OPTIMIZING COLLABORATION: A QUALITATIVE ANALYSIS OF BONE MARROW TRANSPLANT PROVIDER PERCEPTIONS OF PALLIATIVE CARE ROLES

Abstract

Bone marrow transplantation (BMT), also referred to as hematopoietic stem cell transplantation (HPSCT), is a medical procedure utilized to treat a range of malignant and non-malignant diseases including leukemias, lymphomas, aplastic anemia, immune deficiency disorders, solid tumor cancers, and more (Champlin, 1990; Bone Marrow Transplantation, 2021; Franjul Sanchez et al., 2020). BMT patients typically experience symptoms associated with induction or condition regiments that are especially burdensome, including but not limited to pain, mucositosis, nausea and vomiting, diarrhea, psychological, spiritual, and emotional concerns that may not be thoroughly addressed through their primary oncology and BMT teams alone (Ruiz et al., 2017). Palliative care integration has been observed to optimize care and quality of life for chronically ill patients due to factors such as consistent inclusion of families in decision-making, successful facilitation of difficult prognostic conversations, and earlier recognition of terminal prognoses, thus leading to increased palliative care and curative treatments (Bogetz et al., 2021; Boyden et al., 2018; Schwantes & O’Brien, 2014). Nevertheless, numerous studies indicate low rates of palliative care integration among patients undergoing hematopoietic stem cell transplantation (HSCT) (Booker et al., 2023; Button et al., 2014; Johnston et al., 2018; LeBlanc & El-Jawahri, 2018; Roeland & Ku, 2015; Selvaggi et al., 2014). Virtual qualitative interviews of BMT providers at Children’s Wisconsin were conducted with the goal of characterizing BMT provider perceptions and understanding of palliative care roles and services. Such analyses may identify opportunities for better coordination of services and better treatment experiences for these vulnerable families.