الفهرس 
Bone Marrow TransplantationOnly 14 pages are availabe for public view
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Abstract
Bone marrow transplantation, formerly a highly experimental, rarely used procedure, has become a fairly common and accepted treatment. Bone marrow transplant (BMT) has evolved over the past two decades from an experimental treatment modality to the treatment of choice for certain malignant and non-malignant hematological disorders. Bone marrow transplant (BMT) is, however, a risky procedure, with attendant side effects and complications. Many of these are serious; some can be life-threatening (Grimm, et al, 2012).
The caregiver has an important role rule in helping adjust to the children’s condition post transplantation. The caregiver’s adjustment to the condition assessed during initial and ongoing interviews. The caregiver helps them to explore any feelings of guilt or blame about the children’s condition and encourages them to express doubts they may have about their ability to cope with the children’s future (Brenes, et al., 2012).
The aim of this study was to:
Assess health needs and problems among children post bone marrow transplantation through:
1. Identifying caregiver’s knowledge about bone marrow transplantation.
2. Assessing caregiver’s practices toward care the child post bone marrow transplantation.
3. Recognizing child health needs and problems.
4. Assessing caregiver’s compliance related to follow up system.
5. Assessing home environment.
Research Questions
1. Is there a relation between caregiver’s knowledge and their socio demographic characteristics?
2. Is there a relation between caregiver’s knowledge and practices toward care the child post bone marrow transplantation?
3. Is there a relation between caregiver’s knowledge and compliance to follow up system?
4. Is there a relation between caregiver’s practices and health needs& problems among children post bone marrow transplantation?
Subjects and Methods
Research Design
A descriptive analytical research design was utilized in this study to conduct the study aim.
Setting:
The study was conducted at Bone Marrow Transplantation (BMT) outpatient clinic at Naser Institute- Egypt, this unit considered the biggest unit for BMT in Egypt.
Subjects:
The subjects of this study composed of all children had BMT at 2016 which equal 72 children after discharge from BMT until one year, their age from 6-18 years and they accompanied by their caregivers which living with them in the same home.
Tools of data collection: three tools were used in this study for data collection
Tool І: Interview questionnaire form was designed by the investigator and written in simple Arabic language based on scientific literature review to assess data about the following:
Part one: Children and Caregivers socio-demographic characteristic.
Part two: A: Caregivers’ General knowledge about bone marrow transplantation.
Caregivers’ knowledge about autologous transplantation. Also,
Caregivers’ knowledge about allogeneic transplantation.
B: Caregivers’ practices toward care the child post bone marrow transplantation.
Part three: Child needs and problems post bone marrow transplantation.
Part four: Caregiver’s compliance related to follow up system.
Tool ІІ: Medical record to assess child health status.
Tool ІІІ: Home environment checklist.
Pilot Study
A pilot study was conducted on 10% of total sample of caregivers to test availability of study sample and clarity of the study tools. The pilot has also served to estimate the time needed for each subject to fill in the questions. According to the results of the pilot, some corrections and omissions of items were performed as needed. They were excluded in the main study subjects during the actual collection of data. The process of pilot study took one week (from 1/2 to 7/2) in Feb. 2016.
The study results can be summarized as follows:
1. Regarding socio-demographic characteristics of the children, 58.3% of children aged between 6 - < 12 years, 59.7% of them were males, 55.6% of them in primary school and 31.9% of them were the last child in their family.
2. Concerning to socio-demographic characteristics of the caregivers, 47.2% of them aged were ranged between 29- < 39 years, 75.0% of caregivers were mothers, 45.8 % of them have average education, 51.4% not working, 41.7% of them have two child in their family, 68.1% of them lives in urban area and 87.5% of caregivers suffering from insufficient income.
3. Regarding caregivers total score of the knowledge and practice, 68.1 % of caregivers have correct knowledge level about bone marrow transplantation and 100% of caregivers have done correctly practice level for post-transplantation complications at home.
4. Regarding child needs post bone marrow transplantation, 41.7% of child achieved their needs post bone marrow transplantation regarding safety and security at school followed by 39.0% of them achieved their needs regarding personal hygiene then 36.1% related to nutritional pattern and sleep pattern.
5. Regarding children present health problems, 19.4% of children have urinary system problems followed by 16.7% of them have digestive systems and skin problems, and then 15.3% of them have cardiovascular system and behavioral and psychological problems.
6. Concerning caregivers’ compliance toward follow-up system with the medical team, 98.6% of caregivers were compliance in adherence to the rules of prevention of infection at home and to the child’s personal hygiene, 93.1% of them were compliance in adherence to periodic follow-up dates, proper nutrition precautions and commitment to give medicines prescribed by the doctor on time.
7. Concerning home environment, 68.0% of caregivers have a suitable environment while 32.0% of them lives in unsuitable environment.
8. There no a statistically significant difference between caregiver’s knowledge and socio-demographic characteristics of the caregivers except number of children in the family.
9. There was no statistically significant difference between mean scores of caregiver’s knowledge and total practice score toward care the child post bone marrow transplantation.
10. There was no statistically significant difference between mean scores of caregiver’s knowledge and compliance to follow up system
Conclusion:
Based on the findings of the current study , it can be concluded that: more than two third of the caregiver’s have satisfactory knowledge level about bone marrow transplantation, all of them caring their children by correctly practices, and the vast majority of the caregivers’ have a good compliance toward follow-up system with the medical team.
According to the findings it is recommended that:
• Carrying out rehabilitation program for the patients and their caregivers to be performed properly during the rehabilitation period at caner hospitals such as, 57357 Hospital, and the National Cancer Institute in Cairo.
• Appropriate support services should also extend to family members, recognizing the impact cancer and transplant care can have on them as they support family members receiving treatment.
• Patients and their caregivers should be empowered and fully informed to become an active participating member of the multidisciplinary team. Full access to their record including all relevant nonmedical information and data should be given to them so that they are informed of their condition.