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Zhang MQ, Liu X, Huang Y. Does Mandala Art Improve Psychological Well-Being in Patients? A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:25-36. [PMID: 37668598 PMCID: PMC10801676 DOI: 10.1089/jicm.2022.0780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Objectives: Psychological disorders and symptoms are common and can significantly impair functioning in some areas in patients. We aimed to investigate the effects of mandala art (MA) on psychological well-being in patients. Design: A systematic review. Methods: We did a systematic review to assess the associations between MA and psychological well-being among patients. A systematic search of PubMed, EMBASE, Web of Science, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trial databases was conducted by independent reviewers from database inception to April 2023. We include randomized controlled trials, quasi-experimental studies, and qualitative studies. Outcome measures included any measurement of subjective and objective psychological well-being outcomes, such as stress, anxiety, depression, distress, mindfulness, hope, resilience, pain, mood, fatigue, and trauma symptoms. Results: Eleven studies of 405 participants were identified in the systematic review. Overall, the included studies provided preliminary evidence to suggest that MA may improve negative symptoms and hope, relieving pain, and reducing some physiological indicators of stress in patients. However, the quality of the existing evidence limited the generalization of results. Conclusions: According to the current evidence, the therapeutic benefits of using mandalas for improving the psychological well-being of patients are uncertain. More well-designed and high-quality studies in the field of MA are needed in the future.
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Affiliation(s)
- Meng-Qin Zhang
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xing Liu
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yan Huang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Chengdu, China
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Lykke C, Ekholm O, Olsen M, Sjøgren P. Paediatric end-of-life care - symptoms and problems: parent assessment. BMJ Support Palliat Care 2023; 13:e327-e333. [PMID: 33707300 DOI: 10.1136/bmjspcare-2021-002891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Symptoms and problems (S&P) are under-reported in children in end-of-life care.To target future interventions, the primary aim was to examine S&P in children in end-of-life care. METHODS All parents, who lost a child under the age of 18 years due to life-limiting diagnoses in the period 2012-2014 in Denmark, were invited to complete a self-administered questionnaire in 2017. In all, 152 (38%) children were represented by 136 mothers and 57 fathers. In the present study, parents' assessments of S&P during the last month of life were restricted to children aged 3-18 years. Data were analyses by means of descriptive statistics. RESULTS Children ≥3 years at the time of death were represented by 71 parents (48 mothers and 23 fathers) representing 56 out of the 152 children. Physical fatigue (93%), sleepiness (90%), poor appetite (87%), pain (84%) and nausea (84%) were the five most frequent symptoms reported by the parents. In all, 65% of the parents reported that satisfactory pain relief was obtained and 64% of the parents reported that the healthcare services to a large extent reacted quickly, when the child and/or family needed help. However, 46% of the parents experienced 'mess-ups' or sloppy services in the primary ward and 27% experienced that the children suffered from fear of death. CONCLUSION According to the parents, children with life-limiting diagnosis are highly symptomatic and have substantial problems during end-of-life care. Our findings indicate that systematic screening of S&P in children should be considered.
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Affiliation(s)
- Camilla Lykke
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
- Department of Oncology and Palliative Care, Nordsjællands Hospital, Hillerod, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
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3
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Lai JS, Jensen SE, Peipert JD, Mitchell SA, Garcia SF, Cella D, Goldman S, Lenzen A. Using IT to Improve Outcomes for Children Living With Cancer (SyMon-SAYS): Protocol for a Single-Institution Waitlist Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e50993. [PMID: 37682593 PMCID: PMC10517385 DOI: 10.2196/50993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Children and adolescents with cancer may experience multiple disease- and treatment-related symptoms that negatively affect health-related quality of life. Routine symptom surveillance thus constitutes an important component of supportive care in pediatric oncology. The Symptom Monitoring and Systematic Assessment and Reporting System in Young Survivors (SyMon-SAYS) system will administer, score, interpret, and display the results of symptom assessments captured weekly using patient-reported outcomes presented via the electronic health record (EHR) portal between clinic visits in oncology ambulatory settings, when patients are likely to be more symptomatic. This study is testing a digital system for routine symptom surveillance that includes EHR-based reports to clinicians and alerts for severe symptoms. OBJECTIVE In this randomized trial, we are examining the effects of the SyMon-SAYS system on perceived barriers to symptom management, self-efficacy, and symptom severity. Better self-management and timely clinical intervention to address symptoms promote adherence to treatment plans, strengthen child and parent self-efficacy, improve interactions between children, parents, and their clinical providers, and optimize clinical outcomes. METHODS The SyMon-SAYS system is integrated into the EHR to streamline the presentation of symptom scores and delivery of alerts for severe symptoms to clinicians using EHR (Epic) messaging functionalities. Children (aged 8 to 17 years) complete the weekly symptom assessment and review the symptom report by logging into the patient portal (Epic MyChart). This single-institution waitlist randomized controlled trial is recruiting 200 children (aged 8-17 years) with cancer and their parents, guardians, or caregivers. Participating dyads are randomly assigned to receive the intervention over 16 weeks (Group A: 16-week SyMon-SAYS intervention; Group B: 8-week usual care and then an 8-week SyMon-SAYS intervention). Analyses will (1) evaluate the efficacy of SyMon-SAYS at week 8 and the maintenance of those effects at week 16; (2) evaluate factors associated with those efficacy outcomes, including contextual factors, adherence to the SyMon-SAYS intervention, demographic characteristics, and clinical factors; and (3) evaluate predictors of adherence to the SyMon-SAYS intervention and preference of SyMon-SAYS versus usual care. RESULTS Data collection is currently in progress. We hypothesize that at 8 weeks, those receiving the SyMon-SAYS intervention will report decreased parent-perceived barriers to managing their children's symptoms, increased parent and child self-efficacy, decreased child symptom burden, and ultimately better child health-related quality of life, compared to waitlist controls. Feasibility, acceptability, and engagement from the perspectives of the children with cancer, their parents, and their clinicians will be examined using mixed methods. CONCLUSIONS We anticipate that this system will facilitate prompt identification of problematic symptoms. Additionally, we hypothesize that with the availability of graphical symptom reports over time, and timely provider responses, children or parents will become better informed and take an active role in managing their symptoms, which will further improve clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT04789720; https://clinicaltrials.gov/study/NCT04789720. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50993.
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Affiliation(s)
- Jin-Shei Lai
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States
| | - Sally E Jensen
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - John Devin Peipert
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States
| | - Sandra A Mitchell
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States
| | - Sofia F Garcia
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States
| | - David Cella
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States
| | - Stewart Goldman
- Department of Child Health, College of Medicine - Phoenix, University of Arizona, Phoenix, AZ, United States
- Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Alicia Lenzen
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States
- Division of Hematology, Oncology, Neuro-Oncology & Stem Cell Transplantation, Ann & Robert Lurie Children's Hospital of Chicago, Chicago, IL, United States
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4
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Nurhidayah I, Nurhaeni N, Allenidekania A, Gayatri D, Rustina Y. Uncertainty of parents due to having children with cancer: A concept analysis. BELITUNG NURSING JOURNAL 2023; 9:218-226. [PMID: 37492752 PMCID: PMC10363973 DOI: 10.33546/bnj.2612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/06/2023] [Accepted: 05/19/2023] [Indexed: 07/27/2023] Open
Abstract
Background Parents of newly diagnosed cancer children often experience significant concerns about the implications of the diagnosis. They find themselves in challenging decision-making situations, navigating through uncertain conditions following the disclosure. Uncertainty is a prevailing issue in healthcare, yet its interpretation and application within the context of health and nursing practice exhibit multiple meanings and variations. Objective This study aimed to clarify the concept of parental uncertainty arising from having children with cancer. Methods The concept analysis followed the steps outlined by Walker and Avant. A thorough literature search was conducted using the Embase, CINAHL, and MEDLINE databases to identify articles published between 1980 and 2022. Results The literature search yielded 147 articles from various disciplines, including health, nursing, medicine, psycho-oncology, and management. After analysis, 20 articles were selected for inclusion. This study identified four key attributes of parental uncertainty associated with having a child with cancer: (1) emotional disturbance, (2) unpredictability, (3) insufficient information, and (4) problems with decision-making. The antecedents of parental uncertainty encompassed the complexity of the disease, the diagnostic and treatment processes, the hospital environment, communication, and support from credible authorities. The consequences of parental uncertainty included the pursuit of new information, parental adaptability to their role, and parental distress. Conclusion Understanding the four attributes of parental uncertainty, along with their antecedents and consequences, can facilitate the future development and operational translation of the concept of uncertainty in nursing practice. This concept is valuable in the evidence-based provision of nursing care to parents of children with cancer, enabling comprehensive recognition and assessment of parental uncertainty and the implementation of appropriate interventions that are sensitive to parental experiences. Ultimately, this approach promotes the adaptation of both the child and the parent.
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Affiliation(s)
- Ikeu Nurhidayah
- Postgraduate Program, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Pediatric Nursing Department, Faculty of Nursing, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Nani Nurhaeni
- Pediatric Nursing Department, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | | | - Dewi Gayatri
- Basic Science and Fundamental Nursing Department, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Yeni Rustina
- Pediatric Nursing Department, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
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5
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Han T, Li S, Li X, Yu C, Li J, Jing T, Bai M, Fang Y, Qian K, Li X, Liang H, Zhang Z. Patient-centered care and patient satisfaction: Validating the patient-professional interaction questionnaire in China. Front Public Health 2022; 10:990620. [PMID: 36420009 PMCID: PMC9676965 DOI: 10.3389/fpubh.2022.990620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
Objective To introduce patient-centered approach in China and to relate it with Chinese patient satisfaction via validating the Chinese version of Patient-Professional Interaction Questionnaire (PPIQ-C). Design This cross-sectional survey was conducted through face-to-face interviews from June to September in 2019. Participants rated their patient-centered care experience via the 16-item translated PPIQ, their experience of the received medical service, and their overall satisfaction. Setting Kunshan Huaqiao People's Hospital in Jiangsu, China. Participants A total of 230 participants (87 males and 143 females; 108 outpatients and 122 inpatients). Results PPIQ-C exhibited acceptable psychometric properties. Data revealed a single factor model of the 16 PPIQ-C items [ χ ( 4 ) 2 = 12.394, p = 0.823, CFI = 1.000, TLI = 1.019, RMSEA = 0.000, SRMR = 0.032] had a superior model fit over the original first-order with four correlated factors and the second-order structures. The overall reliability was excellent (McDonald's ω = 0.975). In terms of patient satisfaction, process, treatment quality, and communication significantly predicted patient satisfaction, while environment, staff attitude, and medical ethics did not [R 2 = 0.427, F (6) = 24.887, p < 0.001]. Most importantly, the total score of PPIQ-C predicted patient satisfaction above and beyond the above-mentioned medical service perspectives (B = 0.595, SE = 0.207, p = 0.004). Finally, the constructive effect of PCC on patient satisfaction was stronger for departments of Pediatrics than Surgery. Conclusions The Chinese version of the PPIQ scale (PPIQ-C) exhibited acceptable psychometric properties. Yet the distinction among the four factors was not supported, suggesting potential difference(s) across cultures. Patient-centered care (PCC), reflected by the overall PPIQ-C score, predicted overall patient satisfaction above and beyond other medical service perspectives. Adopting PCC approach in appropriate situations will probably advance the development of performance evaluation systems in China, thus improving the overall health care and patient satisfaction.
