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Blood transfusion in haematology: A qualitative exploration of patients’ and healthcare professionals’ perceptions

Volkmer, B., Lorencatto, F., Stanworth, S. J. , Hirani, S. P. ORCID: 0000-0002-1577-8806 & Francis, J. J. ORCID: 0000-0001-5784-8895 (2022). Blood transfusion in haematology: A qualitative exploration of patients’ and healthcare professionals’ perceptions. British Journal of Health Psychology, 27(4), pp. 1241-1274. doi: 10.1111/bjhp.12597

Abstract

Objectives
Repeated blood transfusions are indicated for the management of patients with cancer or blood disorders. Patients’ perceptions about transfusions may be associated with decision-making and coping, which has been under-explored in the haematology context. This study therefore aimed to explore haematology transfusion patients’ and HCPs’ perceptions of blood transfusion, drawing on theory and previously identified themes of transfusion perceptions.

Design
Semi-structured interview study with 14 adult blood transfusion patients and 14 HCPs (consultants, registrars, nurses) at two UK haematology units.

Methods
Patient- and HCP-tailored topic guides were developed based on themes of blood transfusion perceptions identified in a systematic review: ‘Health benefits’, ‘Safety/risk’, ‘Negative emotions’, ‘Alternatives’ ‘Decision making’ and ‘Necessity’. Transcripts were analysed using deductive and thematic analysis. Patient and HCP themes were compared using triangulation methods. Conceptual models (one for patients, one for HCPs) specific to haematology portraying the association between themes were developed.

Results
Findings for patients and HCPs converged with transfusion reported as beneficial for patients, who were largely involved in the decision-making. Both groups also reported concerns about transfusion, including iron-overload, allergic reactions and challenges to deliver transfusions in time-pressurized services. Themes in the conceptual models included patient ‘Burden’ of receiving repeated transfusions and ‘Supportive relationships’, reflective of patients’ positive interactions with other patients and HCPs in the haematology unit.

Conclusion
Despite the challenges for patients receiving repeated transfusions, convergent perceptions suggest a shared understanding of patients’ transfusion experiences. Identified challenges could inform ways to improve transfusion services and patients’ experiences.

Publication Type: Article
Additional Information: © 2022 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: Blood transfusion, cancer, haematology, outpatients, treatment decision-making, treatment perceptions
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
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