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Abstract

This thesis contains two studies; the main study investigating psychological consequences of Bone Marow Transplantation for patients and a study investigating the difficulties experienced by the 'significant other' close to the patient investigated.

Study into Psychological Consequences of Bone Marrow Transplantation

The aim of this study was to investigate the feelings of anxiety, depression, quality of life and mental adjustment to cancer in a group of patients undergoing Bone Marrow Transplantation at the Royal Marsden Hospital and the Royal Free Hospital. It was hoped that the findings, as well as offering a contribution to knowledge, would provide a basis for improving the care of patients, and that a fuller understanding of their changing feelings during the period of treatment would enable medical staff to respond more effectively to their needs.

To this end the main study follows a group of patients from their decision for transplant as a treatment option to a year post-transplant. Assessment of the patients' psychological states was done at fixed points at the end of evaluated stages. These stages were evaluated according to findings from literature and the observation of past research that the psychological well-being of these patients closely follows their medical procedure.

Seven sequential stages were evaluated for this study and patients were assessed at the end of each stage. Furthermore, 3 non-sequential assessments were added. These were at the time of discharge, first rehospitalization following transplant and if the patient relapsed.

At each assessment patients' psychological state was assessed by a number of established questionnaires with regards to their levels of anxiety, depression, quality of life and mental adjustment to cancer. In addition a semi-structured interview was used to evaluate issues around the patient's decision for transplant, the patients' expectations, stressful events and available support throughout the transplant period.

It was hypothesised that the variables investigated do not remain constant during the treatment but are influenced by the changes in the treatment during the different stages.

The result shows that patients' emotional well-being changes with changing stages. The obtained results confirm hypotheses that patients' emotional well-being does not remain consistent throughout the transplant period, but tended to change during different stages depending on treatment procedures and events happening during the assessed stage.
However patients' expectations regarding the outcome of this treatment tend to remain stable throughout.

Responses Of The Patient's Relative

The aim of the study of the patient's significant other was to investigate the psychological responses of the 'significant other' to the patient's medical and psychological experiences during the medical procedure. This was done by one interview. The interview sought to discover the information provided to them about the procedure, the distress they experienced from their close contact with the patient, and what kind of support they needed and found. To this end, relatives of surviving patients were interviewed once at three months post-transplant by a questionnaire designed by the author and based on observations on the ward.

The results of these interviews indicated that the relatives were generally well informed about the medical procedure and its physical side effects, but that they felt ill-prepared and unsupported in dealing with the unexpected side effects of the treatment. Patients in pain and feeling hopeless and low caused most distress to the involved relatives.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Departments:	School of Health & Psychological Sciences > Psychology School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses Doctoral Theses

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