation, life limitations, and insufficient posttransplant information, alongside gratitude and strengthened family ties. They mobilized positive coping strategies-social support, positive reframing, autonomy/self-management, self-transcendence, and reward by stage-counterbalanced by defense mechanisms. Five behavioral or e-health interventions were acceptable and feasible but yielded limited evidence for improving adherence or long-term outcomes.

HSCT profoundly affects adolescent mental health and daily life. Spontaneous coping may support adjustment but does not appear sufficient to ensure adherence, while existing interventions remain insufficiently evaluated, particularly regarding adherence and long-term outcomes.

Oncology nurses should routinely assess coping and mental health to guide early psychosocial and educational support. They should provide adolescent-specific preparation and post-HSCT education on the constraints and self-management demands of home-based care. Age-appropriate behavioral and e-health tools may support autonomy and motivation.