The psychological effects of protective isolation on haematological stem cell transplant patients: an integrative, descriptive review.

Abstract

Purpose: Protective isolation is used during haematopoietic stem cell transplantation (HSCT) to protect patients at increased risk of infection. However, it is suggested that the intensity of strict isolation conditions combined with intense treatments can impact patients psychologically. This review explored the psychological effect of protective isolation on HSCT patients.

Method: CINAHL, MEDLINE, and ASSIA databases were used to search for qualitative research undertaken between 2016 and 2023. Quality was appraised using the CASP tool and thematic analysis was utilised to identify themes using Thomas and Harden as a guiding framework.

Results: Five papers were included and demonstrated that being in protective isolation during HSCT hospitalisation and after discharge created a feeling of disconnection from others and society, and that long periods of contemplation and a feeling of loss of control led to negative psychological impacts. All included papers found that patients experienced a range of negative emotional states during their time in protective isolation.

Conclusion: Psychological health management is an important part of holistic patient care. Patients who experience HSCT report considerable negative psychological effects from the need for protective isolation. Interventions and strategies to improve this are slow to be developed and have not received the necessary focus in recent years. Critically, to maximise the patient experience and provide the best care possible, interventions are urgently required to minimise the longer-term psychological impact of HSCT in this patient group to contribute to maximising quality of life post-HSCT.