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Emotional State Evolution and Nursing Interventions in Patients Undergoing HSCT in Laminar Airflow Clean Rooms: A
Ying Gao1, Fei Li1, Xiaohong Cheng1
1Department of Hematology, First Hospital of Harbin.
Abstract:
Hematopoietic stem cell transplantation (HSCT) is an established treatment for hematologic and other serious disorders, but the transplantation process can impose substantial psychological burdens. Protective isolation in laminar airflow clean rooms restricts social contact while patients simultaneously experience intensive conditioning, treatment-related symptoms, uncertainty, and dependence on professional care. This narrative review synthesizes evidence on the evolution of emotional states across the HSCT trajectory, factors associated with psychological distress, assessment approaches, and nursing strategies. Relevant literature was searched in PubMed/MEDLINE, Web of Science Core Collection, CINAHL, China National Knowledge Infrastructure, and Wanfang Data from database inception to August 31, 2026. Available evidence suggests that emotional responses vary across treatment phases and patient groups rather than following a uniform trajectory. Anxiety and uncertainty may be more prominent before transplantation and during entry into protective isolation, whereas depressive symptoms and broader distress may increase during myelosuppression and prolonged isolation. Psychological distress is associated with environmental isolation, physical symptom burden, information-related uncertainty, limitations in social and family support, treatment-related neuropsychiatric effects of corticosteroids, and inflammatory signaling. Nurses can contribute through repeated assessment, symptom management, communication and psychoeducation, support for family and social contact, sleep and relaxation strategies, and timely referral to specialist services. Empirical support varies across interventions, with stronger evidence for selected approaches such as inpatient palliative care and emerging evidence for educational, relaxation, digital, and recreational interventions. Future research should prioritize standardized assessment, longitudinal multicenter designs, and phase-specific individualized supportive care.