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Affiliation(s)
- Tao Han
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sisi Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xueyuan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenhao Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiahui Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiantian Jing
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mayangzong Bai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Fang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Qian
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Kunshan Huaqiao People's Hospital, Kunshan, China
| | - Huigang Liang
- Department of Business Information and Technology, Fogelman College of Business and Economics, University of Memphis, Memphis, TN, United States,Huigang Liang
| | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Zhiruo Zhang
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6
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Kerimoglu Yildiz G, Yildiz S, Yoruk MA, Sevgen S. A tablet game or training booklet: Two methods for evaluating symptom management and quality-of-life of children receiving chemotherapy. Eur J Oncol Nurs 2022; 61:102190. [DOI: 10.1016/j.ejon.2022.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/26/2022] [Accepted: 08/04/2022] [Indexed: 11/04/2022]
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Hinds PS, Pinheiro LC, McFatrich M, Waldron M, Baker JN, Mowbray C, Maurer SH, Cheng Y, Reeve BB, Wang J. Recommended scoring approach for the pediatric patient-reported outcomes version of the Common Terminology Criteria for Adverse Events. Pediatr Blood Cancer 2022; 69:e29452. [PMID: 34866311 PMCID: PMC9038621 DOI: 10.1002/pbc.29452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/12/2021] [Accepted: 10/25/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Collecting symptom, function, and adverse event (AE) data directly from children and adolescents undergoing cancer care is more comprehensive and accurate than relying solely on their caregivers or clinicians for their interpretations. We developed the pediatric patient-reported outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE) measurement system with input from children, parents, and clinicians. Here, we report how we determined the recommended Ped-PRO-CTCAE item scoring approach. METHODS Data from 271 patients were analyzed using three scoring approaches: (a) at the AE attribute (frequency, severity, interference) using ordinal and dichotomous measures; (b) a weighted composite AE item score by AE attribute (0.5 - frequency; 1.0 - severity; 1.5 - interference); and (c) overall number of AEs endorsed. Associations of each AE attribute, AE item score, and overall AE score with the Patient-Reported Outcome Measurement Information System (PROMIS) Pediatric measures were examined. The ability of the overall Ped-PRO-CTCAE AE score to identify patients with PROMIS symptom T-scores worse than reference population scores was assessed. Clinician preference for score information display was elicited through interviews with five pediatric oncology clinical trialists. RESULTS The diverse scoring approaches yielded similar outcomes, including positive correlations of the Ped-PRO-CTCAE attributes, AE item score, and the overall AEs score with the PROMIS Pediatric measures. Clinicians preferred the most granular display of scoring information (actual score reported by the child and corresponding descriptive term). CONCLUSIONS Although three scoring approaches yielded similar results, we recommend the AE attribute level of one score per Ped-PRO-CTCAE AE attribute for its simplicity of use in care and research.
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Affiliation(s)
- Pamela S Hinds
- Children's National Health System, Washington, District of Columbia, USA.,George Washington University, Washington, District of Columbia, USA
| | | | - Molly McFatrich
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Mia Waldron
- Children's National Health System, Washington, District of Columbia, USA.,George Washington University, Washington, District of Columbia, USA
| | - Justin N Baker
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Catriona Mowbray
- Children's National Health System, Washington, District of Columbia, USA
| | - Scott H Maurer
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yao Cheng
- Children's National Health System, Washington, District of Columbia, USA
| | - Bryce B Reeve
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Jichuan Wang
- Children's National Health System, Washington, District of Columbia, USA.,George Washington University, Washington, District of Columbia, USA
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Freyer DR, Lin L, Mack JW, Maurer SH, McFatrich M, Baker JN, Jacobs SS, Lucas N, Withycombe JS, Tomlinson D, Villabroza KR, Waldron MK, Hinds PS, Reeve BB. Lack of Concordance in Symptomatic Adverse Event Reporting by Children, Clinicians, and Caregivers: Implications for Cancer Clinical Trials. J Clin Oncol 2022; 40:1623-1634. [PMID: 35294262 PMCID: PMC9113216 DOI: 10.1200/jco.21.02669] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/15/2021] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To examine concordance in symptomatic adverse event (AE) grading using the Common Terminology Criteria for Adverse Events (CTCAE 4.0) for clinicians and its patient-reported outcome (PRO) versions for children (Ped-PRO-CTCAE) and caregivers (Ped-PRO-CTCAE [Caregiver]). METHODS Children age 7-18 years with a first cancer diagnosis, their clinicians, and caregivers completed CTCAE-based measures before starting a treatment course (T1) and after the treatment (T2). Grades (0-3) were assigned by each reporter for 15 core AEs spanning physical and mental health. Mean grades were compared between reporters using two-sample t-tests; agreement was estimated using weighted kappa (κ) statistics. Multivariable mixed regression models were used to evaluate associations of clinical factors with AE reporting concordance. Significance was set at α = .05 (two-sided). RESULTS There were 438 child-clinician-caregiver triads with complete data at either T1 or T2. For children, the mean age was 13 years (standard deviation = 3.4), 53.7% were male, 32.6% non-White, and 56.4% had leukemia/lymphoma. At T1, clinician mean AE grades were significantly lower (ie, better) than children for all AEs and remained significantly lower at T2 except for constipation, nausea, anorexia, neuropathy, and anxiety. Caregiver mean AE grades were similar to children at T1 and significantly higher (ie, worse) at T2 for nausea, vomiting, anorexia, pain, fatigue, anxiety, and depression. Agreement for child-clinician grading was poor-to-fair at T1 (κ range, 0.08-0.34) and T2 (0.11-0.35), and for child-caregiver, was fair-to-good at T1 (0.34-0.65) and T2 (0.24-0.60). No factors were consistently associated with reporter concordance across AEs. CONCLUSION Compared with children, symptomatic AEs were consistently under-reported by clinicians with low agreement and over-reported by caregivers with low-moderate agreement. Direct reporting by children using Ped-PRO-CTCAE or similar measures should be routinely incorporated for toxicity assessment in clinical trials.
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Affiliation(s)
- David R. Freyer
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Li Lin
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Jennifer W. Mack
- Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA
| | - Scott H. Maurer
- UPMC Children's Hospital and University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Justin N. Baker
- Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN
| | - Shana S. Jacobs
- Division of Oncology, Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC
| | | | | | - Deborah Tomlinson
- The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada
| | | | - Mia K. Waldron
- Department of Nursing Science, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Pamela S. Hinds
- Department of Nursing Science, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Bryce B. Reeve
- Departments of Population Health Sciences and Pediatrics, Duke University School of Medicine, Durham, NC
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Namisango E, Bhakta N, Wolfe J, McNeil MJ, Powell RA, Kibudde S, Luyirika EBK, Mulema V, Feudtner C, Baker JN. Status of Palliative Oncology Care for Children and Young People in Sub-Saharan Africa: A Perspective Paper on Priorities for New Frontiers. JCO Glob Oncol 2021; 7:1395-1405. [PMID: 34546790 PMCID: PMC8457851 DOI: 10.1200/go.21.00102] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The burden of cancer disproportionately affects low- and middle-income countries. Low 5-year survival figures for children with cancer in low-income countries are due to late presentation at diagnosis, treatment abandonment, absence of sophisticated multidisciplinary care, and lack of adequate resources. The reasons for late presentation are partly due to limited awareness of cancer symptoms, high treatment costs, and facility-level barriers to timely access to treatment. Given the systemic challenges, the regional need for palliative oncology care for children care is high. Despite the enormity of the need for palliative oncology for children with cancer in Africa, its level of development remains poor. This paper presents the evidence on the status of palliative oncology care for children in sub-Saharan Africa. Countries must prioritize integration of pediatric palliative care in SSA pediatric oncology.![]()
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Affiliation(s)
- Eve Namisango
- African Palliative Care Association, Kampala, Uganda.,Cicely Saunders Institute, King's College London, London, United Kingdom
| | - Nickhill Bhakta
- Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Joanne Wolfe
- Department of Pediatrics, Boston Children's Hospital, Boston, MA.,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
| | - Michael J McNeil
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Richard A Powell
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.,MWAPO Health Development Group, Nairobi, Kenya
| | - Solomon Kibudde
- Department of Medical Oncology, Uganda Cancer Institute, Kampala, Uganda
| | | | | | - Chris Feudtner
- Department of Medical Ethics, The Children's Hospital of Philadelphia, Philadelphia, PA.,Departments of Pediatrics and of Medical Ethics and Health Policy, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA
| | - Justin N Baker
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
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10
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Cheng L, Zhao X, Ge Y, Wang Y, Kang Q. The Experiences of Chinese Children 5- to 7-year-old during cancer Treatment Reflected Through Interviews and Drawings. J Pediatr Oncol Nurs 2021; 39:88-98. [PMID: 34533397 DOI: 10.1177/10434542211041919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: For children with cancer, the experience during treatment can be challenging. There is a limited number of studies on self-reported treatment experiences of younger Chinese children with cancer using qualitative methods. Objectives: This study aimed at exploring the experience of Chinese children aged 5 to 7 years during cancer treatment reflected through interviews and drawings. Methods: This study used a descriptive qualitative design with the technique of "draw-and-tell." Participants were enrolled from the pediatric oncology inpatient department of one national children's medical center in China. They were asked to draw a picture of "your feelings in the hospital." An inductive content analysis approach was used. Results: Twelve participants were enrolled (8 male, mean age 5.7 years). Four themes were established: (1) suffering from adverse treatment effects; (2) perceiving changed relationships; (3) being thankful for others; and (4) trying out coping strategies. Conclusion: Chinese children aged 5 to 7 years expressed multiple cancer treatment impacts. They appreciated others' support and had their own way to cope with treatment demands. The authors also extended the dynamic nature of using the "draw-and-tell" methodology. Study findings highlight the importance of inviting and hearing the voice of young children during their cancer treatment, with particular consideration of the influence of disease, treatment, child development, family dynamics, and culture.
