Reintegration after bone marrow transplantation

OBJECTIVES: This study examines the problem of bone marrow transplantation (BMT) survivors in returning to "normal" life in the community after BMT. MATERIALS AND METHODS: Before being released from The Johns Hopkins Oncolog y Center, 84 recipients of BMT were interviewed regarding their quality of life and psychosocial adaptation. Survivors were reinterviewed at 6 months and at 1 year post-BMT, producing considerable qualitative data regarding t heir problems in living. Eighty-four patients who had received BMT complete d qualitative interviews and standardized measures before treatment, before the return home, and at 6 and 12 months post-BMT. The interviews were subj ected to a content analysis methodology to establish units and categories t o examine the body of material. RESULTS: Content analysis of these interviews from the first year after BMT , identified three areas of psychosocial morbidity: 1) physical problems, w hich included fatigue, appearance, troubles in eating and physical restrict ions: 2) psychosocial problems, which included fears and the future, sense of loss of control, anxiety, and depression; and 3) community reintegration problems, which included difficulty returning to former social roles, sepa ration from home, family and friends, difficulty in resuming social relatio ns, dealing with stigmatization, problems with family and children, and fin ancial and employment difficulties. CONCLUSIONS: Identification of these problems for BMT survivors can be used to guide the development of specific materials and services to prepare rec ipients of BMT and their families for life after the transplant. These qual itative results can also be used to direct the development of assessment to ols to identify potential patients and family problems.