Experiences of Difficulty in Hematopoietic Cell Transplant Nurses: A Qualitative Systematic Review Protocol

ObjectiveThis review aimed to explore the experiences of nurses working in the field of hematopoietic stem cell transplantation (HSCT) and identify the psychological, emotional, and ethical challenges they face. Given the limited literature specifically focusing on HSCT nurses, this review also includes the experiences of nurses caring for patients with hematologic malignancies in order to provide a comprehensive evaluation of the unique difficulties and coping strategies associated with HSCT. IntroductionNursing in HSCT requires a high level of specialization and is accompanied by multifaceted challenges, including psychological stress, emotional exhaustion, and ethical dilemmas. HSCT involves destroying the patients bone marrow function through intensive chemotherapy and total body irradiation, followed by transplantation of hematopoietic stem cells to restore blood cell production (Kanda, 2015). Introduced in Japan in 1974, more than 5,500 procedures are performed annually. However, life-threatening risks such as graft-versus-host disease (GVHD) and severe infections remain high (Japan Data Center for Hematopoietic Cell Transplantation, 2023). Nurses face not only technical challenges such as infection prevention and complex treatment management, but also the psychological and emotional burden of supporting patients suffering from severe stress. Many patients struggle with anxiety about relapse, isolation in sterile environments, and long-term psychological burden of recovery. The five-year survival rate for acute myeloid leukemia remains between 44% and 56% (Japan Data Center for Hematopoietic Cell Transplantation, 2023), further exacerbating the difficulties of nursing care due to the severity and complexity of the treatment. This review examines the challenges faced by nurses in HSCT and hematologic oncology settings using qualitative and mixed methods research to clarify the realities of these experiences. In doing so, it aims to provide insights that can serve as a foundation for future support measures and educational programs. Inclusion CriteriaThis review included qualitative and mixed-methods studies focusing on the psychological, emotional, and ethical challenges faced by nurses caring for HSCT and hematologic malignancy patients. Studies targeting pediatric patients and those focusing on professions other than nursing were also excluded. MethodsThe primary search engines for this review were PubMed, CINAHL, and Ichushi-Web, and searches were conducted between May and July 2025. The search was limited to the English and Japanese literature. The study selection will involve screening titles and abstracts, followed by a full-text review of relevant studies. Methodological rigor will be critically appraised, and data will be synthesized to identify recurring themes and patterns. The reliability of the findings was evaluated based on the consistency and quality across studies. PROSPERO Registration NumberCRD42024605711