Keeping courage during stem cell transplantation: A qualitative research

Purpose: The purpose of this qualitative study was to explore how patients undergoing stem cell transplantation (SCT) keep courage and pull through this demanding therapy. Method: A qualitative design using a grounded theory approach was used. Data were collected by participant observation and by conducting 16 semi-structured interviews with patients who had undergone SCT and six interviews with nurses. Results: Research findings provide an explanation for the process of keeping courage during SCT. In this publication we focus on the core category in that process: the writing of a positive story. To endure and give meaning to the suffering of the therapy, patients do their best to believe in a happy ending. Patients exert every effort to keep faith: they count their blessings, they protect their positive story from the assaults of negative information and threatening signals through rationalization and they do everything in their power to increase their chances of a happy ending. The positive story is most vulnerable during aplasia, when patients seem to lose both physical and mental strength. Patients feel nurses and doctors help them to muster up courage. Nurses carry patients through the hardest and most despondent moments. Conclusions: During stem cell transplantation, patients make many efforts in order to write a positive story and to keep courage. These efforts involve much more active strategies than the rather passive concept of hope suggests. (c) 2010 Elsevier Ltd. All rights reserved.