Implementation of a Population Care Model Utilizing the Electronic Medical Record to Screen and Manage Late Effects of Hematopoietic Stem Cell Transplant Is an Effective Way to Ensure Good Intermediate Health Outcomes and Cost Efficient Clinical Processes
Biology of Blood and Marrow Transplantation
Objective: The primary objective of this study was to identify patients' experience of sexuality following autologous or allogeneic hematopoietic stem cell transplantation (HSCT). Methods: This study utilized a concurrent, mixed qualitativequantitative design. Participants completed the Functional Assessment of Chronic Illness Therapy-BMT (FACT-BMT) as well as underwent semi-structured interviews. Results: Eleven individuals participated in the study. The mean age at time of transplant was 43
... transplant was 43 years (range: 17-62) and mean number of months from transplant to time of study participation was 29 (range: 2-86). Participants scored relatively high on the FACT-BMT (mean 106 [range: 56-134] out of a possible 148), where higher scores indicate better quality of life. Despite the high FACT-BMT scores, the majority of participants indicated some level of dissatisfaction with his/her sex life. Regarding sexual function, the most common changes experienced by the participants were: decreased libido (67% of female participants; 63% of male participants), difficulties with erectile function (88% of male participants), dyspareunia (67% of female participants), vaginal dryness (100% of female participants) and not feeling desirable (33% of female participants; 38% of male participants). Analysis of the qualitative data obtained from the interviews revealed several themes pertaining to sexuality and HSCT including: changes in sexual function, the impact of the disease/treatment on the participant's relationship, the experience of discussing sexuality with health care providers, and recommendations for potential strategies that may make it easier for patients to discuss sexuality with health care providers. Interview responses provided context for the participants' FACT-BMT scores and perspectives on each individual's experience with sexuality throughout the illness and treatment trajectory. Conclusion: In this study, 100% of participants experienced changes in sexuality following HSCT. While many participants encountered changes in sexual function, the interview component of this study revealed that sexuality, as a broader concept, went beyond the physical realm. The study findings have led to the development of a proposal to involve more participants as well as to include the participants' partners or spouses, if available.