An exploration of the influences on clinical decision making and the culture of blood transfusion practise in cancer-related anaemia using an ethnographic methodology.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Liz BishopHelen Allan

Abstract

This study seeks to explore the cultural practises, which shape the culture of transfusion, and to identify the key elements, which influence clinical decision making in blood transfusion in haemato-oncology and lung cancer patients. The assessment and decision making processes for blood transfusion were explored using fieldwork observation, six patient and nine clinician interviews based on ethnographic methodology. Data were analysed using thematic analysis. First, the findings suggested that despite anaemia and transfusion being ubiquitous in this cancer setting, it sits low in the hierarchy of clinical concerns (The unimportance of anaemia). Second, there is a great deal of uncertainty surrounding the diagnosis and management of this clinical problem; but this uncertainty was acknowledged by both patients and clinicians (Acknowledging uncertainty). Third, clinicians and to some extent patients, are socialised into the practise of the sub-discipline (Socialisation in practise). Fourth, the haemoglobin level was used as a distinct fragment of information on which to assess for the presence of anaemia and base the decision to treat with blood transfusion (Disaggregation of the body). The management of anaemia is not a priority...Continue Reading

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Citations

Oct 9, 2012·The Annals of Thoracic Surgery·Ruyun JinUNKNOWN Providence Health & Services Cardiovascular Disease Study Group
Mar 18, 2021·European Journal of Cancer Care·Wendy McSporran, Natalie A Pattison
Oct 20, 2021·Nursing Standard·Wendy McSporran

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