ABSTRACT
PURPOSE/OBJECTIVES: To compare nursing assessments of moods, behaviors, and activity levels of patients receiving bone marrow transplants (BMTs) according to type of isolation environment. DESIGN: Retrospective, descriptive. SETTING: University BMT unit. SAMPLE: Records of 22 patients receiving BMT treated over a two-year period-12 were treated in laminar air flow (LAF) rooms and 10 in reverse isolation. METHODS: Using a retrospective chart review, daily nursing assessments of patients' moods, behaviors, and activity levels were collected and compared based on type of isolation. MAIN RESEARCH VARIABLES: Type of isolation and patient's behavior, mood, and activity level. FINDINGS: Patients assigned to LAF had significantly higher anxiety levels at admission than those assigned to reverse isolation. CONCLUSIONS: Admission to LAF isolation appeared to be more anxiety-provoking than admission to reverse isolation; however, this finding needs to be replicated in a study with a prospective design using standardized psychosocial assessment. Findings are consistent with the evidence that patients view isolation as a temporary inconvenience rather than a major stressor. IMPLICATIONS FOR NURSING PRACTICE: Future research is needed. Preparing patients for isolation can include tours, educational materials, and explanations of procedures and events. Physical contact, even through gloves, can impart warmth and caring in the isolation environment.
Subject(s)
Activities of Daily Living , Affect , Anxiety/etiology , Anxiety/nursing , Bone Marrow Transplantation/nursing , Bone Marrow Transplantation/psychology , Environment, Controlled , Nursing Assessment , Patient Isolation/psychology , Adaptation, Psychological , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , Female , Humans , Male , Middle Aged , Patient Admission , Patient Education as Topic , Pilot Projects , Retrospective Studies , TouchABSTRACT
The pattern of oral mucositis and related treatment variables was studied in 20 bone marrow transplant patients. Patients received either total body irradiation (TBI) or busulfan in combination with cyclophosphamide and etoposide as pretransplant conditioning. Daily oral assessment scores were analyzed. Mucosal changes began approximately 2 days before transplant and peaked approximately 8 days after transplant. There was a trend for patients receiving TBI to have slightly higher oral scores during the first week posttransplant than patients receiving busulfan. The TBI patients averaged almost twice the number of days of continuous intravenous morphine infusion for oral pain and 6 additional days of total parenteral nutrition when compared with patients receiving busulfan. Subjects who died during aplasia manifested mucositis that gradually worsened and did not return to baseline. Differences in oral status based on type of transplant, either autologous or allogeneic, were not shown in this study.
