Original Article
Search for Meaning in Hematopoietic Stem Cell Transplantation in the Elderly
2014 Volume 28 Issue 2 Pages 5-14
Details
2014 Volume 28 Issue 2 Pages 5-14
Abstract
Purpose：Reduced-intensity stem cell transplantation （RIST） has become a standard treatment for hematological malignancies in patients aged ≥60 years. However, RIST in the elderly is associated with high morbidity and mortality rates. The purpose of this study was to identify the process of meaning of RIST in the elderly.
Methods：Each participant submitted informed consent to participate in this study. All participants were aged ≥60 years, were diagnosed with acute myeloid leukemia or myelodysplastic syndrome, and received RIST at a university hospital. Semi-structured interviews were conducted to assess the process of acceptance of hematopoietic malignancies suffered by the participants. Descriptions were analyzed using a modified grounded theory approach.
Results：This study comprised 10 participants （9 males and 1 female）, aged 60‒70 years. The process of meaning of RIST for the elderly was classified into three core categories：（1） stress associated with a diagnosis of a hematopoietic malignancy and severe adverse events following RIST, （2） wisdom and vigor through life experiences, and （3） expectations of improved quality of life.
Conclusions：The search for meaning of RIST faced by the elderly who received RIST enabled them to overcome severe physical and mental distress associated with hematopoietic malignancies. Furthermore, in the surviving participants, wisdom, vigor, and life experiences were identified to be the most relevant attributes in the face of a life-threatening disease, which the elderly participants credited to their adaptation ability and personal strength acquired from life experiences. It is necessary to offer individualized nursing care based on the three described core processes to enable elderly RIST survivors to share their experiences and provide encouragement to support long-term survival. Furthermore, it is important to provide care for the elderly to achieve spiritual and emotional growth.
