Caring spouses under hematopoietic stem cell transplant based on Meleis' transition theory: a qualitative study

Spousal caregivers often provide physical, psychological, and emotional support at home during and after hematopoietic stem cell transplantation (HSCT). This study aimed to explore the transition experiences of spousal caregivers (wives and husbands) of patients undergoing autologous HSCT at 2 weeks and 6 months after hospital discharge, using Meleis' Transition Theory as the conceptual framework.

This longitudinal qualitative study employed directed deductive thematic analysis based on Meleis' Transition Theory. Data were collected through open-ended, in-depth interviews with 14 spousal caregivers at 2 weeks and 6 months after hospital discharge.

Thematic analysis developed three main themes and seven subthemes. The first theme is decreased marital satisfaction due to relational distancing, which encompasses the subthemes of (a) the impact of sexual dysfunction on the marital relationship and (b) immunosuppression and intentional sexual abstinence due to fear of infection. The second theme is difficulty in balancing demands, which encompasses the subthemes of (a) individual burden, (b) suppression of conflict, and (c) longing for normal routine. The third theme is managing fears, which encompasses (a) a sense of guilt and responsibility and (b) from enduring to inner calm. At 2 weeks post-transplant, spouses need help managing anxiety. By 6 months, they focus on reframing fears, rebuilding identity, and restoring normality.

Continuous psychosocial support during these phases is essential. HSCT significantly affects spousal caregivers, who face multifaceted physical, emotional, and psychosocial challenges throughout a prolonged adjustment process.