Psy Day - Saturday 29 August, 15:00-16:00H, Auditorium 4
The complex mixture of psychological issues faced by donors, caregivers and the transplant team are the basis of a three-part session on Saturday afternoon, the first day of this year’s EBMT online congress.
The first talk on the dynamics of donor commitment will be given by Dr Anne-Marie van Walraven, of the Donor and Medical Affairs Team at Sanquin, the not-for-profit agency responsible for safe and efficient blood supply in the Netherlands.
“The first step of the volunteer donor journey is signing up at the registry, a free choice that only for a limited number also leads to an actual donation,” says Dr van Walraven. “How different this situation is from the confrontation that family donors face: they are asked to have their tissue typed, before they even had the opportunity to think about it.”
She will discuss how the concept of original commitment and motivation contribute to the experience of the donor. These drivers differ for unrelated donors and family members, and might even differ in different cultures. “What is the feeling of obligation to donate that might be experienced by a family member? This would be at odds with the concept of being a volunteer. What is the best way to support family donors?” she asks. Gaining insight and understanding the concept of commitment is, she explains, vital. She says: “It is known from research in unrelated donors, that those who were more ambivalent experienced the donation as more psychologically and physically difficult (Switzer, 2005). Much can be learned from the field of living organ donation.”
Haplo-identical transplantations are increasing, and numbers are still rising. The majority of the haplo-identical donors are a relative of the patients: parent, sibling, offspring or an extended family member (e.g. cousin or grandparent). As a result, in-hospital donor care activities are increasing. “Every donor deserves respect and sufficient support,” concludes Dr van Walraven. “The latest developments give us the unique opportunity to share information and best practices and lay a more solid foundation for related donor care management.”
A presentation on supporting the transplant team will then be given by Dr Alice Polomeni, clinician psychologist in the Department of Hematology and cellular therapy of the Hospital Saint Antoine at Paris, France.
She will discuss that haematopoietic cell transplantation (HCT) teams are engaged in providing rendering care and psychological support to patients and their families throughout the complex transplant process. HCT professionals are exposed to many stressors, such as coping with unrealistic expectations about HCT and coping with HCT ethical issues (e.g. related-donation). They must also deal with patients’ suffering during treatment and recovery, feeling disappointed about treatment results and of course the subject faced by all medical doctors and nurses: dealing with death.
“These stressors may lead to burnout – a critical issue to the health care system,” explains Dr Polomeni. “It has been shown that burnout is associated with reduced patient safety and satisfaction, higher physician and nurse turnover and a negative impact on the quality of care.” Indeed, she will discuss how in the specific setting of HCT, up to 40% of health care professionals present burnout symptoms and high scores of moral distress (Neumann et al, Biol Blood Marrow Transplant, 2018).
Dr Polomeni says: “HCT is a demanding setting, but also an interesting and challenging workplace. Mitigating work-related distress is essential to foster recruitment and retention of HCT teams so as to ensure the development of HCT, its broadening indications, clinical advances and improvement in survival, and to continue improving quality of care.”
Different methods to support HCT team have been proposed, including individual-focused (communication skills, mindfulness, meaning-centred interventions) and organisational approaches, notably team-focused interventions. Some HCT team initiatives to contribute to staff wellbeing and, therefore, quality of care will be described by Dr Polomeni in her presentation.
The third part of this session will be presented by Professor Maria Die Trill, Director of ATRIUM: Psycho-Oncology & Clinical Psychology, Madrid, Spain and President of the International Psycho-Oncology Society. She will address the support of transplant caregivers in her talk.