Psychological Prehabilitation for People Undergoing Autologous Stem Cell Transplant: A Qualitative Study.

BACKGROUND

Autologous stem cell transplant (AuSCT) improves survival in haematological cancers, yet often involves a lengthy recovery associated with a myriad of psychological and physical challenges. Psychological prehabilitation is recommended to improve functional outcomes by addressing psychological concerns and promoting optimal mental and physical health prior to AuSCT. Despite this, little is known about the implementation and experiences of psychology-specific prehabilitation for AuSCT.

AIMS: The current study explores the perspectives and experiences of AuSCT recipients and healthcare professionals (HCPs), regarding optimal psychological prehabilitation.

METHODS

Qualitative interviews were conducted with AuSCT recipients and HCPs experienced in working with AuSCT recipients. AuSCT recipients were recruited at a regional Victorian public health service offering psychological prehabilitation. Purposive sampling was used for HCPs, ensuring a range of professions participated. Reflexive thematic analysis was conducted on interview data, with triangulation utilised to identify themes.

RESULTS

Nine AuSCT recipients and 12 HCPs participated. All themes were shared across AuSCT recipients and HCPs. Four themes (each with subthemes) were identified: Fostering Psychological Preparedness for Transplant (Exploring Expectations, Addressing Psychological Concerns), Getting Through the Long Haul (Prioritising Social Support, Planning Emotional and Practical Care), Strengthening Engagement with Psychology (Destigmatising Psychology, Psychology Enhances Overall Prehabilitation) and Looking Toward Sustainability (Individualised Stepped-Care, Screening and Risks).

CONCLUSIONS

Psychological prehabilitation is considered crucial for optimal preparation and recovery from AuSCT, however stigma and limited psychology resources can impact access. Future research should investigate sustainable models of psychological prehabilitation, such as stepped care, to adequately meet the needs of this growing population.