Abstract
OBJECTIVE: To examine how cognitive load and socio-emotional adaptation shape patient education experiences among older adults with multiple myeloma (MM) undergoing autologous stem cell transplantation (ASCT). METHOD: Interpretative Phenomenological Analysis (IPA) was used to analyze 150 h of ethnographic observations of nurse-patient education sessions (N = 70), supplemented by retrospective and prospective participant interviews (N = 35) and clinician interviews (N = 7) conducted over 18 months. Socio-Emotional Adaptation (SEA) Theory and Cognitive Load Theory were used as sensitizing frameworks to guide coding, interpretation, and theoretical integration. RESULTS: Participants reported anxiety, information overload, and limited health literacy, which contributed to cognitive overload. Across ethnographic observations and clinician interviews, facilitators included tailored education, strong caregiver support, and clinician reinforcement of key concepts. CONCLUSION: Cognitive and socio-emotional factors influence how people with MM engage with and process transplant education. Interventions designed to optimize information delivery while enhancing socio-emotional support can improve comprehension and confidence in managing treatment. PRACTICE IMPLICATIONS: Integrating cognitive load reduction strategies and socio-emotional adaptation principles into patient education can enhance patient-centered learning experiences and improve readiness for complex treatments.