Fear — Stem Cell Collection Nursing Care Plan

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Fear Common Related Factors

• Impending surgery or apheresis procedure
• Threat of anesthesia
• Anticipated pain
• Feelings about HSC recipient (if allogenic recipient)
• Responsibility of being a donor
• Fear of the unknown
• Fear of injections (needed for administration of growth factors)

Fear Defining Charactersitics

• Increased questioning
• Restlessness
• Tense appearance
• Uncertainty
• Jitteriness
• Apprehension

Fear Common Expected Outcomes

• Patient verbalizes reduction in fear.
• Patient verbalizes ability to cope.
• Patient expresses willingness, commitment, and positive feelings about being a donor.

Fear Assessment

• Determine what the patient is most fearful of. This helps guide the treatment plan.
• Assess the patient’s relationship with the recipient and the circumstances under which the patient became a stem cell donor. The patient may feel “obligated” or “pressured” to donate HSCs, especially when it is the only tissue “match” suitable for transplantation.

Fear Therapeutic Interventions

1. Acknowledge your awareness of the patient’s fear. This validates the feelings that the patient is having and communicates acceptance of these feelings.
2. Encourage verbalization of feelings, especially about the donor’s role, if appropriate. Donors may feel they are a “last resort” and that the recipient’s fate rests with them.
3. Assist the patient in identifying strategies used to deal with fear in the past that were helpful or comforting. This helps the patient focus on his or her fear as being a natural part of life and something that can continue to be dealt with successfully.
4. Provide environment of confidence and reassurance.