{
    "abstract": "Caregivers of children undergoing allogeneic hematopoietic stem cell transplantation (HSCT) face substantial psychological, social, and logistical challenges throughout the transplant journey. This multicenter, longitudinal qualitative study explored the evolving mental health experiences, stressors, and coping strategies of 49 caregivers interviewed across four key time points: transplant (Day 0), Day +30, Day +100, and Day +180. Participants reported acute distress early in the process, exacerbated by restrictive hospital environments, the demands of hypervigilant caregiving, financial strain, and the emotional toll of family separation. As care transitioned to the outpatient setting, challenges shifted toward navigating complex home care, managing lingering uncertainty, and balancing the needs of other family members. Throughout the process, caregivers expressed heightened anxiety related to fear of relapse, infection, and long-term complications. Despite these burdens, many caregivers described powerful sources of resilience. Children's emotional strength, honest communication, and a desire to return to normal life helped sustain caregiver optimism. Support from the healthcare team, financial assistance, and access to professional mental health services further alleviated stress. Caregivers emphasized the need for enhanced inpatient environments, clearer outpatient guidance, structured mental health resources, and practical tools like caregiver handbooks. These findings underscore the need for holistic, family-centered care that addresses caregiving's psychological and practical dimensions during pediatric HSCT. Tailored, time-sensitive support strategies are essential to improving caregiver well-being and, in turn, optimizing patient outcomes across the transplant continuum.",
    "authors": [
        {
            "affiliation": "Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA.",
            "firstname": "Neel S",
            "initials": "NS",
            "lastname": "Bhatt"
        },
        {
            "affiliation": "Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA.",
            "firstname": "Leslie",
            "initials": "L",
            "lastname": "Lehmann"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: Christopher.Dandoy@CCHMC.org.",
            "firstname": "Christopher E",
            "initials": "CE",
            "lastname": "Dandoy"
        },
        {
            "affiliation": "Center for International Blood and Marrow Transplant Research (CIBMTR), NMDP, Minneapolis, MN; Hematology/Oncology/Blood and Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH.",
            "firstname": "Jeffery J",
            "initials": "JJ",
            "lastname": "Auletta"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Priscila",
            "initials": "P",
            "lastname": "Badia"
        },
        {
            "affiliation": "Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA.",
            "firstname": "Sheri A",
            "initials": "SA",
            "lastname": "Ballard"
        },
        {
            "affiliation": "Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA.",
            "firstname": "Robyn",
            "initials": "R",
            "lastname": "Blacken"
        },
        {
            "affiliation": "University of Cincinnati College of Medicine, Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Medical Center, Cincinnati, OH.",
            "firstname": "Nancy M",
            "initials": "NM",
            "lastname": "Daraiseh"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Catherine",
            "initials": "C",
            "lastname": "Desmond"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Chloe",
            "initials": "C",
            "lastname": "Dunseath"
        },
        {
            "affiliation": "Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH.",
            "firstname": "Preston",
            "initials": "P",
            "lastname": "Epling"
        },
        {
            "affiliation": "Division of Bone Marrow Transplant, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.",
            "firstname": "Taylor J",
            "initials": "TJ",
            "lastname": "Fitch"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Laura",
            "initials": "L",
            "lastname": "Flesch"
        },
        {
            "affiliation": "University of Cincinnati College of Medicine, Cincinnati, OH; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.",
            "firstname": "David",
            "initials": "D",
            "lastname": "Hartley"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "John",
            "initials": "J",
            "lastname": "Huber"
        },
        {
            "affiliation": "Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA.",
            "firstname": "Kari",
            "initials": "K",
            "lastname": "Jenssen"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Georgia",
            "initials": "G",
            "lastname": "Kent"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Anna",
            "initials": "A",
            "lastname": "Klunk"
        },
        {
            "affiliation": "Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA.",
            "firstname": "Malika",
            "initials": "M",
            "lastname": "Kapadia"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Katilyn",
            "initials": "K",
            "lastname": "Kusnier"
        },
        {
            "affiliation": "Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.",
            "firstname": "Nicole",
            "initials": "N",
            "lastname": "Liberio"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Steffani",
            "initials": "S",
            "lastname": "Maier"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Kasiani C",
            "initials": "KC",
            "lastname": "Myers"
        },
        {
            "affiliation": "Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.",
            "firstname": "Gabby",
            "initials": "G",
            "lastname": "O'Connor"
        },
        {
            "affiliation": "Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA.",
            "firstname": "Sarah",
            "initials": "S",
            "lastname": "Tarquini"
        },
        {
            "affiliation": "Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.",
            "firstname": "Rachel",
            "initials": "R",
            "lastname": "Phelan"
        },
        {
            "affiliation": "Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University.",
            "firstname": "Ahna",
            "initials": "A",
            "lastname": "Pai"
        },
        {
            "affiliation": "Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH.",
            "firstname": "Seth",
            "initials": "S",
            "lastname": "Rotz"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025. Published by Elsevier Inc.",
    "doi": "10.1016/j.jtct.2025.04.013",
    "journal": "Transplantation and cellular therapy",
    "keywords": [
        "Caregiver burden",
        "Financial challenges",
        "Mental health",
        "Pediatric hematopoietic stem cell transplant",
        "Psychosocial stress",
        "Qualitative Longitudinal Research",
        "Resilience",
        "Support mechanisms"
    ],
    "methods": null,
    "publication_date": "2025-04-24",
    "pubmed_id": "40268054",
    "results": null,
    "title": "Multicenter Study on Caregiver Experiences in Pediatric Hematopoietic Stem Cell Transplantation Part I: Integrative Analysis of Mental Health, Psychosocial Stressors, and Support Mechanisms.",
    "xml": "<Element 'PubmedArticle' at 0x788502ab3e20>"
}