Bone marrow transplantation is an emerging therapeutic modality in aplastic anemia, immunodeficiency disease, and acute leukemia.1 The total care of patients undergoing this procedure requires attention to and an appreciation of the multiplicity of stress-producing factors (technically called stressors2), emotional issues, and responses associated with this procedure.
An initial stressor is the decision to proceed with bone marrow transplantation. Though emotional acceptance may lag far behind, the patient and family are immediately thrust into a confrontation with the critical nature of the illness. In addition, environmental stressors are numerous. The current reliance on isolation techniques places the patient within an extreme environment for a protracted period. Physical contact is restricted; each day is highly regimented, and intense nursing care promotes infantilization. The ability of the patient to accept such "enforced regression" appears, in our judgment, to influence the efficacy of clinical treatment. This ability may be a function