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Depressive disorders are the most common manifestation of psychological distress in allogenic hematopoietic stem cell transplantation. Few studies have yet investigated the relationship between therapeutic educational interventions and outcomes in these patients with specific attention to those related to mental health. Aim of this study was to understand how much educational intervention can represent a protective factor in preventing psycho-emotional distress-related issues in this setting. A prospective observational study of a multicenter cohort was conducted. Adult patients undergoing allogeneic hematopoietic stem cell transplantation. A pre-transplant therapeutic educational programme was offered to a cohort of adult patients undergoing allo-HSCT recruited in ten transplant centers of the GITMO network between May 2018 and January 2019. Depression, Anxiety and Stress scale was used to collect data on psycho-emotional distress at admission (T0), at the day of transplant (T1) and at discharge (T2). Descriptive data were collected and reported, and comparative analyses were done among patients who were compliant with the pre-transplant educational intervention and those who did not (for any reason). A cohort of 133 allo-HSCT patients was observed. In patients who did not receive pre-transplant educational intervention, higher levels of depression at admission (p = 0.01) and at the day of transplant (p = 0.03), higher levels of anxiety (p = 0.01 and p = 0.01 respectively) as well as higher levels of stress (p < 0.01 and p = 0.01) were observed. Problem solving and "face to face" interview were the best methods to provide education to patients. Those who received pre-transplant education through "face-to-face" interview reported significant low levels of depression during the whole hospital stay period (p < 0.01; p = 0.01; p = 0.01) and less anxiety and stress at admission (p < 0.05 and p = 0.01 respectively). Depression was more represented in female than male participants at T0 (16.5% vs 9.0%; p = 0.01), while among T0 and T2 the males had a significant higher increasing of depression than females (p = 0.03). Our study demonstrated that pretreatment therapeutic educational programs with specific learning modalities can be effective in limiting the potential risk of developing moderate-to-severe anxiety-depressive states and stress symptoms related to allo-HSCT. Further studies are needed to confirm our results and to understand whether containing psycho-emotional distress can have any relationship with medium- and long-term post-transplant complications. [ABSTRACT FROM AUTHOR]

Background: There is minimal information regarding sleep disturbance and burnout during COVID-19 in nurses working within haematology-oncology and hematopoietic stem cell transplantation (HSCT) settings. Aim: To identify socio-demographic and professional factors that predicted burnout and sleep disturbance during COVID-19 in nurses working in HSCT settings. Design/Methods: Data were collected using the Maslach Burnout Inventory and the Pittsburgh Sleep Quality Index. Descriptive statistics and linear regression examined relationships. Results: 308 responses were received. Nurses working in outpatient settings had greater emotional exhaustion (Rpartial = −0.12, n = 308, p = 0.03). Negative predictors for quality of sleep were transplant programme setting (Rpartial = −0.19, n = 308, p < 0.01) and years working in HSCT (Rpartial = −0.17, n = 308, p < 0.01). Other relationships were found on univariate analysis. Conclusion: Institutions must offer programmes for nurses to develop sleep strategies, self-care, and work-related stress management. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: Haematopoietic stem cell transplantation (HSCT) has become the standard of care for many haematological diseases unresponsive to traditional treatments; pretransplant therapy still causes high mortality and morbidity today. Due to the high risk, patient care requires careful assessment and often complex, intensive and non-risk free interventions; the NANDA-I classification provides a way to classify and standardise areas of nursing interest. In 2011, Speksnijder, using the Delphi technique, identified 68 diagnoses relevant to identify health problems in the field of oncohaematology., Aim: Based on Speksnijder's contribution, the study tries to identify which of these diagnoses were relevant in identifying health problems in HSCT patients., Method: A quantitative-descriptive study was carried out; a structured questionnaire on a 4-point Likert scale was used to build consensus, involving 57 expert nurses enrolled in the Italian GITMO Centres., Results: Of the 68 NANDA-I diagnoses defined as relevant by Speksnijder in the oncohaematological field, this study identified 37 as relevant in detecting health problems in patients undergoing HSCT (34 in Round 1, 3 in Round 2) and also defined 12 as important diagnoses having obtained an absolute consensus., Discussion: Using the NANDA-I diagnoses to identify, from a panel of experts, the most important and relevant health problems associated with the toxicity of pre-TCSE treatment, allows to focus attention on expected and known outcomes in order to be able to intervene with performances aimed at reducing specific risks and complications.

Introduction: Haematopoietic Stem Cell Transplantation ( HSCT) has become the standard of care for some haematological diseases that do not respond to traditional treatments: pre-transplant therapy still causes high mortality and morbidity today. Due to the high risk, patient care requires careful evalua- tion and often complex, intensive and non-risk free interventions; the NANDA-I classification provides a way to classify and standardise areas of nursing interest. A previous consensus among experts had iden- tified 61 diagnoses, according to the classification NANDA-I 2018-2020, relevant in onco-haematolo- gical field., Objective: The aim of the study was to identify which of the 61 diagnoses were relevant for patients undergoing HSCT., Method: A Delphi study was conducted in two rounds; a structured questionnaire on a 4 point Likert scale was used to build consensus, involving 57 experienced nurse enrolled in Italian GITMO Centres., Results: The present study has identified 34 relevant NANDA-I diagnoses in patients undergoing HSCT; it also defined 11 as important diagnoses having obtained absolute consensus., Discussion: Use the NANDA-I diagnoses to know, from a panel of experts, the most important and relevant health problems associated with the toxicity of pre- HCSE treatment, it can direct assistance and resources towards expercied and known outcomes so as to be able to intervene effectively with performances aimed at reducing risks and specific complications.