4.3 Article

Blood transfusion in haematology: A qualitative exploration of patients' and healthcare professionals' perceptions

Journal

BRITISH JOURNAL OF HEALTH PSYCHOLOGY
Volume 27, Issue 4, Pages 1241-1274

Publisher

WILEY
DOI: 10.1111/bjhp.12597

Keywords

Blood transfusion; cancer; haematology; outpatients; treatment decision-making; treatment perceptions

Funding

  1. City, University of London Doctoral Studentship

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This study explored the perceptions of blood transfusion among haematology patients and healthcare professionals, finding that both groups generally viewed transfusions as beneficial but also had concerns such as iron overload, allergic reactions, and challenges in delivering transfusions in timely manner.
Objectives Repeated blood transfusions are indicated for the management of patients with cancer or blood disorders. Patients' perceptions about transfusions may be associated with decision-making and coping, which has been under-explored in the haematology context. This study therefore aimed to explore haematology transfusion patients' and HCPs' perceptions of blood transfusion, drawing on theory and previously identified themes of transfusion perceptions. Design Semi-structured interview study with 14 adult blood transfusion patients and 14 HCPs (consultants, registrars, nurses) at two UK haematology units. Methods Patient- and HCP-tailored topic guides were developed based on themes of blood transfusion perceptions identified in a systematic review: 'Health benefits', 'Safety/risk', 'Negative emotions', 'Alternatives' 'Decision making' and 'Necessity'. Transcripts were analysed using deductive and thematic analysis. Patient and HCP themes were compared using triangulation methods. Conceptual models (one for patients, one for HCPs) specific to haematology portraying the association between themes were developed. Results Findings for patients and HCPs converged with transfusion reported as beneficial for patients, who were largely involved in the decision-making. Both groups also reported concerns about transfusion, including iron-overload, allergic reactions and challenges to deliver transfusions in time-pressurized services. Themes in the conceptual models included patient 'Burden' of receiving repeated transfusions and 'Supportive relationships', reflective of patients' positive interactions with other patients and HCPs in the haematology unit. Conclusion Despite the challenges for patients receiving repeated transfusions, convergent perceptions suggest a shared understanding of patients' transfusion experiences. Identified challenges could inform ways to improve transfusion services and patients' experiences.

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