Caring Process in Hematopoietic Stem Cell Transplantation: A Grounded Theory Study

Abstract

Background: Caring is one of the main concepts in nursing and its modes of delivery in different diseases have been widely studied. Hematopoietic Stem Cell Transplantation (HSCT) is a novel, complex, and time-consuming clinical intervention which is applied as a final medical choice in several life-threatening diseases. The aim of the current study was to explore the process of caring for patients undergoing HSCT. Materials and Methods: In this article, we present a qualitative research study conducted between 2011 and 2013 in accordance with the procedures of grounded theory methodology. Data were gathered by interviewing and observing health professionals involved in HSCT process, as well as patients and their families. The study participants consisted of 18 HSCT nurses, 2 physicians, 12 patients, and 7 members of patients' families. The initial sampling in the study was purposeful, followed by theoretical sampling. Data were analyzed using the Corbin & Strauss (2008) method. Results: Four main categories, reflecting 13 sub-categories, were emerged by analyzing the data: struggling of patients between life and death, trying to reduce the chance of patient's death, enforcing patients' spirit and caring achievements. The core variable of study, defined as "supporting patients to go through the HSCT process successfully", represented the nature and efficiency of care delivered to HSCT patients in the study setting. Conclusion: HSCT patients enter the caring process in the context of life-and-death limbo. The caring strategy in HSCT patients is aimed at trying to reduce the chance of the patient's death, as well as enforcing patients' spirit. The HSCT process affects all areas involved in various ways and has some outcomes. The findings and the theoretical conclusions of this study are potentially valuable in improving nursing practice, designing of educational programs and setting of caring policies.