Blood transfusion matters

: a narrative inquiry into patients' experience of receiving regular blood transfusion in a day unit setting whilst in a palliative stage of a haematological malignancy

Abstract

As patients reach the palliative stage of a haematological malignancy such as leukaemia, lymphoma, myeloma or myelodysplasia, most will require regular blood transfusions. This thesis reports my professional doctorate study, the purpose of which was to gain a deep insight into the everyday life experiences of this patient population, who were receiving their blood transfusions in a day unit setting.
A narrative inquiry approach, underpinned by a pragmatic philosophical foundation, was employed. Twenty-two longitudinal, unstructured interviews with a purposive sample of eight participants allowed exploration of rich narratives of everyday-life blood transfusion experiences. During data collection and narrative analysis of transcripts, experiences were explored through three dimensions: sociality, place and temporality. Analysis produced eight narrative accounts. Meaning, implicit within and across these accounts was revealed through resonant plotlines (themes or threads). Plotlines of special interest were those which illuminated feelings, hardships and concerns. These plotlines provided the foundation for the development of five overarching narrative storylines. Found poetry, developed from raw data, supports storyline findings.
Discussion and implications for clinical practice are addressed through a review of the literature and a palliative lens focussed on the six Cs of nursing: compassion, care, communication, confidence, competence and courage.Essentially, to provide compassionate blood transfusion care healthcare professionals should: communicate realistic expectations when explaining benefits of blood transfusions; consider early involvement of the palliative care team to aid with difficulties around goal setting; the setting where blood is administered should be reconsidered; waiting in clinical areas should be significantly reduced and professional competence, courage and commitment should be developed to achieve individualised patient-centred care.

Date of Award	2018
Original language	English
Awarding Institution	University of Portsmouth
Supervisor	Assaf Givati (Supervisor) & Karen Burnell (Supervisor)