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A comparison of attitudes toward HSCT and survival estimations post HSCT across two pediatric Hematology–Oncology and Intensive Care departments in Canada

Bone Marrow Transplantation volume 53, pages 511–514 (2018)Cite this article

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A proportion of 10–20% of children undergoing haemopoietic stem cell transplantation (HSCT) need to be hospitalized in an intensive care unit (ICU) as a result of life-threatening complications (e.g., pulmonary), infections, or graft-vs-host disease. It has been reported that patients surviving after an ICU admission during the transplantation process have a low survival rate in the long run, particularly if they received prolonged mechanical ventilation (e.g., 36% following ICU discharge) [1]. As a result of this low survival rate and the frailty of many hematology–oncology (HO) patients, ICU teams may consider HSCT with mixed feelings with regards to its necessity and associated concerns. Historically, HSCT patients are considered as complex, demanding, and particularly fragile [2]. These perceptions may lead ICU teams to question the benefit of HSCT itself, contrasting with the views of HO teams that the care plan should be followed through as long as there remains some hope for cure. These different outlooks may have pervasive consequences on how ethics dilemmas are approached and how professionals from different departments coordinate, an aspect that is of paramount importance when professionals and families have difficult decisions to make. Communication difficulties between ICU and HO teams may be exacerbated by the intense and dramatic experience of families who are directly confronted with the threat posed to their children’s life when these must be treated in ICUs. In these cases, families must deal with an unknown team and experience a complete lack of control [3, 4]. It is notable that how these different teams consider HSCT has not been studied quantitatively [5]. Although from the existing literature, we could speculate differences in perceptions, there is no data on to what extent teams hold different views. Positive and negative attitudes toward HSCT may result from different sets of factors, including education, regular exposition to scientific data, age, or seniority.

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References

  1. Balit CR, Horan R, Dorofaeff T, Frndova H, Doyle J, Cox PN. Pediatric hematopoietic stem cell transplant and intensive care: have things changed? Pediatr Crit Care Med. 2016;17(3):e109–e16.

    Article  Google Scholar 

  2. Zinter MS, Dvorak CC, Spicer A, Cowan MJ, Sapru A. New insights into multicenter PICU mortality among pediatric hematopoietic stem cell transplant patients. Crit Care Med. 2015;43(9):1986.

    Article  Google Scholar 

  3. Packman W, Weber S, Wallace J, Bugescu N. Psychological effects of hematopoietic SCT on pediatric patients, siblings and parents: a review. Bone Marrow Transplant. 2010;45(7):1134–46.

    Article  CAS  Google Scholar 

  4. Ullrich CK, Rodday AM, Bingen KM, Kupst MJ, Patel SK, Syrjala KL, et al. Three sides to a story: child, parent, and nurse perspectives on the child’s experience during hematopoietic stem cell transplantation. Cancer. 2017;123:3159–66.

    Article  CAS  Google Scholar 

  5. Cremer R, Fourestié B, Binoche A, Botte A, Moutel G, Leclerc F. Que deviennent les décisions de limitation ou d’arrêt des traitements actifs à la sortie de réanimation pédiatrique? Arch De pédiatrie. 2008;15(7):1174–82.

    Article  CAS  Google Scholar 

  6. Krumpal I. Determinants of social desirability bias in sensitive surveys: a literature review. Qual Quant. 2013;47:2025–47.

    Article  Google Scholar 

  7. Ajzen I. Theory of Planned Behaviour Questionnaire. In: Measurement Instrument Database for the Social Science. 2013. www.midss.ie. Accessed on 15 February 2015.

  8. Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47(6):555–67.

    Article  CAS  Google Scholar 

  9. Slovic P. The perception of risk. Abingdon-on-Thames: Routledge; 2016.

    Book  Google Scholar 

  10. Parker RI. Hematopoietic stem cell transplantation: better data, better care? Big data, bigger questions! Crit Care Med. 2015;43(9):2037–8.

    Article  Google Scholar 

Download references

Acknowledgments

Financial support for this research came from the Charles-Bruneau Cancer Care Centre Foundation (Québec, Canada). We wish to thank the research assistants who helped with formatting and collecting data: Marie-Jeanne Léonard, Julie Martin, and Martin Lamothe. Full approval for this research was awarded by the Sainte-Justine UHC ethics committee.

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Authors and Affiliations

  1. Sainte-Justine University Health Centre, Montréal, QC, Canada

    Serge Sultan, Marie-France Vachon, Marie-Claude Charette, Émélie Rondeau, Bryan Provost, Guillaume Émériaud & Pierre Teira

  2. Department of Pediatrics, Université de Montréal, Montréal, QC, Canada

    Serge Sultan, Guillaume Émériaud & Pierre Teira

  3. Department of Psychology, Université de Montréal, Montréal, QC, Canada

    Serge Sultan

  4. Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada

    Marie-France Vachon

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Correspondence to Serge Sultan.

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Sultan, S., Vachon, MF., Charette, MC. et al. A comparison of attitudes toward HSCT and survival estimations post HSCT across two pediatric Hematology–Oncology and Intensive Care departments in Canada. Bone Marrow Transplant 53, 511–514 (2018). https://doi.org/10.1038/s41409-017-0074-4

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