The perceptions of hematopoietic stem cell transplantation decision-making in patients with hematologic malignancies: a qualitative systematic review.

In 30 seconds

This qualitative systematic review synthesized research on how patients with hematologic malignancies perceive decisions about hematopoietic stem cell transplantation (HSCT). Searches across eight databases identified 20 studies, which were appraised using Joanna Briggs Institute criteria and integrated through content analysis. Four themes emerged: constrained choices; decision-making within relationships; financial and logistical burdens; and concerns about social participation and identity after transplantation. The review concludes that decisions reflect more than clinical risks and benefits, highlighting the need for shared decision-making support that explores patients’ understanding, constraints, values, and longer-term concerns.

Key findings

• The review included 20 qualitative studies and identified four integrated findings about HSCT decision-making.
• Patients’ perceptions encompassed constrained choices and the influence of relational contexts.
• Financial constraints and logistical hurdles were identified as part of the decision experience.
• Patients raised concerns about restricted social participation and threats to identity associated with transplantation.

Why it matters

HSCT decisions involve substantial risks and may affect patients’ practical circumstances, relationships, social participation, and sense of identity. This synthesis broadens the focus of decision support beyond explaining clinical information, underscoring the importance of understanding what constrains choice and which future-life concerns matter to patients.

What to keep in mind

The review synthesizes qualitative studies; its findings describe patient perceptions and do not establish the effects of particular decision-support approaches.