RESUMEN
OBJECTIVES: To identify which factors can influence the patients' perception of protective isolation following Haematopoietic Stem Cell Transplantation (HSCT). METHODS: This is a prospective study conducted in 10 Italian centres, members of the Italian Group of stem cell transplant (GITMO). Patients' perception of protective isolation was assessed using the ISOLA scale between 7 and 9 days post-transplant. Statistical linear regression analysis was performed. RESULTS: The participants were 182 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. Male sex (ß = .152), education level (ß = -.245), double room (ß = .186), satisfaction with visiting hours (ß = -.174) and emotional support from nurses (ß = -.169) were independently associated with isolation-related suffering. Significant predictors of the relationship with oneself included body temperature (ß = -.179), fatigue (ß = -.192) and emotional support from nurses (ß = -.292). Factors independently associated with the relationship with others were education (ß = -.230), chemotherapy cycles (ß = -.218), pain (ß = .150) and satisfaction with visiting hours (ß = -.162). CONCLUSION: Healthcare providers should pay greater attention in caring for those patients who are at risk for a negative isolation experience. Nurses should provide emotional support.
Asunto(s)
Actitud Frente a la Salud , Trasplante de Células Madre Hematopoyéticas/psicología , Aislamiento de Pacientes/psicología , Adulto , Anciano , Femenino , Neoplasias Hematológicas/psicología , Neoplasias Hematológicas/terapia , Humanos , Italia , Modelos Lineales , Masculino , Persona de Mediana Edad , Percepción , Estudios Prospectivos , Encuestas y Cuestionarios , Trasplante Autólogo/psicología , Trasplante Homólogo/psicología , Adulto JovenRESUMEN
The aim of this study was to develop and psychometrically test a questionnaire assessing patients' perception of protective isolation following haematopoietic stem cell transplantation (HSCT). The conceptual framework for developing the questionnaire was a three-dimensional model that emerged from a metasynthesis: isolation-related suffering, relationship with oneself and relationship with others. Item selection was performed through a focus group, comparison with the findings of two phenomenological studies, and content validity with 22 experts. Cognitive interviews with five patients were used to verify face validity. A validation study was conducted in 10 Italian centres, all members of the Italian Group of stem cell transplant (GITMO). Patients completed the questionnaires between 7 and 9 days post-transplant. Dimensionality was tested through exploratory factor analysis (EFA). A total of 17 items yielded a content validity index (CVI) of 0.88. Participants included 186 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. The EFA yielded a three-factor solution, explaining 55% of the variance. The scale showed adequate psychometric properties, with the exception of three items, which were eliminated. Future studies should test the psychometric properties of the questionnaire through confirmatory factor analysis and verify its transcultural validity.
Asunto(s)
Actitud Frente a la Salud , Trasplante de Células Madre Hematopoyéticas/psicología , Aislamiento de Pacientes/psicología , Encuestas y Cuestionarios , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mieloma Múltiple/psicología , Mieloma Múltiple/terapia , Percepción/fisiología , Estudios Prospectivos , PsicometríaRESUMEN
UNLABELLED: . Burnout and risk of burnout in the Italian teams of bone marrow transplant: a multicentre survey. INTRODUCTION: The term burnout is used to describe a state of work-related psychological distress in healthcare employees characterized by three related, but independent, components: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). AIM: The aim of this study was to evaluate the prevalence of burnout and stress symptoms in physicians, nurses, and other healthcare professionals in Italian Bone Marrow Transplantation Units. METHODS: All personnel of a multidisciplinary group of the Italian Group of Bone Marrow Transplantation were asked to answer two different validated questionnaires: the Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-12) for the assessment of general wellbeing. Logistic regression was used to investigate possible risk factors for burnout. RESULTS: This study showed a relatively low burnout prevalence (3.7%), however about 43.5% of health workers were at risk for developing a burnout syndrome. No personal or center characteristics seemed related to burnout risk, but there was a strong correlation between higher scores from the general health questionnaire and burnout risk. CONCLUSIONS: Results from our survey suggest that burnout is a relevant problem in transplant teams and as such strategies should be implemented to prevent it.