Ethnography on Isolation Unit for Hematopoietic Stem Cell Transplantation: Focusing on Patients

조혈모세포이식 병동에 관한 문화기술지: 환자를 중심으로

  • Received : 2008.08.08
  • Accepted : 2009.02.05
  • Published : 2009.02.28

Abstract

Purpose: The purpose of the study was to understand how patients experience everyday life in an isolation unit for hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 25 patients with HSCT at the isolation unit from January to March in 2008 in one general hospital in Korea. The data were collected by participant observations and ethnographic interviews and were analyzed using ethnographic method. Results: Four themes regarding environmental area emerged: 'barrier pulling up the drawbridge', 'very strange world', 'small and restricted space tied by IV and other treatment lines', and 'loud noise in a silent space.' Three themes regarding patients emerged: 'facing fear and anxiety', 'continuation of loneliness and lethargy', and 'compromising with a very long, dull, and boring time'. These themes describe how patients with HSCT suffer from continuous physical and psychosocial problems in a confined space, while endeavoring to control these problems and to search for hope for a new life. Conclusion: The results of the study provide an in-depth understanding of the experience and culture of patients in an isolation unit for HSCT. They would be used in developing practical programs to decrease patient's culture shock including fear and anxiety at isolation unit for HSCT.

Keywords

References

  1. National Medical Center. 2006 KONOS (Korean Network for Organ Sharing) Annual Report. Seoul, 2007.
  2. Collins C, Upright C, Aleksich J. Reverse isolation: what patients perceive. Oncol Nurs Forum 1989;16:675-9.
  3. Molassiotis A, Mank A, Van der Lelie H. Is there still an indication for nursing patients with prolonged neutropenia in protective isolation?: an evidence-based nursing and medical study of 4 years experience for nursing patients with neutropenia without isolation. Eur J Oncol Nurs 2002;7:17-23.
  4. Rizzo JD, Vogelsang GB, Krumm S, Frink B, Mock V, Bass EB. Outpatient-based bone marrow transplantation for hematologic malignancies: cost saving or cost shifting? J Clin Oncol 1999;17:2811-8. https://doi.org/10.1200/JCO.1999.17.9.2811
  5. Haberman M, Bush N, Young K, Sullivan KM. Quality of life of adult long-term survivors of bone marrow transplantation: a qualitative analysis of narrative data. Oncol Nurs Forum 1993;20:1545-53.
  6. Molassiotis A. Late psychosocial effects of conditioning for BMT. Br J Nurs 1996;11;5:1296-302.
  7. Saleh US, Brockopp DY. Quality of life one year following bone marrow transplantation: psychometric evaluation of the quality of life in bone marrow tansplant survivors tool. Oncol Nurs Forum 2001;28:1457-64.
  8. Whedon M, Ferrell BR. Quality of life in adult bone marrow transplant patients: beyond the first year. Semin Oncol Nurs 1994;10:42-57. https://doi.org/10.1016/S0749-2081(05)80044-0
  9. Gaskill D, Hederson A, Fraser M. Exploring the everyday world of the patient in isolation. Oncol Nurs Forum 1997;24:695-700.
  10. Shuster GF, Steeves RH, Onega L, Richardson B. Coping patterns among bone marrow transplant patients: a hermeneutical inquiry. Cancer Nurs 1996;19:290-7. https://doi.org/10.1097/00002820-199608000-00005
  11. Cohen MZ, Ley CD. Bone marrow transplantation: the battle for hope in the face of fear. Oncol Nurs Forum 2000;27:473-80.
  12. Thain CW, Gibbon B. An exploratory study of recipients' perceptions of bone marrow transplantation. J Adv Nurs 1996;23:528-35. https://doi.org/10.1111/j.1365-2648.1996.tb00015.x
  13. Bok JN, Sohng KY, Park HJ. Quality of life and family burden in hematopoietic stem cell transplantation recipients. J Korean Oncol Nurs 2005;5:136-45.
  14. Oh PJ. The meaning of quality of life for bone marrow transplant survivors. J Korean Acad Nurs 1998;28:760-72. https://doi.org/10.4040/jkan.1998.28.3.760
  15. Lee HJ, Kwon HJ, Kim KH. A study on the patient's treatment experiences in bone marrow transplantation. J Korean Acad Adult Nurs 1997;9:239-50.
  16. Kim KS. The levels of anxiety and depression in patients according to the stages of bone marrow transplantation [dissertation]. Seoul:Catholic Univ.;1994.
  17. Zerbe MB, Parkerson SG, Spitzer T. Laminar air flow versus reverse isolation: nurses' assessments of moods, behaviors, and activity levels in patients receiving bone marrow transplants. Oncol Nurs Forum 1994;21:565-8.
  18. Campbell T. Feeling of oncology patients about being nursed in protective isolation as a consequence of cancer chemotherapy treatment. J Adv Nurs 1999;30:439-47. https://doi.org/10.1046/j.1365-2648.1999.01099.x
  19. Sasaki T, Akaho R, Sakamaki H, Akiyama H, Yoshino M, Hagiya K, et al. Mental disturbances during isolation in bone marrow transplant patients with leukemia. Bone Marrow Transplant 2000;25:315-8. https://doi.org/10.1038/sj.bmt.1702117
  20. Kim KJ. Differences of symptom experiences according to gender and stage in hematopoietic stem cell transplant process [dissertation]. Seoul:Yonsei Univ.;2004.
  21. Choi SE, Park HR, Ban JY. Anxiety in patients undergone hematopoietic stem cell transplantation. J Korean Oncol Nurs 2006;6:37-46.
  22. Kim HJ. Perceived anxiety and uncertainty level in hematopoietic stem cell transplantation recipients and from isolation unit [dissertation]. Seoul:Catholic Univ.;2003.
  23. Spradley JP. The ethnographic interview. Orlando:Holt, Rinehart and Winston, INC;1979.
  24. Spradley JP. Participant observation. Orlando:Holt, Rinehart and Winston, INC;1980.
  25. Choi SE, Lee SY, Park HR, Park HR. The levels of anxiety and depression according the stages of autologus and allogeneic hematopoietic stem cell transplantation. J Korean Hosp and Palliat Care 2005;8:190-9.
  26. Ban JY, Park HR, Sohng KY. Hope and related variables in patients undergoing hematopoietic stem cell transplantation for leukemia. J Korean Oncol Nurs 2005;5:115-25.
  27. Koopmeiners L, Post-white J, Gutknecht S, Ceronsky C, Nickelson K, Drew D, et al. How healthcare professional contribute to hope in patients with cancer. Oncol Nurs Forum 1997;24:1507-13.
  28. Saleh US, Brockopp DY. Hope among patients with cancer hospitalized for bone marrow transplantation: a phenomenologic study. Cancer Nurs 2001;24:308-14. https://doi.org/10.1097/00002820-200108000-00012