An exploration of quality of life issues from the perspectives of autologous stem cell transplant recipients

Autologous stem cell transplantation (ASCT) has been successfully used to treat a variety of haematological cancers and solid tumours. The number of patients surviving this treatment is growing rapidly. In order to provide optimal psychosocial support for these patients following their treatments, an understanding of how the cancer experience has affected their quality of life (QOL) is essential. Numerous methods have been employed to measure QOL, the majority of which have adopted empirical analytical approaches. But few studies have focused on understanding the patient's lived experience and what QOL means to them. Using a Heideggerian phenomenological approach, this research study explored QOL issues from the perspectives of 12 patients who had undergone an ASCT.

All of the participants' QOL had changed, radically. The major themes identified in this change included losses of control and embodiment, the significance of webs of support and the adjustment to living as a cancer survivor. Confronted with the loss of their former worlds the participants re-evaluated their lives. A new set of concerns and values entered their worlds, both positive and negative, and though the quality of their lives had changed, the meanings they had discovered enabled them to renegotiate their lives. The ever-present fear of relapse had altered their perception of time, wrought uncertainty and urgency, and altered their priorities. In the process, another being was born, less certain, but more knowing of life's tenuous qualities. The findings of this study will provide nurses with a more in-depth insight into the QOL issues confronted by patients following an ASCT and assist nurses to provide more specific strategies to assist these patients adjust to their altered lives.