Nursing Care Using Gordon’s Model in Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia: A Case Report

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) exposes patients to complex physiological complications such as oral mucositis, nutritional deficits, infection, and graft-versus-host disease, alongside profound psychosocial distress, demanding structured, evidence-based nursing approaches. While Gordon’s functional health patterns model is used in oncology nursing, it has been described in only a few HSCT case reports, and few report outcomes with defined measures. Case Summary: A 38-year-old Turkish woman with newly diagnosed acute myeloid leukemia (AML-M5) underwent allo-HSCT from an HLA-matched sibling donor after fludarabine/busulfan myeloablative conditioning. Nursing assessment and care planning were organized around Gordon’s 11 Functional Health Patterns. Priority NANDA-I diagnoses were impaired oral mucous membrane integrity with acute pain (oral mucositis), inadequate nutritional intake, risk for infection (neutropenia), inadequate health knowledge, risk for imbalanced blood pressure (orthostatic hypotension), excessive anxiety, and excessive parental role conflict; interventions were mapped to NIC and outcomes were mapped to NOC outcome labels (indicator ratings were not recorded). Oral mucositis was documented with a Beck Oral Assessment Scale (BOAS) score of 15 on day +7, progressed to grade 3 by day +9, and required topical anesthetics, intensive oral care (saline rinses from day +4), and nutritional support; the BOAS score fell to 5 by day +14. Neutrophil engraftment occurred on day +16 without granulocyte colony-stimulating factor, and the patient was discharged on day +18 (3 March 2023) with comprehensive self-management education. Anxiety related to her prior BRCA-positive mastectomy, together with concerns about fertility and family roles, was addressed within this framework; psychosocial outcomes rest on clinical observation and patient report. Conclusion: In this case, Gordon’s model was useful for structuring comprehensive nursing assessment and care planning during allo-HSCT by bringing physiological and psychosocial domains into a single care plan; as a single case, it cannot show that the model itself influenced the clinical outcomes.

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Healthcare
Published
2026-11-05
DOI
https://doi.org/10.3390/healthcare14213777
Primary Topic
Nursing Diagnosis and Documentation
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article
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article

Nursing Care Using Gordon’s Model in Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia: A Case Report

Gamze Oğuz Erdem
Healthcare
Nursing Diagnosis and Documentation
article

Nursing Care Using Gordon’s Model in Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia: A Case Report

Gamze Oğuz Erdem
article en

Abstract

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) exposes patients to complex physiological complications such as oral mucositis, nutritional deficits, infection, and graft-versus-host disease, alongside profound psychosocial distress, demanding structured, evidence-based nursing approaches. While Gordon’s functional health patterns model is used in oncology nursing, it has been described in only a few HSCT case reports, and few report outcomes with defined measures. Case Summary: A 38-year-old Turkish woman with newly diagnosed acute myeloid leukemia (AML-M5) underwent allo-HSCT from an HLA-matched sibling donor after fludarabine/busulfan myeloablative conditioning. Nursing assessment and care planning were organized around Gordon’s 11 Functional Health Patterns. Priority NANDA-I diagnoses were impaired oral mucous membrane integrity with acute pain (oral mucositis), inadequate nutritional intake, risk for infection (neutropenia), inadequate health knowledge, risk for imbalanced blood pressure (orthostatic hypotension), excessive anxiety, and excessive parental role conflict; interventions were mapped to NIC and outcomes were mapped to NOC outcome labels (indicator ratings were not recorded). Oral mucositis was documented with a Beck Oral Assessment Scale (BOAS) score of 15 on day +7, progressed to grade 3 by day +9, and required topical anesthetics, intensive oral care (saline rinses from day +4), and nutritional support; the BOAS score fell to 5 by day +14. Neutrophil engraftment occurred on day +16 without granulocyte colony-stimulating factor, and the patient was discharged on day +18 (3 March 2023) with comprehensive self-management education. Anxiety related to her prior BRCA-positive mastectomy, together with concerns about fertility and family roles, was addressed within this framework; psychosocial outcomes rest on clinical observation and patient report. Conclusion: In this case, Gordon’s model was useful for structuring comprehensive nursing assessment and care planning during allo-HSCT by bringing physiological and psychosocial domains into a single care plan; as a single case, it cannot show that the model itself influenced the clinical outcomes.

HealthcareVol. 14(21)
Atlas Üniversitesi (TR)
Openalex Percentile: Top 9%
Nursing Diagnosis and Documentation
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