A Mixed Method Study Of Self-Care Self-Efficacy In Hematopoietic Stem Cell Transplantation Patients

Objective:To investigate the status and influencing factors of self-care selfefficacy in hematopoietic stem cell transplantation patients.And deeply explore the self-management content and strategies of long-term hematopoietic stem cell transplantation survivors and the promoting factors of self-care self-efficacy.Methods:(1)Convenience sampling was used to recruit 126 hematopoietic stem cell transplantation patients in two grade A hospitals in Changsha,Hunan Province from April 2021 to September 2021.The data were collected by using general information questionnaire,Strategies Used by People to Promote Health(SUPPH),Perceived Social Support Scale(PSSS),Herth Hope Index(HHI),Medical Coping Modes Questionnaire(MCMQ)and Hospital Anxiety and Depression Scale(HADS).SPSS 23.0 software was used for statistical analysis,enumeration data were described by frequency and constituent ratio,and measurement data were described by mean ± standard deviation,t-test,one-way analysis of variance,Pearson correlation analysis and multiple stepwise regression analysis were used to analyze influencing factors of self-care self-efficacy in hematopoietic stem cell transplant patients.(2)A semi-structured interview was conducted among 18 long-term survivors of hematopoietic stem cell transplantation by the method of objective sampling.The interviews revolved around " self-management content and strategies ",and the Colaizzi 7-step analysis method was used to analyze the results.Results:(1)The average score of self-care self-efficacy in hematopoietic stem cell transplant patients was(106.10±22.16)points.Among them,the score of positive attitude dimension was(57.83±12.01)points,the score of selfdecompression dimension was(37.18±8.42)points,and the score of selfdecision-making dimension was(11.09±2.70)points.Univariate analysis showed that there were statistically significant differences in self-care selfefficacy scores of hematopoietic stem cell transplant patients with different disease types(P < 0.05).Pearson correlation analysis found that self-care self-efficacy in hematopoietic stem cell transplant patients was significantly positively correlated with perceived social support,hope level,confrontation coping and avoidance coping(P<0.05);and it was significantly negatively correlated with surrender coping,anxiety and depression(P<0.001).The results of multiple linear regression analysis showed that the main influencing factors of self-care self-efficacy in hematopoietic stem cell transplant patients were hope level,depression,and perceived social support,which could explain 51.9% of the total variance in self-care self-efficacy.(2)Through the Colaizzi 7-step analysis,3 themes and 10 sub-themes were extracted from the self-care self-efficacy of hematopoietic stem cell transplant patients.It includes self-management content(disease symptom management,psychological stress management,social life stress management),self-management strategies(daily life management strategy,medical related behavior management strategy,emotion management strategy),and promoting factors of self-care self-efficacy(social support,support of belief,good physiological status,and economic status).Conclusions:The self-care self-efficacy of patients after hematopoietic stem cell transplantation was at a moderate level.Disease types,hope level,anxiety,depression,coping style and perceived social support were the influencing factors of self-care self-efficacy of patients.Long-term hematopoietic stem cell transplant survivors have developed a variety of self-management strategies and have been able to effectively manage disease symptoms,psychological stress,and social life stress under the action of self-care selfefficacy’s promoting factors.Figure 2,Table 15,Reference 94.