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Affiliation(s)
- Lei Cheng
- School of Nursing, 12478Fudan University, Shanghai, China
| | - Xinlei Zhao
- School of Nursing, 12478Fudan University, Shanghai, China
| | - Youhong Ge
- Pediatric Hematology and Oncology Unit, 145601Children's Hospital of Fudan University, Shanghai, China
| | - Yingwen Wang
- Pediatric Hematology and Oncology Unit, 145601Children's Hospital of Fudan University, Shanghai, China
| | - Qiongfang Kang
- Pediatric Surgical Oncology Unit, Children's Hospital of Fudan University, Shanghai, China
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Wartenberg L, Raber M, Chandra J. Unique Features of a Web-Based Nutrition Website for Childhood Cancer Populations: Descriptive Study. J Med Internet Res 2021; 23:e24515. [PMID: 34515643 PMCID: PMC8477295 DOI: 10.2196/24515] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/12/2020] [Accepted: 03/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background Children with cancer experience a myriad of nutritional challenges that impact their nutrition status during treatment and into survivorship. Growing evidence suggests that weight at diagnosis impacts cancer outcomes, but provider guidance on nutrition and diet during treatment varies. Nutrition literacy and culinary resources may help mitigate some common nutritional problems; however, many patients may face barriers to accessing in-person classes. Along with dietitian-led clinical interventions, web-based resources such as the newly updated electronic cookbook (e-cookbook) created by The University of Texas MD Anderson Cancer Center, @TheTable, may facilitate access to nutrition and culinary education during treatment and into survivorship. Objective We sought to define and describe the features and content of the @TheTable e-cookbook and compare it with analogous resources for a lay audience of patients with childhood cancer and childhood cancer survivors as well as their families. Methods We evaluated freely available web-based resources via a popular online search engine (ie, Google). These searches yielded three web-based resources analogous to @TheTable: the American Institute for Cancer Research’s Healthy Recipes, The Children’s Hospital of San Antonio’s Culinary Health Education for Families Recipe for Life, and Ann Ogden Gaffney and Fred Hutchinson Cancer Research Center’s Cook for Your Life. These sites were analyzed for the following: number of recipes, search functionality, child or family focus, cancer focus, specific dietary guidance, videos or other media, and miscellaneous unique features. Results Cook for Your Life and Culinary Health Education for Families Recipe for Life were the most comparable to @TheTable with respect to cancer focus and family focus, respectively. Healthy Recipes is the least user-friendly, with few search options and no didactic videos. Conclusions The @TheTable e-cookbook is unique in its offering of child- and family-focused content centered on the cancer and survivorship experience.
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Affiliation(s)
- Lisa Wartenberg
- Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Margaret Raber
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Center for Energy Balance in Cancer Prevention and Survivorship, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Joya Chandra
- Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Center for Energy Balance in Cancer Prevention and Survivorship, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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12
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Zhang A, Bing L, Mi Q, Zhou F, Wang J. Pediatric Palliative Care for Children with Cancer in a Children's Tertiary Hospital in China: Six-Year Experience of a Pediatric Palliative Care Service. Palliat Med Rep 2021; 2:1-8. [PMID: 34223496 PMCID: PMC8241364 DOI: 10.1089/pmr.2020.0030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Pediatric palliative care (PPC) does not meet current needs, particularly in low- and middle-income countries. Objective: We evaluated the first PPC team to serve patients with cancer in a tertiary children's hospital in China. Design: Single-center retrospective study. Setting/Participants: The core team members included oncologists, nurses, and a social worker. The team delivered palliative care through the outpatient clinic, consultations, a 24/7 hotline, and a hospice room located in the observation ward. Patients were referred by pediatric oncologists. We analyzed data for 92 children (54 boys and 38 girls; aged 7 months to 16 years) who required palliative care from August 2012 to August 2018. The most common primary diseases were leukemia and neuroblastoma. Measurements: We investigated the time from referral to death, symptoms during the prior month, the effects of informing children above eight years, and family satisfaction. Results: Among 88 deaths, the median time from referral to death was 17 (range 1–218) days. Most children had multiple symptoms (mean ± standard deviation 4.2 ± 3.2 per child). The most common symptoms in the last month of life were pain, loss of appetite, fatigue, fever, and dyspnea. Children above eight years who were not informed about their condition experienced more anxiety or depression. All families were satisfied with the services. Conclusions: The palliative care counseling team is feasible and could be complementary to conventional medicine in caring for children with life-limiting illnesses. This model has an important role in PPC in China or developing countries with scarce medical resources.
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Affiliation(s)
- Anan Zhang
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ling Bing
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qiang Mi
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fen Zhou
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianmin Wang
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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13
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Riedl D, Rothmund M, Darlington AS, Sodergren S, Crazzolara R, de Rojas T. Rare use of patient-reported outcomes in childhood cancer clinical trials - a systematic review of clinical trial registries. Eur J Cancer 2021; 152:90-99. [PMID: 34090144 DOI: 10.1016/j.ejca.2021.04.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/12/2021] [Accepted: 04/12/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Patient-reported outcomes (PROs) are the gold standard to assess the patients' subjective health status. While both the Food and Drug Administration and European Medicines Agency recommend the use of PROs as end-points in paediatric clinical trials to support claims for medical product labelling, it is not known how often PROs are actually used. The aim of this study was to assess the usage of PRO instruments in childhood cancer clinical trials investigating anti-cancer medication. METHODS In June 2020 ClinicalTrials and EudraCT were systematically searched for all trials including children and adolescents (≤21 years) with cancer registered between 2007 and 2020. The use of PRO measures and trials characteristics were analysed. To investigate which trial characteristics are associated with the use of PROs, a binary logistic regression was calculated. RESULTS Of 4789 identified trials, 711 were included. The most frequent reason for exclusion was age limitation (age >21 years). Of all included trials, only 8.2% used PROs as end-points; .6% as the primary end-point. The most commonly used questionnaire was the PedsQL™ (32.8%), followed by the Patient-Reported Outcomes Measurement Information System scales (12.1%). No association was observed between the use of PROs and trial region, number of centres, trial phase, time period or intervention type (all p > .05). The use of PROs did not substantially increase over time. Only 20.3% of the closed studies had published their results. CONCLUSION Despite recommendations of regulatory agencies, PRO assessment is extremely rare in paediatric oncology clinical trials. More efforts should be undertaken to facilitate implementation of PRO in paediatric trials to guarantee patient-centred research and treatments.
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Affiliation(s)
- David Riedl
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Maria Rothmund
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | | | | | - Roman Crazzolara
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Teresa de Rojas
- Pediatric OncoGenomics Unit, Children's University Hospital Niño Jesús, Madrid, Spain.
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14
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Hinds PS, Weaver MS, Withycombe JS, Baker JN, Jacobs SS, Mack JW, Maurer SH, McFatrich M, Pinheiro LC, Reeve BB, Wang J. Subjective Toxicity Profiles of Children in Treatment for Cancer: A New Guide to Supportive Care? J Pain Symptom Manage 2021; 61:1188-1195.e2. [PMID: 33096220 PMCID: PMC8055722 DOI: 10.1016/j.jpainsymman.2020.10.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Children and adolescents with cancer experience treatment-related, subjective adverse events (AEs). Identifying distinct groups of patients who predictably experience higher prevalence of AEs could guide patient care. OBJECTIVES Study aims were to 1) identify groups of children and adolescents reporting AEs using the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE); 2) determine whether demographic and clinical characteristics predict AE group membership; and 3) examine whether AE group membership was related to the distal outcome of psychological stress. METHODS Four hundred seventy-seven patients self-reported AEs via the Ped-PRO-CTCAE at T1 (beginning of treatment) and the PROMIS Pediatric Psychological Stress measure at T2 (7-28 days later). Latent class analysis was conducted to identify groups of patients and the relationships of the groups with demographic and clinical characteristics, and with stress. RESULTS Three distinct a priori unknown AE groups were identified (high AE prevalence, moderate AE prevalence, and low AE prevalence). Females, blacks, patients with high psychological stress, and patients more recently diagnosed were more likely to be in the high AE prevalence group. Gender, age, race, and time since diagnosis were associated with psychological stress. CONCLUSION Children with cancer are heterogeneous in experiencing subjective AEs. Gender, race, and time since diagnosis were significantly associated with higher subjective AE prevalence that may lead to psychological stress.
