Isolation and Its Impact: Understanding Patient–Caregiver Experiences During Isolation for Haematopoietic Stem Cell Transplantation

Abstract

Background: Haematopoietic stem cell transplantation (HSCT) is a complex procedure requiring long-term preparation. Patients undergoing the procedure have increased risks of developing infections and life-threatening complications, so the standard practice has been to isolate them before and after the procedure. Although isolation in a separate ward helps increase the chances of successful transplantation and survival, it has an immense negative effect on patients’ psychological state. Aim: This study aimed to examine the effects of isolation on patients and their caregivers. Specifically, it focused on the psychological/emotional state, health related quality of life, and coping skills of patients and their families. Methodology: An integrative literature review methodology was used to draw the data for this study. The search was limited to articles published in English in the past decade (September 5, 2013, until present), which focused on the experiences of adult patients/caregivers in the context of HTSC isolation. A thorough literature search helped extract 19 studies which were included in the sample. This approach helped obtain qualitative and quantitative data from different locations. Results: The review showed that isolation has a severe effect on patients and caregivers, leading to stress, anxiety, and depression. It is also associated with extreme uncertainty and the loss of control, which, coupled with a plethora of unpleasant and taxing symptoms, negatively impact health related quality of life. Patients and caregivers were found to demonstrate various coping behaviours, such as communication with friends and family, spending time on hobbies, engaging in religious/ spiritual activities, and others. However, maladaptive coping was also found to be common, which points to the importance of teaching patients and families how to overcome stress. Conclusions: Given the adverse effects of isolation on patients and their families, it is extremely important to provide them with relevant psychological support and resource