Psy Day - Workshops 2: Donors, the transplant team and COVID-19
Monday, March 15, 11:00 - 12:15, Auditorium 6
The first talk of this three-part session, titled ‘family donors, who cares?’ will be delivered by Dr Anne-Marie van Walraven, of the Donor and Medical Affairs Team at Sanquin, the not-for-profit agency responsible for safe and efficient blood supply in the Netherlands.
She will discuss how stem cell donor care management became more relevant after the establishment of the first unrelated donor registries. However, to date the share of donations by relatives is about half of the total number of donations. And with encouraging results of the new haplo-identical transplantations, this number might increase.
Dr van Walraven says: “It is therefore important that we care about our family donors: have clear guidelines to assess their suitability for donation; regulate the registration of adverse events or complications of the donation process and long term follow up. That is the only way to prove stem cell donation is safe, both for unrelated and related donors.”
Prospective studies with family donors are scarce, but they have one thing in common: the need to give more attention to the way stem cell donor care is delivered. Dr van Walraven concludes: “If we are able to develop a better tailor-made care for donating relatives, we are together contributing to better donor care and positive donation experiences!”
The second talk on “Supporting the HCT team: end of life issues” will be given by Dr Alice Polomeni, clinician psychologist in the Department of Hematology and cellular therapy of the Hospital Saint Antoine at Paris, France. She will discuss that the HCT unit is a demanding workplace and teams are exposed to many stressors, including caring for critically ill patients and their families, coping with their unrealistic expectations about the treatment and facing the end of life (EoL) issues.
Dr Polomeni says: “Focused on cure and survival, HCT presents specific EoL issues due to the unpredictable illness course, the possibility of cure even in relapsed and refractory settings and the absence of a clear transition between the curative and palliative phase of treatment.”
Despite high rates of relapse and treatment related mortality associated with HCT, research shows late discussions about EoL and insufficient advanced care planning, leading to rare referral to palliative care and high frequency of aggressive interventions immediately prior to death. Dr Polomeni explains that these situations increase moral distress, a significant variable in HCT teams’ burn out. Although recommendations do exist (on, for example, prognosis and EoL discussions, advanced directives, early palliative care, multidisciplinary interventions), organisational and cultural obstacles remain in the implementation of better EoL care in HCT units.
She concludes: “Team-focused intervention, as multidisciplinary meetings and “rounds” (e.g. Schwartz rounds and Balint groups) may help HCT teams to cope with EoL care issues.”
In the final talk Dr Troy Chase, a clinical psychologist currently based at Maggie’s Centres (a charity providing free cancer support across the UK) will address the stresses caused by the COVID-19 pandemic.
“The COVID-19 pandemic continues to have a significant effect on various aspects of our lives. The effects have been far reaching and enduring,” he explains. “The stressors that all individuals faced are well documented. For healthcare workers they include organisational challenges such as isolation from colleagues, feeling the pressure of several ethical dilemmas and at times shortages of personal protective equipment as well as personal challenges including facing the fear of disease transmission.”
Moreover, he will discuss how patients and caregivers have been faced with knowing that they are at a higher risk of serious complications if they contract the virus, worries about the healthcare systems’ ability to provide them with the optimal treatment against the backdrop of capacity issues and not being able to access or utilise usual supports and strategies to sustain emotional well-being.
Dr Chase concludes: “During this presentation I will explore the psychological impact these stressors have had and continue to have on healthcare workers, cancer patients and their caregivers. Clinical observations backed up by reviews of studies will be used to illustrate the impact. There will be an additional focus on highlighting evidence-based strategies that have been delivered in clinical settings to address or reduce the psychological impact.”