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Affiliation(s)
- Pamela S Hinds
- Department of Nursing Science, Professional Practice and Quality, Children's National Hospital, Washington, District of Columbia, USA; Department of Pediatrics, The George Washington University, Washington, District of Columbia, USA.
| | - Meaghann S Weaver
- Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska, USA; Division of Pediatric Oncology, Children's Hospital and Medical Center, Omaha, Nebraska, USA
| | | | - Justin N Baker
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Shana S Jacobs
- Department of Pediatrics, Children's National Hospital, The George Washington University, Washington, District of Columbia, USA
| | - Jennifer W Mack
- Department of Pediatric Oncology and Center for Population Sciences, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, Massachusetts, USA
| | - Scott H Maurer
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Division of Palliative Medicine and Supportive Care, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Molly McFatrich
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Laura C Pinheiro
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA; Department of Pediatrics, Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jichuan Wang
- Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, District of Columbia, USA; Epidemiology and Biostatistics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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15
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Peled O, Lavan O, Stein J, Vinograd I, Yahel A, Valevski A, Weizman A, Kimmel-Tamir E, Apter A, Fennig S, Yaniv I, Bernfeld Y, Benaroya-Milshtein N. Psychopharmacology in the Pediatric Oncology and Bone Marrow Transplant Units: Antipsychotic Medications Palliate Symptoms in Children with Cancer. J Child Adolesc Psychopharmacol 2020; 30:486-494. [PMID: 32845729 DOI: 10.1089/cap.2019.0164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objectives: The present study characterized the psychiatric diagnoses and symptoms that led to the administration of antipsychotic medications in children and adolescents with cancer, and to evaluate the benefits and tolerability of these drugs in a large hospital-based pediatric hematology-oncology practice. Methods: Efficacy and adverse effects of two second-generation antipsychotics were retrospectively analyzed in 43 patients 2.9-19.6 (mean 12.1) years of age. The Clinical Global Impression-Severity (CGI-S) Scale and Improvement (CGI-I) Scale were used to evaluate psychiatric symptom severity before and following treatment, while the incidence of side effects and drug-drug interactions were collected from medical records. Results: Olanzapine was administered to 58% of patients and risperidone to 42%; the choice of drug was at the discretion of the treating psychiatrist. The common psychiatric diagnoses among these patients included adjustment disorder (37%) and medication-induced psychiatric disorders (23%). The most common psychiatric-medical symptoms included irritability/agitation (79%) and depressed mood (74%). CGI-S improved significantly (p < 0.001) between assessments, with no statistically significant difference between olanzapine- and risperidone-treated patients. CGI-I scores at reassessment indicated superiority of olanzapine as compared with risperidone. Adverse effects of treatment were mild. Conclusions: Olanzapine and risperidone can be well tolerated and ameliorate severe psychiatric-medical symptoms in children and adolescents with cancer. The potential palliative benefits of these second-generation antipsychotics (e.g., rapid onset of action, antiemesis, sedation, and appetite stimulation) increase the utility of their use in children treated in oncology and bone marrow transplant units.
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Affiliation(s)
- Orit Peled
- Department of Pharmacy, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orly Lavan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Jerry Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Inbal Vinograd
- Department of Pharmacy, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Yahel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Avi Valevski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Research Unit, Geha Mental Health Center, and Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Research Unit, Geha Mental Health Center, and Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Ella Kimmel-Tamir
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Alan Apter
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Silvana Fennig
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Isaac Yaniv
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Yael Bernfeld
- Department of Pharmacy, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Benaroya-Milshtein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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16
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Gürcan M, Atay Turan S. The experiences of adolescents receiving cancer treatment in Turkey: A qualitative study. Eur J Cancer Care (Engl) 2020; 29:e13239. [DOI: 10.1111/ecc.13239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/15/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
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17
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Tremolada M, Taverna L, Chiavetta IT, Bonichini S, Putti MC, Biffi A. Psychological Wellbeing in Adolescents with Leukaemia: A Comparative Study with Typical Development Peers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020567. [PMID: 31963108 PMCID: PMC7014127 DOI: 10.3390/ijerph17020567] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 01/05/2023]
Abstract
There is still little research on psychological wellbeing, life satisfaction and reported problems in preadolescents and adolescents under therapy for leukaemia, and also little research comparing them with their healthy peers. The present study aimed to analyse the life satisfaction, hope, psychological wellbeing and reported problems’ intensity in 60 patients aged 8–18 during the first year of therapy, to identify those more at risk and to compare their reports with matched healthy peers. A battery of self-reported questionnaires was administered during hospitalisation or day hospital admissions post 6 months and post 12 months from the diagnosis. Younger patients (aged 8–13 years) were more at risk than older ones in their problems’ intensity and psychological symptoms; females and Acute Myeloid Leukaemia patients reported lower current life satisfaction perceptions; hope was associated with lower depression symptoms and mood problems. Healthy peers have a better perception of current life, but reported a lower hope score, more anxiety symptoms and more cognitive problems than patients. The first 6 months were more critical for patients’ psychological health. Basing on these empirical data, the inclusion of mental health care professionals or supportive psychotherapy into the treatment is recognized as extremely useful.
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Affiliation(s)
- Marta Tremolada
- Department of Development and Social Psychology, University of Padua, 35131 Padua, Italy; (I.T.C.); (S.B.)
- Department of Child and Woman Health, University of Padua, 35127 Padua, Italy; (M.C.P.); (A.B.)
- Correspondence: ; Tel.: +39-34-7486-8835
| | - Livia Taverna
- Faculty of Education, Free University of Bolzano-Bozen, 39042 Brixen, Italy;
| | - Ilaria Tamara Chiavetta
- Department of Development and Social Psychology, University of Padua, 35131 Padua, Italy; (I.T.C.); (S.B.)
| | - Sabrina Bonichini
- Department of Development and Social Psychology, University of Padua, 35131 Padua, Italy; (I.T.C.); (S.B.)
| | - Maria Caterina Putti
- Department of Child and Woman Health, University of Padua, 35127 Padua, Italy; (M.C.P.); (A.B.)
| | - Alessandra Biffi
- Department of Child and Woman Health, University of Padua, 35127 Padua, Italy; (M.C.P.); (A.B.)
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18
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de Rojas T, Neven A, Towbin AJ, Carceller F, Bautista F, Riedl D, Sodergren S, Darlington AS, Fernandez-Teijeiro A, Moreno L. Clinical research tools in pediatric oncology: challenges and opportunities. Cancer Metastasis Rev 2020; 39:149-160. [DOI: 10.1007/s10555-020-09856-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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19
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Ramsey WA, Heidelberg RE, Gilbert AM, Heneghan MB, Badawy SM, Alberts NM. eHealth and mHealth interventions in pediatric cancer: A systematic review of interventions across the cancer continuum. Psychooncology 2019; 29:17-37. [DOI: 10.1002/pon.5280] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/09/2019] [Accepted: 10/28/2019] [Indexed: 12/22/2022]
Affiliation(s)
- William A. Ramsey
- Department of PsychologySt. Jude Children's Research Hospital Memphis Tennessee
- Department of Counseling Psychology, Education, and ResearchUniversity of Memphis Memphis Tennessee
| | | | - Alexandra M. Gilbert
- Department of PsychologySt. Jude Children's Research Hospital Memphis Tennessee
- Department of PsychologyUniversity of Mississippi Oxford Mississippi
| | - Mallorie B. Heneghan
- Department of PediatricsNorthwestern University Feinberg School of Medicine Chicago Illinois
- Division of Hematology, Oncology and Stem Cell TransplantAnn & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois
| | - Sherif M. Badawy
- Department of PediatricsNorthwestern University Feinberg School of Medicine Chicago Illinois
- Division of Hematology, Oncology and Stem Cell TransplantAnn & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois
| | - Nicole M. Alberts
- Department of PsychologySt. Jude Children's Research Hospital Memphis Tennessee
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20
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Cheng L, Liu F, Feng S, Wang Y, Gu Y, Kang Q. Symptom Experience of Children With Cancer Younger Than Eight Years of Age: An Integrative Review. J Pain Symptom Manage 2019; 58:157-166. [PMID: 30980884 DOI: 10.1016/j.jpainsymman.2019.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Children with cancer endure multiple symptoms during treatment. However, there remains a lack of systematic approaches to capture the whole picture of the symptom experience of children with cancer younger than eight years of age. OBJECTIVE The purpose of this study was to conduct an integrative review to explore symptom experience of children with cancer younger than eight years of age. METHODS A literature search of PubMed, CINAHL, Web of Science, PsycINFO, Cochrane databases, and four Chinese databases was performed to identify empirical studies, followed by an evaluation of empirical quality and data extraction and synthesis. RESULTS Twelve articles covering 11 symptoms met the inclusion criteria. Children with cancer under the age of eight years experienced multiple intense symptoms, especially pain, worry, and anxiety. PedsQL™ Cancer Module (for age five to seven years) was the most commonly used instruments. There were limited data on these children's symptom quality, timing, and distress. Discordance between a child's age and symptom intensity was noted. Inconsistent concordance existed between children and their proxy symptom reports. CONCLUSION Children with cancer younger than eight years of age experience multiple symptoms. There is a need to investigate the full symptom profiles of these young children in consideration of their developmental nuances; to examine the concordance among different symptom reporters; and to conduct more qualitative studies to explore their symptom experience.
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Affiliation(s)
- Lei Cheng
- School of Nursing, Fudan University, Shanghai, China.
| | - Fang Liu
- Nursing Department, Children's Hospital of Fudan University, Shanghai, China
| | - Sheng Feng
- Pediatric Intensive Care Unit, Shanghai Children's Medical Center (SCMC) affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yingwen Wang
- Pediatric Hematology/Oncology Unit, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Gu
- Nursing Department, Children's Hospital of Fudan University, Shanghai, China
| | - Qiongfang Kang
- Oncology Unit, Children's Hospital of Fudan University, Shanghai, China
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21
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Symptom Clusters and Influencing Factors in Children With Acute Leukemia During Chemotherapy. Cancer Nurs 2019; 43:411-418. [DOI: 10.1097/ncc.0000000000000716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Silva-Rodrigues FM, Hinds PS, Nascimento LC. The Theory of Unpleasant Symptoms in Pediatric Oncology Nursing: A Conceptual and Empirical Fit? J Pediatr Oncol Nurs 2019; 36:436-447. [PMID: 31027449 DOI: 10.1177/1043454219844225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Symptom management knowledge is a priority for pediatric oncology nursing research. Theories and models can frame the studies of symptoms experienced during childhood cancer. This article describes and analyzes the middle-range theory, theory of unpleasant symptoms (TOUS), for its conceptual and empirical fit with pediatric oncology nursing based on its current use in adult oncology research and its limited use to date in pediatric oncology. Searches in PubMed and CINAHL databases using the keywords theory of unpleasant symptoms and cancer and covering the time period 2000 to 2017 yielded 103 abstracts for review. Twenty published reports met eligibility criteria for review; only one included pediatric oncology patients. No study to date has tested all the components of the TOUS in pediatrics. The TOUS component of performance appears to be underaddressed across completed studies that instead include a focus on patient-reported quality of life rather than on perceived behavioral or performance indicators concurrent with the subjective symptom reports. Additionally, the influence of family, essential in pediatric oncology, is absent in the majority of studies guided by the TOUS. The TOUS is a structurally complicated framework that would be a conceptual fit for pediatric oncology if family influence and perceived function were included. Studies across this population and guided by the TOUS are needed, although testing all the theorized linkages in the TOUS would likely require a large sample size of patients and, thereby, multisite approaches given that cancer is a rare disease in childhood.
