Supporting patient preparedness for self-care in allo-HCT using a Swedish dialogue tool: A mixed methods interventional study

OBJECTIVES: To investigate how patients undergoing allo-HCT experience preparedness for self-care and the transition to post-hospital recovery, after using the Assessment of Rehabilitation Needs Checklist (ARNC) in combination with a conversation in a nurse-led intervention. METHODS: Patients were recruited between March and September 2023, at two allo-HCT centres in Sweden. A convergent parallel mixed-methods design with quantitative (The Self-Care of Chronic Illness Inventory-4 and the Care Transitions Measure) and qualitative data (individual interviews, 6-8 weeks post allo-HCT), were collected in parallel for integrated analysis. Descriptive statistics and a deductive content analysis, guided by the Middle Range Theory of Self-Care of Chronic Illness, were used. RESULT: Self-care scores for the 12 patients were generally high and stable over time, with a slight decrease in self-care management at follow-up. However, some reported low scores for self-care. Patients experienced the ARNC enhancing motivation, being a reminder, and improved self-care habits. Support from family and caregivers and access to care facilitated self-care, although patients expressed a desire for earlier dialogue. Preparedness for the care transition was highly scored, and patients reported that using the ARNC and conversation contributed to their preparedness. CONCLUSION: This study provides initial exploration of patients' preparedness for self-care behaviours and perceived self-efficacy. Self-care, particularly self-care management, appeared challenging, highlighting the need for individualised education and support. Patients felt prepared for the transition from hospital to home and indicated that the structured ARNC, and conversation with a nurse were important factors in supporting their preparedness for self-care.