对兄弟干细胞捐献者经历的认知

A. Kisch, A. Forsberg
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摘要

目的:探讨干细胞接受者对从移植前到移植后一年有兄弟姐妹供体的经历的看法,以支持他们的学习过程。方法:连续纳入10名成年受体,5名女性和4名男性,平均年龄52岁(19-68岁),接受来自兄弟姐妹供体的干细胞。我们使用现象学方法分析了移植前和移植后三个月零一年进行的28次开放式访谈。结果:出现了10个类别,包括110种不同的感知,涉及:优势、认可、风险评估、复杂性、家庭影响、非定向捐赠者、自我认同、面对现实、寻求知识和关爱遭遇。从移植前到移植后一年,确定了学习过程的三个不同阶段,即风险收益分析、结果预期和面对现实。结论:在移植之前,接受者对有兄弟姐妹捐赠者有很多看法,并专注于对自己和捐赠者进行全面的风险与收益分析。移植后三个月,接受者寻求知识,以便有现实的期望和理解他们的未来。移植一年后,接受者几乎没有什么看法,而是专注于面对现实,无论结果是好是坏。随着时间的推移,受试者的普遍看法是,严重的血液病是负担沉重和致命的,而治疗应包括持续的护理。
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Perceptions of experiences of having a sibling stem cell donor
Objective: The aim was to explore stem cell recipients’ perceptions of experiences of having a sibling donor from pretransplantation to one year afterwards in order to support their learning process. Methods: Ten adult recipients, five women and four men, with a mean age of 52 years (19-68 years) receiving stem cells from a sibling donor were included consecutively. We used a phenomenographic approach to analyse the 28 open-ended interviews that took place before transplantation and three months and one year afterwards. Results: Ten categories emerged comprising 110 different perceptions pertaining to: Advantages, Acknowledgement, Risk evaluation, Complexity, Family impact, Non-directed donors, Self-identity, Facing the reality, Knowledge seeking and Caring encounters. Three distinct phases of the learning process were identified from before transplantation to one year afterwards, i.e., risk-benefit analysis, outcome expectations and facing the reality. Conclusions: Before transplantation the recipients had many perceptions about having a sibling donor and focused on a thorough risk versus benefit analysis for both themselves and the donor. Three months after transplantation the recipients sought knowledge in order to have realistic expectations and comprehend their future. One year after transplantation the recipients had few perceptions and focused on facing the reality, irrespective of whether the outcome was good or bad. The generic perceptions of the recipients over time were that serious blood diseases are burdensome and lethal, while treatment should include continuity of care.
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