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Affiliation(s)
| | - Pamela S Hinds
- Children's National Health System, Washington, DC, USA.,George Washington University, Washington, DC, USA
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23
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Tsimicalis A, Rennick J, Le May S, Stinson J, Sarkis B, Séguin K, Siedlikowski M, Choquette A, Louli J. “Tell it as it is”: How Sisom prompts children and parents to discuss their cancer experience. Cancer Rep (Hoboken) 2019. [DOI: 10.1002/cnr2.1173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Argerie Tsimicalis
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
| | - Janet Rennick
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
- Montreal Children's HospitalMcGill University Health Centre Montreal Quebec Canada
| | - Sylvie Le May
- UHC Sainte‐Justine Montreal Quebec Canada
- University of Montreal Montreal Quebec Canada
| | - Jennifer Stinson
- The Hospital for Sick Children Toronto Ontario Canada
- Lawrence S Bloomberg Faculty of NursingUniversity of Toronto Toronto Ontario Canada
| | - Bianca Sarkis
- Faculty of MedicineMcGill University Montreal Quebec Canada
| | - Karine Séguin
- Faculty of ScienceMcGill University Montreal Quebec Canada
| | - Maia Siedlikowski
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
| | - Anne Choquette
- Montreal Children's HospitalMcGill University Health Centre Montreal Quebec Canada
| | - Julie Louli
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
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24
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Lopes-Junior LC, Silveira DSC, Olson K, Bomfim EO, Veronez LC, Santos JC, Alonso JB, Nascimento LC, Pereira-da-Silva G, Lima RAG. Clown Intervention on Psychological Stress and Fatigue in Pediatric Patients With Cancer Undergoing Chemotherapy. Cancer Nurs 2019; 43:290-299. [PMID: 30801267 DOI: 10.1097/ncc.0000000000000690] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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25
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McLaughlin CA, Gordon K, Hoag J, Ranney L, Terwilliger NB, Ureda T, Rodgers C. Factors Affecting Adolescents' Willingness to Communicate Symptoms During Cancer Treatment: A Systematic Review from the Children's Oncology Group. J Adolesc Young Adult Oncol 2018; 8:105-113. [PMID: 30489196 DOI: 10.1089/jayao.2018.0111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The purpose of this systematic review is to (1) synthesize evidence facilitators and barriers affecting adolescent willingness to communicate symptoms to health care providers (HCPs) and (2) create practice recommendations. The PICOT (Population, Intervention, Comparison, Outcome, Time) question guiding the review was, among adolescents with cancer, what factors affect their willingness to communicate symptoms to HCPs? Three databases, PubMed, CINAHL, and PsychINFO, were searched using keywords from the PICOT question. Inclusion criteria included original research studies with samples of at least 51% adolescents aged 10-18 years who were receiving or had received cancer treatment. Studies were included that evaluated outcomes related to willingness to communicate in general as well as communication of specific treatment symptoms. Exclusion criteria included systematic reviews and publications emphasizing cancer screening, cancer prevention, survivorship, or decision making. A total of 11 studies were included in the systematic review. Two of the studies focused on symptom communication; the remaining nine studies focused on general communication or the overlap between general and symptom communication. Barriers to symptom and/or general communication included negative expectations, health-related uncertainty, ambiguousness with assessments, unfamiliarity, restriction of information, perceived negative provider characteristics/behaviors, adolescent circumstance, worry about others' perceptions, and provider approach. Facilitators to symptom and/or general communication included open communication, perceived favorable provider characteristics/behaviors, seasoned adolescent, and patient-provider rapport. Five practice recommendations were developed from the evidence that supports general and symptom communication between adolescents who are receiving or have completed cancer treatment and their HCPs.
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Affiliation(s)
- Colleen A McLaughlin
- 1 Department of Pediatrics, Division of Pediatric Blood & Marrow Transplant, Duke University Medical Center, Durham, North Carolina
| | - Kristi Gordon
- 2 Department of Hematology/Oncology & Bone Marrow Transplant, Children's Mercy Hospital, Kansas City, Missouri
| | - Jennifer Hoag
- 3 Department of Pediatrics, Division of Hematology, Oncology, Blood and Marrow Transplant, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Lori Ranney
- 4 Department of Cancer and Blood Disorders Clinic, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - Nancy B Terwilliger
- 2 Department of Hematology/Oncology & Bone Marrow Transplant, Children's Mercy Hospital, Kansas City, Missouri
| | - Tonya Ureda
- 5 Department of Pediatric Hematology/Oncology/Transplant, Levine Children's Hospital, Charlotte, North Carolina
| | - Cheryl Rodgers
- 6 Duke University School of Nursing, Durham, North Carolina
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Bilsin E. Development and validation of the taste alteration scale for children receiving chemotherapy. J Res Nurs 2018; 23:568-580. [PMID: 34394475 PMCID: PMC7932055 DOI: 10.1177/1744987118784987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Taste alteration is one of the most common and frequently ignored side effects of chemotherapy. AIMS Our aim was to develop the Taste Alteration Scale for Children with Cancer Receiving Chemotherapy (TAS-CrC). METHODS This study is a descriptive and cross-sectional type. The study was conducted between May and September 2016 at the child haematology clinics and outpatient clinics of six hospitals. A total of 165 children with cancer who were followed in the clinics and outpatient clinics of the mentioned hospitals between May and September 2016 and received chemotherapy constituted the population of the study. Our sample comprised 95 children with cancer who were followed in the clinic and outpatient clinic between the dates specified and met the study criteria. RESULTS It is observed that the correlation values of the item analysis of the TAS-CrC vary between 0.49 and 0.86. One sub-dimension of the scale was determined by explanatory factor analysis. The Cronbach's alpha reliability coefficient of the scale was determined to be 0.88. It was determined that there was a statistically significant relationship between the test-retest (first and second application) of the scale (p < 0.01). CONCLUSIONS According to the data obtained from the study, it was determined that the TAS-CrC was a valid and reliable scale.
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Affiliation(s)
- Elif Bilsin
- Assistant Professor, Health Science Faculty, Gaziantep
University, Turkey
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27
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Namisango E, Bristowe K, Allsop MJ, Murtagh FEM, Abas M, Higginson IJ, Downing J, Harding R. Symptoms and Concerns Among Children and Young People with Life-Limiting and Life-Threatening Conditions: A Systematic Review Highlighting Meaningful Health Outcomes. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 12:15-55. [DOI: 10.1007/s40271-018-0333-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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28
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Lopes-Júnior LC, Pereira-da-Silva G, Silveira DSC, Veronez LC, Santos JC, Alonso JB, Lima RAG. The Effect of Clown Intervention on Self-Report and Biomarker Measures of Stress and Fatigue in Pediatric Osteosarcoma Inpatients: A Pilot Study. Integr Cancer Ther 2018; 17:928-940. [PMID: 29900751 PMCID: PMC6142113 DOI: 10.1177/1534735418781725] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Pediatric cancer patients experience different psychological processes during hospitalization that may regulate the immune response and affect recovery and response to cancer treatment. In this study, we aimed to examine the feasibility of longitudinal testing of psychophysiological parameters of stress and fatigue in pediatric osteosarcoma patients hospitalized for chemotherapy submitted to clown intervention; and to investigate whether changes in the levels of biomarkers are associated with psychological stress and fatigue levels in these patients after the clown intervention. METHODS A pretest-posttest quasi-experimental pilot study was conducted at the pediatric oncology inpatient unit in a comprehensive cancer care center in Brazil including children and adolescents with osteosarcoma hospitalized for chemotherapy. Eight saliva samples were collected, comprising 4 at baseline (pre-intervention) and 4 after the clown intervention (+1, +4, +9, and +13 hours post-awakening). Salivary cortisol, α-amylase (sAA), cytokines, and matrix metalloproteinase-9 (MMP-9) levels were determined using high-sensitivity enzyme-linked immunosorbent assay (ELISA) kits. Stress and fatigue were measured by Child Stress Scale-ESI and PedsQL Multidimensional Fatigue Scale respectively. Bivariate association analysis between stress and fatigue scores and biomarker levels were investigated using nonparametric statistics. Effect sizes were calculated for each outcome variable. RESULTS Six pediatric osteosarcoma patients were enrolled with no missing data. No significant effects sizes were observed for psychophysiological outcomes. Effect sizes ranged from 0.54 (cortisol) to 0 (interleukin-1β [IL-1β]). Decreasing overall trends were observed for cortisol levels for all 6 pediatric osteosarcoma patients over time. In addition, a similar pattern of tumor necrosis factor-α (TNF-α) levels over time was found for all 6 patients. Patients with metastatic osteosarcoma showed a linear trend for a decrease in MMP-9 levels between 1 and 9 hours after the clown intervention and restoration to basal levels after 13 hours. CONCLUSIONS The results of this pilot study suggest that it is feasible longitudinally measure psychophysiological outcomes in the pediatric osteosarcoma inpatients for chemotherapy. Clown intervention merits further study as a way to reduce stress as well as fatigue, since that the stress and cytokines measurements are feasible based on our work.
