Browsing by Subject "Blood and marrow transplant"

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    Effects of cognitive-behavioral music therapy on fatigue with patients on a blood and marrow transplantation unit: a convergent parallel mixed methods effectiveness study
    (2013-09) Fredenburg, Hilary A.
    Cancer-related fatigue (CRF) is an under-treated condition frequently experienced by cancer patients that can negatively affect wellbeing both during hospitalization and after hospital discharge. The purpose of this mixed methods effectiveness study was to determine if and how cognitive-behavioral music therapy (CBMT) can reduce fatigue of hospitalized patients on an adult Blood and Marrow Transplant (BMT) unit. The researchers measured the effects of CBMT on five aspects of participants' fatigue using a convergent parallel mixed methods design. Participants (N = 11) were randomly assigned to experimental or wait-list control conditions and completed the Multidimensional Fatigue Inventory (Smets, Garssen, Bonke, & Haes, 1995) at pre- and posttest. Experimental participants also completed a semi-structured interview before hospital discharge. Quantitative results indicated no significant between-group differences concerning fatigue. However, experimental participants tended to have decreases in mean fatigue scores from pre- to posttest while control participants had increases in mean fatigue scores from pre- to posttest. Qualitative data tended to support quantitative data and indicated that CBMT a) influenced fatigue cognitively by increasing motivation and self-efficacy, b) influenced fatigue affectively by promoting relaxation and restful states, and c) represented a meaningful, unique, and holistic service for hospitalized BMT patients. It seems that CBMT sessions may be an effective intervention concerning various aspects of fatigue for hospitalized BMT patients. Due to the small sample size, quantitative results should be interpreted with caution. Limitations of the study, implications for clinical practice, and suggestions for future research are provided.
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    The Process Used by Family Surrogate Decision Makers to Withdraw Life-Sustaining Treatments in the Blood and Marrow Transplant Population
    (2015-08) Gerdin, Bethany
    Background: There is limited information about the experience of family surrogate decision makers who make the decision to withdraw life-sustaining treatments (LST) from an individual, and nothing is published about this experience in the blood and marrow transplant (BMT) population. Objective: The purpose of this study was to describe the experience of surrogates who have participated in the decision making process of withdrawing LST from a BMT patient. Method: This study used a phenomenological perspective, using van Manen's (1990) approach to guide the data analysis. In depth, unstructured interviews were conducted with 10 family surrogate decision makers, two to 12 months after the patient's death. van Manen's selective approach was used to identify units of meaning, clusters, themes, and categories that emerged from the data. Findings: The essential themes were: knowing the patient as a person; working through the information, receiving support through trusting relationships; recognizing reality; making the decision; and living with the decision. Conclusion: The results of this study will inform nurses and other health care team members about the experience of surrogates who have chosen to withdraw LST from a BMT patient. Future studies will use this understanding to develop and test interventions for health care providers aimed to decrease the burden of surrogate decision makers. This will promote a peaceful experience for these families and patients, and decrease professional burden of the health care team, who currently does not have evidence based guidelines for these patient/family situations.