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Variations in provision of psychological care to hematopoietic cell transplant recipients: results of a national survey of UK transplant centers

Bone Marrow Transplantation volume 57, pages 1586–1588 (2022)Cite this article

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Hematopoietic cell transplantation (HCT) is both a life-saving and life-threatening treatment for which the associated psychological morbidity is high and associated with poor outcomes [1,2,3,4]. However, studies are limited on how effectively transplant centers address psychological care [5]. The Foundation for the Accreditation of Cellular Therapy and The Joint Accreditation Committee for IST and EBMT (FACT-JACIE) require dedicated psychological staff to assist in pre-transplant recipient evaluation and treatment, and post-transplant care [6]. However, guidelines are limited regarding the optimal structure of psychological services [7, 8]. This national survey explored UK transplant center (TC) psychological care practices. Our objectives were to review psychological workforce and services, psychological screening, quality review processes, participant perceptions on psychological care and current services, factors that would improve services, and impact of center size on workforce and service ratings. The survey also reviews transplant clinician practice in line with a four-tier model of psychological care provision proposed by the National Institute for Health and Care Excellence (NICE), an organization that develops evidence-based guidelines for healthcare in England [9].

This survey was designed in liaison with clinicians and clinical psychologists with experience in HCT. It was electronically distributed to three participants at each UK adult TC (n = 24) that performs allogeneic and autologous HCT: physician, clinical nurse specialist (CNS) and specialist psychological practitioner who reviews HCT patients. The survey comprised 10–32 questions varying in number for each professional role (for example, only psychological practitioners answered questions on workforce and services), and seven common questions on perceptions of psychological care. Questions were mostly closed with options for comments. Three open questions explored barriers to psychological care provision and ways to improve it. Definitions were provided to avoid ambiguity (see supplementary for questionnaire).

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Fig. 1: Structure of psychological support services for patients and staff.

Data availability

The data that support the findings of this study are available from the corresponding author, RN, upon reasonable request.

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Acknowledgements

We thank Dr. Alex King, Consultant Clinical Psychologist at Imperial College London NHS trust for his contribution to the design of the survey tool. We also thank all psychological practitioners, nurses, and doctors who participated in the survey. Dr. Joseph Low’s post was supported by the Marie Curie core and program grant funding (grants MCCC-FCO-16-U and MCCC-FPO-16-U).

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Authors and Affiliations

  1. Anthony Nolan Research Institute, Anthony Nolan, London, UK

    Rosalina Naidoo, Robert Danby & Chloe Anthias

  2. Division of Psychiatry, University College London, London, UK

    Joseph Low

  3. Psychology Department, Nottingham Trent University, Nottingham, UK

    Michael Rennoldson

  4. Patient Services, Anthony Nolan, London, UK

    Hayley Leonard

  5. UCL Cancer Institute, University College London, London, UK

    Alejandro Madrigal

  6. Hematology, Royal Free London NHS Trust, London, UK

    Alejandro Madrigal

  7. British Society for Blood and Marrow Transplantation and Cellular Therapy, London, UK

    Julia Lee

Authors
  1. Rosalina Naidoo
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  2. Joseph Low
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  7. Julia Lee
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Contributions

RN was responsible for the conception and design of the study, literature review, data collection, data analysis and interpretation, drafting the manuscript, and revision of the manuscript. CA was responsible for the conception, design and supervision of the study, and critical revision of the manuscript. JL, RD, and AM were responsible for supervision of the study and critical revision of the manuscript. MR contributed to the design of the survey tool, data collection, data analysis, and critical revision of the manuscript. HL contributed to the design of the survey tool, data collection, and critical revision of the manuscript. J Lee contributed to data collection and critical revision of the manuscript. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Rosalina Naidoo.

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Naidoo, R., Low, J., Rennoldson, M. et al. Variations in provision of psychological care to hematopoietic cell transplant recipients: results of a national survey of UK transplant centers. Bone Marrow Transplant 57, 1586–1588 (2022). https://doi.org/10.1038/s41409-022-01735-1

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