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Affiliation(s)
- Luis C Lopes-Júnior
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Pereira-da-Silva
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.,2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Denise S C Silveira
- 2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Luciana C Veronez
- 2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Jéssica C Santos
- 2 University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
| | - Jonas B Alonso
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Regina A G Lima
- 1 University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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29
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Tsimicalis A, Rennick J, Stinson J, May SL, Louli J, Choquette A, Treherne S, Berube S, Yoon S, Ruland C. Usability Testing of an Interactive Communication Tool to Help Children Express Their Cancer Symptoms. J Pediatr Oncol Nurs 2018; 35:320-331. [PMID: 29848164 DOI: 10.1177/1043454218777728] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Sisom is an interactive computer software program that allows children to rate the severity of their cancer symptoms. The study objectives were to describe the usability of Sisom in terms of ease of use, usefulness, and aesthetics and to offer suggestions for improvement. METHOD A multisite, descriptive study was conducted to describe the usability of Sisom. A purposive sample of children, ages 6 to 12 years, being treated for cancer was recruited. English- and French-speaking children completed the eight tasks in Sisom recorded using Morae software and provided input via an audiotaped interview. Data were downloaded, transcribed verbatim, and analyzed descriptively. RESULTS Thirty-four children with varying cancers participated. The majority of children liked Sisom and found Sisom easy to use, found it to be helpful in expressing their symptoms, and were satisfied with the aesthetics. Some children provided suggestions for improvement to optimize Sisom use in Canada. CONCLUSIONS Children's positive responses and desire to use Sisom again suggest that future research should be directed toward implementing and evaluating its effectiveness in a variety of settings.
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Affiliation(s)
- Argerie Tsimicalis
- 1 McGill University, Montreal, Quebec, Canada.,2 Shriners Hospitals for Children®-Canada, Montreal, Quebec, Canada
| | - Janet Rennick
- 1 McGill University, Montreal, Quebec, Canada.,3 Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jennifer Stinson
- 4 The Hospital for Sick Children, Toronto, Ontario, Canada.,5 University of Toronto, Toronto, Ontario, Canada
| | - Sylvie Le May
- 6 UHC Sainte-Justine, Montreal, Quebec, Canada.,7 University of Montreal, Montreal, Quebec, Canada
| | - Julie Louli
- 1 McGill University, Montreal, Quebec, Canada
| | - Anne Choquette
- 3 Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Sarah Berube
- 6 UHC Sainte-Justine, Montreal, Quebec, Canada.,7 University of Montreal, Montreal, Quebec, Canada
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30
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Representations of Young Cancer Survivorship: A Discourse Analysis of Online Presentations of Self. Cancer Nurs 2018; 42:79-85. [PMID: 29601359 DOI: 10.1097/ncc.0000000000000582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND More young people are surviving treatment for cancer than ever before. Survival can have an adverse impact on their transition to adulthood. Discourses of cancer are applied to cancer survivors of all ages, but they manifest differently for young people. OBJECTIVE The aim of this study was to describe practices of self-representation in an online Web site that supports young Australian cancer survivors. METHOD We conducted a discourse analysis of images and text produced by young cancer survivors (aged 18-35 years) on a public cancer charity Web site. RESULTS The dominant subject position of participants published on this web site is one of empowered, beautiful cancer survivor. This applies to young people who have learned to embrace their cancer as providing a positive influence on their lives. However, this discourse can marginalize those whose cancer experience remains a source of distress or shame. CONCLUSION Web based media can provide a valuable forum for some young people to celebrate their cancer survival and to affirm the constructive influence that their cancer experience has had on their lives. However, we ponder the apparent unsuitability of some forums for young cancer survivors who have not yet found cause for celebration. IMPLICATIONS FOR PRACTICE Nurses have the opportunity to contribute to the development of supportive structures that meet the specific needs of different groups of young cancer survivors. This might mean assisting young cancer survivors who are struggling to find meaning in their cancer experience to negotiate the establishment of a new normal that they can embrace.
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31
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Brock KE, Wolfe J, Ullrich C. From the Child's Word to Clinical Intervention: Novel, New, and Innovative Approaches to Symptoms in Pediatric Palliative Care. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E45. [PMID: 29597333 PMCID: PMC5920391 DOI: 10.3390/children5040045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/12/2018] [Accepted: 03/21/2018] [Indexed: 12/13/2022]
Abstract
Despite vast improvements in disease-based treatments, many children live with life-threatening disorders that cause distressing symptoms. These symptoms can be difficult to comprehensively assess and manage. Yet, frequent and accurate symptom reporting and expert treatment is critical to preserving a patient's physical, psychological, emotional, social, and existential heath. We describe emerging methods of symptom and health-related quality-of-life (HRQOL) assessment through patient-reported outcomes (PROs) tools now used in clinical practice and novel research studies. Computer-based and mobile apps can facilitate assessment of symptoms and HRQOL. These technologies can be used alone or combined with therapeutic strategies to improve symptoms and coping skills. We review technological advancements, including mobile apps and toys, that allow improved symptom reporting and management. Lastly, we explore the value of a pediatric palliative care interdisciplinary team and their role in assessing and managing distressing symptoms and minimizing suffering in both the child and family. These methods and tools highlight the way that novel, new, and innovative approaches to symptom assessment and management are changing the way that pediatrics and pediatric palliative care will be practiced in the future.
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Affiliation(s)
- Katharine E Brock
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.
- Pediatric Palliative Care, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Emory University, Atlanta, GA 30322, USA.
| | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital Cancer and Blood Disorders Center, Boston, MA 02215, USA.
| | - Christina Ullrich
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital Cancer and Blood Disorders Center, Boston, MA 02215, USA.
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32
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Arpaci T, Toruner EK, Altay N. Assessment of Nutritional Problems in Pediatric Patients with Cancer and the Information Needs of Their Parents: A Parental Perspective. Asia Pac J Oncol Nurs 2018; 5:231-236. [PMID: 29607385 PMCID: PMC5863434 DOI: 10.4103/apjon.apjon_78_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: The majority of problems and symptoms occur in the gastrointestinal system in children with cancer. Parents have difficulty in coping with the nutritional problems and changing routines of children and need support in this respect. This study aimed to assess the nutritional problems of children with cancer and the information needs of their parents. Methods: This descriptive study was performed among children with cancer aged 3–18 years and their parents (n = 69). The data were collected through a data collection form developed by the researchers based on the literature. Results: The most prominent nutritional problems experienced by children were loss of appetite (85.5%), nausea (84.1%), vomiting (81.2%), fatigue (79.7%), and mucositis (66.7%). According to the parents, the factors causing these nutritional problems in children were physiological factors (100%) and the foods given to children in the hospital (65.2%). The parents mostly needed information about food–drug interactions (58.0%), food–disease interactions (52.2%), foods that children with neutropenia should avoid or should eat (neutropenic diet) (46.4%), and frequency of nutritional intake (36.2%). Conclusions: This study has shown that most children experience at least one nutritional problem, and the parents need comprehensive and regular information about nutrition. Pediatric oncology nurses have a significant responsibility in the evaluation, education, and monitoring of these children.
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Affiliation(s)
- Tuba Arpaci
- Faculty of Health Sciences, Nursing Department Gazi University, Ankara, Turkey
| | | | - Naime Altay
- Faculty of Health Sciences, Nursing Department Gazi University, Ankara, Turkey
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Tsimicalis A, Genest L, Stevens B, Ungar WJ, Barr R. The Impact of a Childhood Cancer Diagnosis on the Children and Siblings’ School Attendance, Performance, and Activities: A Qualitative Descriptive Study. J Pediatr Oncol Nurs 2017; 35:118-131. [DOI: 10.1177/1043454217741875] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Families of children with cancer are confronted with unexpected out-of-pocket expenses and productivity costs associated with the diagnosis. One productivity cost that falls on children is the impact of cancer on children’s school attendance, performance, and activities (eg, play, friendships, and socialization). Nested within the Childhood Cancer Cost Study, this qualitative descriptive study used convenience sampling to recruit and interview parents of children newly diagnosed with cancer. Content analysis techniques were used to inductively descriptive the semistructured interview data. Sixty-six parents of 65 children with cancer and of 73 siblings participated. The most commonly reported productivity loss in children with cancer was school absenteeism mainly due to cancer treatment. Children fell behind their classmates academically and lost important social time with peers. A few siblings also fell behind their peers primarily due to limited parental attention. Parents adopted various strategies to lessen the impact of the diagnosis on their children’s school attendance, performance, and activities. Providing parents with additional resources and support may optimize their children’s academic and social reintegration into school.
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Affiliation(s)
- Argerie Tsimicalis
- McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children–Canada, Montreal, Quebec, Canada
| | | | - Bonnie Stevens
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wendy J. Ungar
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald Barr
- Pediatric Oncology Group of Ontario (POGO), Toronto, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
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34
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Kudubeş AA, Bektas M, Bektas İ, Selekoglu Y, Sal Altan S, Ayar D. The effect of symptom frequency on the fatigue and sleep quality of adolescent cancer patients. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1227936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Aslı A. Kudubeş
- Department of Pediatric Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Murat Bektas
- Department of Pediatric Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - İlknur Bektas
- Department of Pediatric Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Yasemin Selekoglu
- Department of Pediatric Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Sema Sal Altan
- Department of Pediatric Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Dijle Ayar
- Department of Pediatric Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
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35
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Pinheiro LC, McFatrich M, Lucas N, Walker JS, Withycombe JS, Hinds PS, Sung L, Tomlinson D, Freyer DR, Mack JW, Baker JN, Reeve BB. Child and adolescent self-report symptom measurement in pediatric oncology research: a systematic literature review. Qual Life Res 2017; 27:291-319. [PMID: 28879501 DOI: 10.1007/s11136-017-1692-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Previous work in pediatric oncology has found that clinicians and parents tend to under-report the frequency and severity of treatment-related symptoms compared to child self-report. As such, there is a need to identify high-quality self-report instruments to be used in pediatric oncology research studies. This study's objective was to conduct a systematic literature review of existing English language instruments used to measure self-reported symptoms in children and adolescents undergoing cancer treatment. METHODS A comprehensive literature search was conducted in MEDLINE/PubMed, EMBASE, CINAHL, and PsycINFO to identify relevant articles published through November 10, 2016. Using pre-specified inclusion/exclusion criteria, six trained reviewers carefully screened abstracts and full-text articles for eligibility. RESULTS There were 7738 non-duplicate articles identified in the literature search. Forty articles met our eligibility criteria, and within these articles, there were 38 self-report English symptom instruments. Most studies evaluated only cross-sectional psychometric properties, such as reliability or validity. Ten studies assessed an instrument's responsiveness or ability to detect changes in symptoms over time. Eight instruments met our criteria for use in future longitudinal pediatric oncology studies. CONCLUSIONS This systematic review aids pediatric oncology researchers in identifying and selecting appropriate symptom measures with strong psychometric evidence for their studies. Enhancing the child's voice in pediatric oncology research studies allows us to better understand the impact of cancer and its treatment on the lives of children.
