Myeloma patients’ experiences of haematopoietic stem cell transplant: A qualitative thematic synthesis

Purpose: The aim of this study was to synthesise all qualitative evidence on the experiences of myeloma patients undergoing haematopoietic stem cell transplant (HSCT). Method: A systematic search strategy was developed and a rigorous search of the literature was undertaken searching six databases (CINAHL, Embase, Medline, Psych Info, Ethos and Proquest). The software for systematic reviews www.covidence.org was used to blind screen for eligible papers. Quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme (CASP). Confidence in each finding was assessed using Confidence in the Evidence from Reviews of Qualitative research (CERQual). Results: Eight qualitative studies (reported in eleven papers and including seventy six myeloma patients) were selected in the final sample for evidence synthesis. Four themes were identified relating to patients’ feeling ‘dead’ disconnecting and isolating themselves, cognitive impairment and engagement with exercise and its benefits in recovery. Conclusions: The burden of cognitive functioning among myeloma patients was often under detected. Nurses should ask patients regularly about their memory and any challenges they may be experiencing to their concentration and recall, Exercise during the transplant process can help improve patients’ recovery, both physically and psychologically. A structured exercise programme developed by a physiotherapist to suit the needs of each patient should be standard practice in the transplant process.