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Acute Leukemia Patients' Needs: Qualitative Findings and Opportunities for Early Palliative Care.

Publication ,  Journal Article
Boucher, NA; Johnson, KS; LeBlanc, TW
Published in: J Pain Symptom Manage
February 2018

CONTEXT: Patients with acute leukemias likely have needs that palliative care can respond to, yet little is known about specific challenges they face, particularly during active treatment. We examined acute myeloid leukemia (AML) patients' expressed challenges and supports after intensive induction chemotherapy. OBJECTIVES: We aimed to understand opportunities for palliative care interventions in this population. METHODS: We conducted a qualitative study of AML patients with high-risk disease at Duke University Hospital, Durham, NC. Patients were interviewed about care experiences approximately 3 months after treatment initiation. Multiple coders used descriptive content analysis to identify common and recurrent themes. RESULTS: We analyzed 22 patient transcripts. Sample demographics included 10 (45.5%) females, 12 (54.5%) males, mean age 62 (SD 10.9), 19 (86.4%) non-Hispanic white, and three (13.6%) nonwhite/non-Hispanic. All had high-risk disease, by age, relapse status, or molecular markers. We identified four themes in our analysis: physical symptoms, psychological issues, uncertainty regarding prognosis, and patients' sources of support. Specific challenges noted by patients included feelings of helplessness/hopelessness, activity restriction, fatigue, fevers, caregiver stress, and lack of clarity regarding treatment decision making. CONCLUSION: AML patients face substantial challenges regarding physical symptoms, psychological distress, and uncertainty regarding prognosis. These challenges signal needs for which palliative care in high-risk AML patients may help. Our findings highlight opportunities to develop targeted palliative care interventions addressing unmet needs in AML patients.

Duke Scholars

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Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

February 2018

Volume

55

Issue

2

Start / End Page

433 / 439

Location

United States

Related Subject Headings

  • Terminal Care
  • Stress, Psychological
  • Qualitative Research
  • Palliative Care
  • Middle Aged
  • Male
  • Leukemia, Myeloid, Acute
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

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ICMJE
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Boucher, N. A., Johnson, K. S., & LeBlanc, T. W. (2018). Acute Leukemia Patients' Needs: Qualitative Findings and Opportunities for Early Palliative Care. J Pain Symptom Manage, 55(2), 433–439. https://doi.org/10.1016/j.jpainsymman.2017.09.014
Boucher, Nathan A., Kimberly S. Johnson, and Thomas W. LeBlanc. “Acute Leukemia Patients' Needs: Qualitative Findings and Opportunities for Early Palliative Care.J Pain Symptom Manage 55, no. 2 (February 2018): 433–39. https://doi.org/10.1016/j.jpainsymman.2017.09.014.
Boucher NA, Johnson KS, LeBlanc TW. Acute Leukemia Patients' Needs: Qualitative Findings and Opportunities for Early Palliative Care. J Pain Symptom Manage. 2018 Feb;55(2):433–9.
Boucher, Nathan A., et al. “Acute Leukemia Patients' Needs: Qualitative Findings and Opportunities for Early Palliative Care.J Pain Symptom Manage, vol. 55, no. 2, Feb. 2018, pp. 433–39. Pubmed, doi:10.1016/j.jpainsymman.2017.09.014.
Boucher NA, Johnson KS, LeBlanc TW. Acute Leukemia Patients' Needs: Qualitative Findings and Opportunities for Early Palliative Care. J Pain Symptom Manage. 2018 Feb;55(2):433–439.
Journal cover image

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

February 2018

Volume

55

Issue

2

Start / End Page

433 / 439

Location

United States

Related Subject Headings

  • Terminal Care
  • Stress, Psychological
  • Qualitative Research
  • Palliative Care
  • Middle Aged
  • Male
  • Leukemia, Myeloid, Acute
  • Humans
  • Follow-Up Studies
  • Female