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Affiliation(s)
- Laura C Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, 10064, USA.
| | - Molly McFatrich
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Nicole Lucas
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Walker
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Pamela S Hinds
- Department of Nursing Research and Quality Outcomes, Children's National Health System, Department of Pediatrics, George Washington University, Washington, DC, USA
| | - Lillian Sung
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.,Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Deborah Tomlinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - David R Freyer
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Justin N Baker
- Division of Quality of Life and Palliative Care, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Bryce B Reeve
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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Mansouri A, Motaghedi R, Rashidian A, Ashouri A, Kagrar M, Hajibabaei M, Gholami K, Ansari S. Validity and Reliability Assessment of the Persian Version of Therapy-Related Symptom Checklist. IRANIAN JOURNAL OF MEDICAL SCIENCES 2017; 42:292-300. [PMID: 28533578 DOI: pmid/28533578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Therapy-related symptom checklist for children (TRSC-C) was developed as a symptom assessment tool in children receiving chemotherapy. The objective of the present study was to evaluate the validity and reliability of the Persian version of TRSC-C. This cross-sectional study was conducted in 2013-2014 in Tehran, Iran. TRSC-C was translated using backward-forward approach. The content validity, face validity, and comprehensiveness were investigated based on the opinion of experts. The item content validity index (I-CVI) and scale content validity index (S-CVI) were calculated by the mean approach and inter-rater agreement. The scale was revised based on the comments from a team of five experts, after which it was evaluated by an additional group of four experts. To assess the inter-rater reliability, two raters filled the scale with 29 and 30 patients in the outpatient clinic of Hazrat-e Ali Asghar Hospital. The Cronbach's alpha was calculated and factor analysis was performed. The scores of content validity were analyzed in Excel. Other statistical analyses were performed using the SPSS software version 20.0. Based on the initial assessment, the S-CVI with less conservative approach was 60% for clarity, 33% for relevancy, and 60% for simplicity. After revising the scale, the S-CVI reached 100%. The comprehensiveness and face validity of the scale were appropriate. The scale was inter-rater reliable and the Cronbach's alpha was 0.803. Eleven subscales were found in the TRSC-C. It is concluded that the Persian TRSC-C is a valid and reliable tool for measuring children symptoms. Availability of a valid and reliable checklist is a fundamental step in monitoring the symptoms of patients while receiving chemotherapy.
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Affiliation(s)
- Ava Mansouri
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Rozita Motaghedi
- School of Pharmacy, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Asieh Ashouri
- School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Mona Kagrar
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Moluk Hajibabaei
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Kheirollah Gholami
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahla Ansari
- Department of Hematology and Oncology, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
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Lima L, Silva V, Lemos MS. How chronic disease affects children's views on being ill and healthy: a comparative study. Scand J Caring Sci 2017; 31:922-929. [PMID: 28239881 DOI: 10.1111/scs.12415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 11/09/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Understanding children's views of illness and health is vital to a child-centred approach in patient education and care. Paediatric healthcare providers should incorporate children's views of health and illness to enable children and their families to participate in self-management plans and achieve better health outcomes. However, there is limited scientific knowledge regarding the views of children with specific diseases. METHOD This comparative study investigated whether and in what ways the experience of having different chronic diseases influenced children's views of being ill and healthy. The participants were 82 children aged 8-13 years diagnosed with a chronic disease (31 had asthma, 27 had diabetes and 24 had cancer). A group of 81 healthy children participated as a comparison group. The 'draw-and-write' technique was used to collect the children's views, and the data were analysed using a previously validated coding system (inter-rater agreement of 93%) and subsequently quantified for the examination of any differences in relation to illness. RESULTS Statistically significant differences were found in all dimensions of the children's conceptions of health and illness according to whether they had a chronic condition (effect sizes calculated with Cohen's d ranged from 0.35 to 1.22). Globally, the chronically ill children expressed a narrower definition of being healthy and ill than their healthy peers. Moreover, the comparison among the children with asthma, diabetes and cancer showed differences that seemed to reflect their specific experiences with their type of chronic disease and the associated treatments (effect sizes calculated with Eta-squared ranged from 0.07 to 0.25). CONCLUSIONS This study's findings can be used to guide education and clinical services tailored to ill children suffering from different chronic conditions.
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Affiliation(s)
- Lígia Lima
- Escola Superior de Enfermagem do Porto (Nursing School of Porto), Porto, Portugal
| | - Vanessa Silva
- Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Marina S Lemos
- Faculdade de Psicologia e Ciências da Educação, Center for Psychology at University of Porto Research Unit, Universidade do Porto, Porto, Portugal
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Pugh G, McCann L. Assessing the Quality, Feasibility, and Efficacy of Electronic Patient Platforms Designed to Support Adolescents and Young Adults With Cancer: A Systematic Review Protocol. JMIR Res Protoc 2017; 6:e4. [PMID: 28096067 PMCID: PMC5285605 DOI: 10.2196/resprot.6597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background A range of innovative websites, mobile technologies, eHealth and mHealth platforms have emerged to support adolescents and young adults (AYAs) with cancer. Previous reviews have identified these various applications and solutions, but no review has summarized the quality, feasibility, and efficacy of existing patient platforms (inclusive of websites, mobile technologies, mHealth and eHealth platforms) developed specifically for young people with cancer. Objective This paper describes the design of a protocol to conduct a review of published studies or reports which describe or report on an existing platform designed specifically for AYAs who have had a cancer diagnosis. Methods A search string was developed using a variety of key words and Medical Subject Heading and applied to bibliographic databases. General data (sample characteristics, patient platform development, design and, if applicable, pilot testing outcomes) will be extracted from reports and studies. Drawing on a previously developed coding schematic, the identified patient platforms will be coded for mode of delivery into (1) automated functions, (2) communicative functions, and (3) use of supplementary modes. An adapted version of the Mobile App Rating Scale (MARS) will be used to assess the of quality of each identified patient platform. The methodological quality of included studies will be assessed using the Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields (QualSyst). Both authors will independently screen eligible studies for final inclusion and will both be responsible for data extraction and appraisal. Data will be synthesized narratively to provide an overview of identified patient platforms. Results The review began in October 2016 and is currently in progress. The review paper will be submitted for peer-review and publication in the summer of 2017. Conclusions This review will be unique in its focus on assessing, where possible, the quality and efficacy of patient platforms for adolescents and young adults diagnosed with cancer. Results generated from this review will provide an invaluable insight into the utility of modern technology in supporting young people with cancer.
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Affiliation(s)
- Gemma Pugh
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Lisa McCann
- School of Health Sciences, Faculty of Health and Medical Science, University of Surrey, Guildford, Surrey, United Kingdom
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Schwartz LA, Brumley LD. What a Pain: The Impact of Physical Symptoms and Health Management on Pursuit of Personal Goals Among Adolescents with Cancer. J Adolesc Young Adult Oncol 2016; 6:142-149. [PMID: 27792462 DOI: 10.1089/jayao.2016.0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study examined health-related hindrance (HRH) of personal goals among adolescents receiving treatment for cancer and healthy peers. METHODS Adolescents and parents completed measures of demographics and psychosocial variables. Adolescents reported on their HRH, measured by ratings of the impact of pain, fatigue, other physical symptoms, and doing things to manage their health on self-identified personal goals. Disease-related information was abstracted from patient charts. RESULTS Adolescents with cancer experienced significantly more HRH than healthy peers, and their HRH was significantly associated with poorer health-related quality of life (p < 0.001), negative affect (p = 0.03), and depressive symptoms (p = 0.03). Risk and resilience factors associated with HRH for those with cancer included pain (current and past month severity, frequency, and pain-related quality of life), fatigue, nausea, cognitive problems, worse parent-reported family functioning, and female gender. When testing these significant associates in a regression model predicting HRH among adolescents with cancer, those with more severe pain (p < 0.001) and worse parent-reported family functioning (p = 0.01) were significantly associated with HRH; fatigue was marginally (p = 0.09) significant. CONCLUSIONS Results suggest that HRH is a significant problem for adolescents with cancer, particularly those who are experiencing pain. Addressing pain and other symptom management, enhancing family functioning, and helping adolescents adjust their goals or enhance support for goal pursuit may reduce HRH among adolescents with cancer. This may improve psychosocial well-being, address adolescent unmet needs, and ultimately help adolescents with cancer maintain normal developmental trajectories.
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Affiliation(s)
- Lisa A Schwartz
- 1 Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.,2 Perelman School of Medicine, The University of Pennsylvania , Philadelphia, Pennsylvania
| | - Lauren D Brumley
- 3 Department of Psychology, The University of Pennsylvania , Philadelphia, Pennsylvania
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Construct validity and reliability of a real-time multidimensional smartphone app to assess pain in children and adolescents with cancer. Pain 2016; 156:2607-2615. [PMID: 26580680 DOI: 10.1097/j.pain.0000000000000385] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We evaluated the construct validity (including responsiveness), reliability, and feasibility of the Pain Squad multidimensional smartphone-based pain assessment application (app) in children and adolescents with cancer, using 2 descriptive studies with repeated measures. Participants (8-18 years) undergoing cancer treatment were drawn from 4 pediatric cancer centers. In study 1, 92 participants self-reported their level of pain twice daily for 2 weeks using the Pain Squad app to assess app construct validity and reliability. In study 2, 14 participants recorded their level of pain twice a day for 1 week before and 2 weeks after cancer-related surgery to determine app responsiveness. Participants in both studies completed multiple measures to determine the construct validity and feasibility of the Pain Squad app. Correlations between average weekly pain ratings on the Pain Squad app and recalled least, average, and worst weekly pain were moderate to high (0.43-0.68). Correlations with health-related quality of life and pain coping (measured with PedsQL Inventory 4.0, PedsQL Cancer Module, and Pain Coping Questionnaire) were -0.46 to 0.29. The app showed excellent internal consistency (α = 0.96). Pain ratings changed because of surgery with large effect sizes between baseline and the first week postsurgery (>0.85) and small effect sizes between baseline and the second week postsurgery (0.13-0.32). These findings provide evidence of the construct validity, reliability, and feasibility of the Pain Squad app in children and adolescents with cancer. Use of real-time data capture approaches should be considered in future studies of childhood cancer pain. A video accompanying this abstract is available online as Supplemental Digital Content at http://links.lww.com/PAIN/A169.
