Abstract
Purpose
Treatment of adult acute myeloid leukemia (AML) is intensive, with induction treatment initiated in an inpatient setting and subsequent consolidation therapy often conducted in an outpatient setting. The purpose of the present qualitative paper is to provide insight into the experience of patients in the transition from inpatient to ambulatory care.
Methods
Participants were 35 AML patients who were interviewed about their experience of the illness and treatment. Utilizing the grounded theory method, we describe the adjustment of participants to the transition to ambulatory care.
Results
As outpatients, participants described adjusting to the intensity of ambulatory treatment and to the need to assume greater responsibility for their care. They also expressed a growing desire to understand their long-term care plan, compared to their preference to focus on the present prior to discharge, and they were struggling to construct a new sense of identity.
Conclusions
AML patients are now leaving acute care settings sicker and earlier. Considering their perceptions can inform interventions to facilitate adjustment during the transition to outpatient care.
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Acknowledgments
The authors would like to thank our study participants who kindly gave their time and effort, and our research and clinical staff who contributed to this project. We also would like to thank members of the Psychosocial Oncology and Palliative Care Scientists’ Manuscript Review Seminar for reviewing earlier versions of this manuscript. This study was supported by a Canadian Institutes of Health Research Operating Grant (#MOP 84317, G.R. and C.Z., Co-Principal Investigators). This research was also funded in part by the Princess Margaret Cancer Centre Foundation Hertz Centre Fund, the Campbell Family Cancer Research Institute, the Ontario Cancer Institute at the Princess Margaret Cancer Centre, and by the Ontario Ministry of Health and Long Term Care (OMOHLTC). The views expressed do not necessarily reflect those of the OMOHLTC. G.R. is also supported by the University of Toronto/University Health Network Harold and Shirley Lederman Chair in Psychosocial Oncology and Palliative Care, and C.Z. by the Rose Chair in Supportive Care, Faculty of Medicine, University of Toronto.
Conflict of interest
We have no conflicts of interest to declare. We have full control of all primary data and agree to allow the journal to review the data if requested.
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Nissim, R., Rodin, G., Schimmer, A. et al. Finding new bearings: a qualitative study on the transition from inpatient to ambulatory care of patients with acute myeloid leukemia. Support Care Cancer 22, 2435–2443 (2014). https://doi.org/10.1007/s00520-014-2230-3
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DOI: https://doi.org/10.1007/s00520-014-2230-3