Grateful for Gratitude

Bone Marrow Transplant

UNC Health
Summer 2021
Britney Huynh
 Goals of Presentation

G1: Benefits of coping for BMT patients

G2: Education of EBP to promote positive emotion and

connection with social support
About Bone Marrow Transplant (BMT)
Who can get a transplant?

leukemia, lymphomas, multiple myeloma, severe aplastic anemia

● Autologous bone marrow transplant: The donor is themself. Stem cells are taken from the
patient either by bone marrow harvest or apheresis (a process of collecting peripheral blood
stem cells), frozen, and then given back to the patient.
● Allogeneic bone marrow transplant: The donor shares the same genetic type as the patient.
Stem cells are taken either by bone marrow harvest or apheresis from a genetically matched
donor.

(John Hopkins Medicine, 2021)

About Bone Marrow Transplant (BMT) Cont.
Candidates:

● Review your medical history

● Perform a physical examination
● Conduct blood tests
● Perform imaging tests
● Conduct tests to check organ functions
● Remove a small sample of bone marrow (biopsy) to evaluate conditions
● Perform other tests
● Order a psychosocial evaluation

(John Hopkins Medicine, 2021)

Risk Factors Role of RT
● Spend several weeks in the hospital 1. Activity Maintenance
● Susceptible to infection a. Engage in activity
● Need blood transfusions 2. Engagement in health coping
● Graft-versus-host disease (allogeneic) a. Emotional support
● Mental confusion b. Healthy coping mechanisms
● Emotional/psychological distress
● Less hopeful
Coping with Social Support
Social support enhances quality of life and provides a buffer against adverse life events.

● Promotes coping

6 relevant studies demonstrated increased rate of survival in BMT patients based on social support (Beattie,
2013)

● Decrease stress = Better immune system

● Improves quality of life (Molassiotis, 1997)
○ Psychosocial adjustment
○ Increasing survival
How can RT aide with coping
Journaling
● Improve mood
● Decrease stress
● Identifying negative thoughts
● Provide self-talk
Establishing Routine
● Sense of normalcy
● Adds structure to disordered days
Psychosocial Councling/Support
● Emotional support
● Improves well-being
Expressive arts:
● Decrease treatment related symptoms
(distraction)
● Decrease depression
● Increase QOL and coping
Tiles of Hope program

Analysis of tiles painted by blood and marrow transplant patients during treatment

Midwest outpatient cancer centre implemented by a Certified Therapeutic Recreation Specialist and
occupational therapy students

Common Theme of Painting Tiles

● Hope (inspirational words or messages)
● Positive attitude (outlook on life, positive images, celebrations of success and healing/curing messages)
● Social support (Names, initials, and words identifying people (e.g. family, friends, & SO)

(Mische Lawson, Chau, & Schoel, 2016)

Gratitude Garden Program
Creating paper flowers to promote positivity to those who are supporting patients and to peers

● Self, social support, staff, other BMT patient

G1: Promote feelings of connectedness to social support

G2: Promote positive emotions/feelings of hopefulness

Outcomes
The Gratitude Questionnaire-Six Item Form (gq-6)

Pre-assessment: 42/42

Post-assessment: 42/42
References
Beattie S, Lebel S, & Tay J. (2013) The influence of social support on hematopoietic stem cell transplantation survival: a
systematic review of literature. PLoS One 8(4): e61586. doi:10.1371/journal.pone.0061586
John Hopkins Medicine (2021). Bone Marrow Transplantation. [online]. Retrieved on July 12, 2021, from
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/bone-marrow-transplantation
Mische Lawson, L., Chau, J. & Schoel, A. (2016). Thematic analysis of tiles painted by blood and marrow transplant patients
during treatment. European Journal of Cancer Care 25 (6), 1044– 1055. DOI: 10.1111/ecc.12328
Molassiotis, A., Van den Akker, O.B.A., Milligan D.W., and Goldman J.M. (1997). Symptom distress, coping style and
biological variables as predictors of survival after bone marrow transplantation. Journal of Psychosomatic Research
42(3), 275-285. DOI: 10.1016/S0022-3999(96)00298-X
Questions?