An interview-based study of young adults (YAs) with acute leukemia undergoing hospital-based induction therapy revealed 3 themes related to their strategies for coping with treatment: getting through, supported yet isolated, and information exchange preferences. The findings from this study were published in the Journal of Hospice and Palliative Nursing.

Initial treatment for acute leukemia involves intense induction chemotherapy delivered in the hospital setting, and typically requires a hospital stay of 4 to 6 weeks. Hence, the burgeoning experiences and choices often associated with young adulthood, such as attending college, establishing a career, marriage, and parenthood, are dramatically contrasted with the rigid restrictions and uncertainties associated with a diagnosis of acute leukemia and its initial treatment in this group of patients.

This study involved a convenience sample of young adults (aged 18 to 39 years) with acute myeloid or acute lymphocytic leukemia receiving induction therapy at the hematology/oncology unit of a quaternary academic medical center. It was conducted as part of a larger mixed methods study, involving the collection of both quantitative and qualitative data. Semi-structured interviews, and journal entries in some cases, were the source of qualitative data, with the former conducted at enrollment and hospital discharge.  Interviews lasted 15 to 30 minutes and took place in the patient’s private hospital room.

Seven patients with newly diagnosed or relapsed acute leukemia participated in the study, with 2 returning journals. The mean patient age was 32 years, and the mean hospital stay was 30 days. Only 1 patient received a palliative care consultation while in hospital.

All patients reported satisfaction with their care, but they also reported challenges. For example, patients often described effective coping strategies “to get through” treatment, yet some found remaining positive a challenge. Another common theme was feelings of isolation despite a high level of support from family and friends. The importance of social media as a means of staying in touch and updating friends and family was frequently mentioned. In addition, a number of patients expressed a desire for additional health-related information, including information provided using different delivery methods.

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Limitations of this study, noted by the authors, included a small number of participating patients (n=7), a very limited number of journals returned (n=2), and the convenience sampling used to recruit patients. Furthermore, no minority patients were included.

“The findings from this study may help to inform strategies to deliver personalized supportive care for the young adult patients with acute leukemia, especially as the involvement of palliative care in this population continues to expand,” wrote the authors. In addition, more research is needed to further understand the specific needs of this understudied patient population.

Reference

Albrecht TA, Keim-Malpass J, Boyiadzis M, Rosenzweig M. Psychosocial experiences of young adults diagnosed with acute leukemia during hospitalization for induction chemotherapy treatment. J Hosp Palliat Nurs. 2019;21(2):167-173.