Study of representations of end-of-life platelet transfusion by its protagonists: Patients, nurses and hematologic oncologists

Introduction > End-of-life platelet transfusion practice in onto-hematology is subjective and depends on representations shored by patients, nurses and hematologists. This study aims to describe these representations of platelet transfusion in a context of a severe and advanced hematologic malignancy through the social representation of its protagonists. Methods > A qualitative study, using the associative network method and including three groups of 15 participants (patients with an advanced hematologic malignancy, regularly transfused in platelet concentrates; nurses and hematologic oncologists) from four hematology centers was conducted between February and April 2019. Analysis was carried out using IroMuTeQ software. Results > Patients expect platelet transfusion to have a direct beneficial impact on their health and highlight human relations. Nurses aim at the patient's well-being, in his or her individuality, and at respecting the transfusion protocol. Physicians seek to relieve symptoms by taking into account a multitude of decision-making factors. The textual clustering method, nuances those previous results and individualizes four different orientations, independent of groups: dependency, singularity, subjectivity and neutrality. Discussion > The perception of the social representations related to platelet transfusion at the end-of-life should make it possible to adopt the discourse to the preferred orientation of the speaker and could be on asset in goals of care discussion with patients as well as with teams in charge of palliative care.