ABSTRACT
Quality of life (QOL) is increasingly recognized as an important clinical outcome of hematopoietic cell transplantation (HCT), but patient education is often overlooked. The aim of the current qualitative study was to examine education regarding post-HCT QOL from the patient's perspective. Allogeneic HCT recipients participated in one of four focus groups. Participants were asked to recall what they had been told about post-HCT QOL as they were preparing for transplant, how their QOL differed from what they expected and how to educate future patients about post-HCT QOL. Verbatim transcripts were coded for both a priori and emergent themes using content analysis. A total of 24 patients participated (54% female, mean age 51, range 23-73 years). Participants frequently expressed the desire for additional education regarding post-HCT QOL, particularly late complications. They noted that late complications were often unexpected, had a profound impact on their QOL and threatened their ongoing sense of recovery. They emphasized that the timing, content and format of education regarding QOL should be flexible to meet their diverse needs. Findings from the current study draw attention to the importance of patient education regarding post-HCT QOL as well as additional QOL research designed with patient education in mind.
Subject(s)
Hematopoietic Stem Cell Transplantation/psychology , Patient Education as Topic/methods , Transplantation Conditioning/psychology , Female , Hematopoietic Stem Cell Transplantation/methods , Humans , Male , Patient Education as Topic/ethics , Patient Education as Topic/standards , Quality of Life , Transplantation Conditioning/methods , Transplantation, HomologousABSTRACT
In a retrospective study we compared the efficacy and safety of trabeculectomy and nonpenetrating trabeculectomy (NPT). In the latter procedure under a thin scleral flap, juxtacanalicular trabecular meshwork with Schlemm's canal is excised leaving the innermost trabecular meshwork behind. Trabeculectomy was performed on 86 eyes (66 blacks, 20 whites), whereas 71 eyes underwent NPT (44 blacks, 27 whites). The mean follow-up period was 1.7 years. Postoperatively at one year, trabeculectomy controlled 70.3% of patients with no or topical antiglaucoma medication, whereas 83.7% of NPT patients were similarly controlled. There was a difference in the number and severity of complications between trabeculectomy and NPT. Postoperative flat anterior chamber, uveitis, hyphema, vitreous loss, and choroidal detachment occurred more frequently after trabeculectomy.
Subject(s)
Glaucoma, Open-Angle/surgery , Glaucoma/surgery , Trabecular Meshwork/surgery , Adult , Female , Humans , Intraocular Pressure , Male , Middle Aged , Postoperative Complications/etiology , Retrospective Studies , Visual Acuity , Visual FieldsABSTRACT
Nonpenetrating trabeculectomy was performed on 28 aphakic eyes consisting of 18 with chronic open-angle glaucoma and 10 with secondary and/or complicated glaucoma. The canal of Schlemm and the juxtacanalicular trabecular meshwork were excised for a length of 4 mm beneath a 6 mm x 6 mm scleral flap. At one year postoperatively, 72.0% of all patients were controlled, 24% required no antiglaucoma medications. However, 88% of chronic simple glaucoma patients were satisfactorily controlled. The mean follow-up period was 1.4 years. Minimal complications have been encountered to date. Nonpenetrating trabeculectomy may be valuable as an initial procedure in aphakic patients who require glaucoma filtration surgery.