Nursing Intervention for Caregivers of Post Autologous Bone Marrow Transplantation Patients at Home

Abstract

one marrow transplantation, formerly a highly experimental, rarely used procedure, has become a fairly common and accepted treatment. Bone marrow transplant (BMT) has evolved over the past two decades from an experimental treatment modality to the treatment of choice for certain malignant and non-malignant hematological disorders. BMT is, however, a risky procedure, with attendant side effects and complications. Many of these are serious; some can be life-threatening (Grimm et al., 2017). A stem cell transplant is a procedure that replaces unhealthy blood- cells with healthy ones. An autologous transplant is a type of stem cell transplant that uses the patients’ own stem cells. These cells are collected in advance and returned at a later stage. They are used to replace stem cells that have been damaged, and then returned to them after they receive high-doses of chemotherapy. In the 1970s, bone marrow transplantation (BMT) was still an experimental procedure. Over the past two decades the BMT has become the treatment of choice for certain malignant and non-malignant hematological disorders. BMT is, however, a risky procedure, with attendant side effects and complications. Many of these are serious; some can be life-threatening (Majhail, 2015). Autologous bone marrow transplantation involves the use of a patient’s own stem cells. The stem cells are collected from marrow or blood, then frozen. The thawed cells are returned to the patient after he or she has received intensive chemotherapy and/or radiation therapy for his or her disease. The primary purpose of an autologous transplant is to allow the patient to be given high doses of chemotherapy with or without radiation that would otherwise be too toxic to tolerate because the marrow would be severely damaged. Such high doses of treatment can sometimes overcome resistance of the disease to standard doses of chemotherapy. Autologous transplantation requires that an individual has sufficient numbers of healthy stem cells in the marrow or blood (Michelle, 2017). Having a caregiver at home is a basic requirement to be considered for transplantation. The presence of active and effective caregivers is critical to the success of the transplant process. A caregiver must be available at home to the patient 24 hours a day, 7 days a week after transplant. After discharge, and staying at home, some patients might have experience physical or psychological problems. These ongoing needs must be managed by following up in the hospital by health team and at home by caregiver as family support which is very important (Mittelman, 2016).