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Psychosocial Study

Allogeneic BMT and patient eligibility based on psychosocial criteria: a survey of BMT professionals

Bone Marrow Transplantation volume 37, pages 223–228 (2006)Cite this article

Abstract

BMT professionals were compared regarding their willingness to proceed with allogeneic BMT given select psychosocial issues. A questionnaire was sent to 660 physician members of ASBMT, 92 social work members of BMT Special Interest Group, Association of Oncology Social Work, and 626 nurse members of BMT Special Interest Group, Oncology Nursing Society; 597 responded with a response rate of 43.5%. Items included background information, followed by 17 case vignettes; each represented a different psychosocial issue to which respondents indicated whether or not they would recommend proceeding with allogeneic BMT. In every vignette, at least 10% of respondents indicated they would not proceed. In six vignettes, at least 64% indicated do not proceed: suicidal ideation (86.8%), uses addictive illicit drugs (81.7%), history of noncompliance (80.5%), no lay caregiver (69.3%), alcoholic (64.8%), and mild dementia/Alzheimer's (64.4%). In 10 vignettes, at least 73% indicated proceed. On four vignettes, professional subgroups differed in their recommendation on whether or not to proceed with allogeneic BMT. Qualitative data suggest that this decision is contingent on the perceived acuity, severity, and currency of the psychosocial issue, patient ability to comply with treatment given the issue, and its manageability as a risk factor for treatment related vulnerability and outcomes.

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Acknowledgements

We wish to thank Julie Curtis, RN, Administrator, BMT Program, Cleveland Clinic Foundation, for assistance obtaining the Oncology Nursing Society mailing list and for administrative support of this research project. We also wish to thank Candice Vidovic, graduate assistant, School of Social Work, Cleveland State University, for assistance in reviewing and summarizing qualitative data.

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Authors and Affiliations

  1. School of Social Work, Cleveland State University, Cleveland, OH, USA

    L W Foster

  2. Department of Hematology and Medical Oncology, Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH, USA

    L J McLellan, J Dabney, E Welsh & B J Bolwell

  3. Department of Quantitative Health Sciences, The Cleveland Clinic Foundation, Cleveland, OH, USA

    L A Rybicki

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  1. L W Foster
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  2. L J McLellan
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  3. L A Rybicki
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  4. J Dabney
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  5. E Welsh
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  6. B J Bolwell
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Correspondence to L W Foster.

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Foster, L., McLellan, L., Rybicki, L. et al. Allogeneic BMT and patient eligibility based on psychosocial criteria: a survey of BMT professionals. Bone Marrow Transplant 37, 223–228 (2006). https://doi.org/10.1038/sj.bmt.1705219

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