Psychosocial transitions in the long-term survivors of bone marrow transplantation.

Abstract

Psychosocial transitions were assessed in the long-term survivors of bone marrow transplantation (BMT). A combination of quantitative and qualitative data from 91 survivors led to the identification of several psychosocial phases and transit points after the transplant. Throughout the years post-BMT survivors were concerned with their sexual functioning. Adjustment with social environment was initiated during the first 2 years post-BMT and finalised in the fourth year post-BMT. The third year post-BMT was characterized by a grieving phase which was followed by a life re-evaluation phase. Loss of control and independence were the main problems reported during the third and fourth year post-BMT. Occupational adjustment was also of main concern in the fourth and subsequent years post-BMT. The fifth year post-BMT featured a phase characterized by despair for those survivors who still had physical problems, and thoughts of what the future held for them. Moving on with life was a feature of those who had survived over a long period of time (6 years plus post-BMT), although a fraction of patients still had difficulties adjusting in their psychosocial environment. The identification of psychosocial transitions could help in understanding the specific psychosocial needs of the patients over time, which, in turn, could improve psychosocial services, with provision of professional support in crucial periods post-BMT.