Lived experience of comfort with sexuality and fertility for survivors of hematopoietic progenitor cell transplants: phenomenological study

Introduction: Sexuality and fertility are deeply personal and fundamental aspects of human identity and quality of life. For survivors of hematopoietic stem cell transplants (HSCT), these areas can be profoundly affected by the physical, emotional, and social impacts of the treatment. Discomfort or lack of clarity regarding these issues can lead to long-term psychological distress, relationship challenges, and decreased overall well-being. Addressing this discomfort through research helps to fill a critical gap in supportive care, providing survivors with the tools and knowledge they need to navigate these challenges and enhance their post-treatment quality of life. Purpose: To grasp the scope of sexuality and fertility within the lived experiences of comfort and discomfort among allogeneic stem cell transplant survivors. Methods: We employed a qualitative approach through van Manen’s phenomenology of practice. The phenomenon was revealed via phenomenological interviews, incorporating narratives and illustrative episodes that captured the lived experiences of 20 survivors. We gathered descriptions of these experiences from participants from July 2020 to May 2021. During our phenomenological reflection on these accounts, we adhered to stages like epoché, reduction, and vocative, as outlined by van Manen (van Manen 2014). Results: The exploration of comfort within the realms of sexuality and fertility yielded several themes: desire and the relationship; immunosuppression as a limitation on sexual activity; the body does not correspond to desire; the future: fertility and the couple’s relationship; the challenges of disclosure and intervention. Conclusion: The findings indicate that survivors have long-term challenges with sexual expression and activity, stemming from the physical constraints of graft-versus-host disease (GVHD), perceptions of their immunosuppression, and the significance of their partnership, all of which translate into requirements for nursing care. Implications for Care and Support Cancer Survivors: Considering the experiences of these participants and the observed comfort linked to the sexuality of ASCT survivors, we can contemplate the care practices and recognize sexuality as a field of action for nurses in this context to enhance comfort for these individuals.