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Alhelih E, Ghazi Baker O, Aboshaiqah AE. Retracted: Symptom trajectories and occurrence in older Saudi children with cancer during a course of chemotherapy. Eur J Cancer Care (Engl) 2016; 26:e12555. [PMID: 27434998 DOI: 10.1111/ecc.12555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2016] [Indexed: 11/30/2022]
Abstract
This research aimed to describe changes in symptom occurrence and severity of the 31 symptoms during the chemotherapy cycle at three time points. This descriptive, longitudinal study investigated Saudi children who underwent a cycle of chemotherapy (n = 132) in four tertiary hospitals. The Arabic version of the Memorial Symptom Assessment Scale, Karnofsky Performance Status and a demographic questionnaire were used. More than 30% of children reported 10 or more symptoms during the cycle. Symptom occurrence trajectories were analysed using multilevel logistic regression. Six symptoms (i.e. fatigue, sadness, irritability, worrying, weight loss, sweating) showed a decreasing linear trend. Significant quadratic patterns of change were found for feeling drowsy, nausea and vomiting. No significant differences, over time were found in any of the symptom severity scores by using multilevel negative binomial regression. This study is the first to examine the trajectory of multiple symptoms that children experience during a cycle of chemotherapy in Saudi Arabia. Children in this study reported a high number of symptoms across the entire cycle of chemotherapy. Intervention studies are needed to improve care for these symptoms.
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Affiliation(s)
- E Alhelih
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - O Ghazi Baker
- Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - A E Aboshaiqah
- Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Tsimicalis A, Le May S, Stinson J, Rennick J, Vachon MF, Louli J, Bérubé S, Treherne S, Yoon S, Nordby Bøe T, Ruland C. Linguistic Validation of an Interactive Communication Tool to Help French-Speaking Children Express Their Cancer Symptoms. J Pediatr Oncol Nurs 2016; 34:98-105. [PMID: 27226380 DOI: 10.1177/1043454216646532] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Sisom is an interactive tool designed to help children communicate their cancer symptoms. Important design issues relevant to other cancer populations remain unexplored. This single-site, descriptive, qualitative study was conducted to linguistically validate Sisom with a group of French-speaking children with cancer, their parents, and health care professionals. The linguistic validation process included 6 steps: (1) forward translation, (2) backward translation, (3) patient testing, (4) production of a Sisom French version, (5) patient testing this version, and (6) production of the final Sisom French prototype. Five health care professionals and 10 children and their parents participated in the study. Health care professionals oversaw the translation process providing clinically meaningful suggestions. Two rounds of patient testing, which included parental participation, resulted in the following themes: (1) comprehension, (2) suggestions for improving the translations, (3) usability, (4) parental engagement, and (5) overall impression. Overall, Sisom was well received by participants who were forthcoming with input and suggestions for improving the French translations. Our proposed methodology may be replicated for the linguistic validation of other e-health tools.
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Affiliation(s)
- Argerie Tsimicalis
- 1 McGill University, Montreal, Quebec, Canada.,2 Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Sylvie Le May
- 3 University of Montreal, Montreal, Quebec, Canada.,4 CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Jennifer Stinson
- 5 The Hospital for Sick Children, Toronto, Ontario, Canada.,6 University of Toronto, Toronto, Ontario, Canada
| | - Janet Rennick
- 1 McGill University, Montreal, Quebec, Canada.,7 Montreal Children's Hospital, Montreal, Quebec, Canada
| | | | - Julie Louli
- 1 McGill University, Montreal, Quebec, Canada.,7 Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Sarah Bérubé
- 3 University of Montreal, Montreal, Quebec, Canada.,4 CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Stephanie Treherne
- 1 McGill University, Montreal, Quebec, Canada.,7 Montreal Children's Hospital, Montreal, Quebec, Canada
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Arvidsson S, Gilljam BM, Nygren J, Ruland CM, Nordby-Bøe T, Svedberg P. Redesign and Validation of Sisom, an Interactive Assessment and Communication Tool for Children With Cancer. JMIR Mhealth Uhealth 2016; 4:e76. [PMID: 27343004 PMCID: PMC4938887 DOI: 10.2196/mhealth.5715] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/08/2016] [Accepted: 05/11/2016] [Indexed: 11/25/2022] Open
Abstract
Background Children with cancer undergo intensive and long treatment periods that expose them and their families to a number of difficult physical, mental, and social challenges. Empowering children by actively involving them in their care can help them to cope with these challenges. It can, however, be difficult for children to be involved and talk about their illness experiences in a “traditional” conversation with health care professionals, especially for younger children. Sisom (Norwegian acronym “Si det som det er” or “Tell it how it is”) is an interactive computer-based assessment and communication tool to give children (aged 6-12 years) with cancer a “voice” in their care. Because of technological advances and widespread use of mobile devices Sisom had to be redesigned to better meet the needs of children of today. Objective To redesign Sisom for use on mobile devices and to validate and adapt it for use in a Swedish population of children with cancer. Methods A user-experience design was used. Content adaptation included forward-backward translation by Swedish and Norwegian translators. Healthy children (n=5), children with experiences of cancer treatment (n=5) and their parents (n=5), and pediatric nurses (n=2) were then involved in culturally adapting Sisom to the Swedish context. The iterative low- and high-fidelity evaluation was supported by a think aloud method, semistructured interviews, and drawings to capture children’s views of Sisom. The redesign and evaluation continued until no further changes or improvements were identified by the participants or the researchers. Results Children, parents, and pediatric nurses offered many suggestions for improvements to the original version in terms of content, aesthetics, and usability of Sisom. The most significant change that emerged through user input was a modification that entailed not using problem-focused statements in the assessment items. The parents and pediatric nurses considered the revised assessment items to be general and less diagnosis specific. The evaluation of aesthetics resulted in brighter colors and more positive and exciting details in the animations. The evaluation of usability included improvements of the verbal instructions on how to navigate in Sisom 2, and also that the answers to assessment items in Sisom 2 should be saved to provide the children with the option to pause and to continue answering the remaining assessment items at a later stage. Conclusions Overall, this paper describes the process of using user-experience design with children in order to redesign and validate an interactive assessment and communication tool and how the outcomes of this process resulted in a new version, Sisom 2. All participants confirmed the usability and qualities of using the final version. Future research should be directed toward the implementation of Sisom 2 in clinical practice and to evaluate outcomes from individual and organizational levels.
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Affiliation(s)
- Susann Arvidsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.
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Usability testing of a computerized communication tool in a diverse urban pediatric population. Cancer Nurs 2016; 37:E25-34. [PMID: 24457227 DOI: 10.1097/ncc.0000000000000115] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Developed in Norway, Sisom is an interactive, rigorously tested, computerized, communication tool designed to help children with cancer express their perceived symptoms/problems. Children travel virtually from island to island rating their symptoms/problems. While Sisom has been found to significantly improve communication in patient consultations in Norway, usability testing is warranted with US children prior to further use in research studies. OBJECTIVE The objective of this study was to determine the usability of Sisom in a sample of English- and Spanish-speaking children in an urban US community. METHODS A mixed-methods usability study was conducted with a purposive sample of healthy children and children with cancer. Semistructured interviews were used to assess healthy children's symptom recognition. Children with cancer completed 8 usability tasks captured with Morae 3.3 software. Data were downloaded, transcribed, and analyzed descriptively. RESULTS Four healthy children and 8 children with cancer participated. Of the 44 symptoms assessed, healthy children recognized 15 (34%) pictorial symptoms immediately or indicated 13 (30%) pictures were good representations of the symptom. Six children with cancer completed all tasks. All children navigated successfully from one island to the next, ranking their symptom/problem severity, clicking the magnifying glass for help, or asking the researcher for assistance. All children were satisfied with the aesthetics and expressed an interest in using Sisom to communicate their symptoms/problems. CONCLUSIONS A few minor suggestions for improvement and adjustment may optimize the use of Sisom for US children. IMPLICATIONS FOR PRACTICE Sisom may help clinicians overcome challenges assessing children's complex symptoms/problems in a child-friendly manner.
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Darcy L, Björk M, Knutsson S, Granlund M, Enskär K. Following Young Children’s Health and Functioning in Everyday Life Through Their Cancer Trajectory. J Pediatr Oncol Nurs 2015; 33:173-89. [DOI: 10.1177/1043454215610489] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Knowledge of living with childhood cancer, through the trajectory, is sparse. Aim: The aim of this study was to follow young children’s health and functioning in everyday life through their cancer trajectory. Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis. Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children’s trajectories in relation to diagnosis but individual patterns were seen for each child. Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.
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Affiliation(s)
- Laura Darcy
- Jönköping University, Jönköping, Sweden
- University of Borås, Borås, Sweden
| | - Maria Björk
- Jönköping University, Jönköping, Sweden
- University of Skövde, Skövde, Sweden
| | - Susanne Knutsson
- Jönköping University, Jönköping, Sweden
- University of Borås, Borås, Sweden
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Lai JS, Yount S, Beaumont JL, Cella D, Toia J, Goldman S. A patient-centered symptom monitoring and reporting system for children and young adults with cancer (SyMon-SAYS). Pediatr Blood Cancer 2015; 62:1813-8. [PMID: 25856587 DOI: 10.1002/pbc.25550] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 03/17/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND This study evaluated the feasibility of implementing a patient-centered, technology-based symptom monitoring and reporting system (SyMon-SAYS) in pediatric oncology clinics using fatigue as a prototypic symptom. Timely identification of symptoms related to multi-modal therapy for children with cancer is fundamental to the overall success of cancer treatment. SyMon-SAYS was developed to address this need. PROCEDURE Patients with a cancer diagnosis, ages 7-21 years, currently on treatment, or off treatment within 6 months, were eligible. Patients/parents completed weekly fatigue assessments over 8 weeks via the internet or interactive voice response (IVR) by phone. Alert emails were generated when pre-defined fatigue score thresholds were met, and fatigue reports were forwarded to clinicians accordingly. Clinicians and parents/patients received cumulative graphic reports of fatigue scores prior to clinic visits at 4 and 8 weeks post-baseline to facilitate discussion. Parents/patients completed an exit survey at their last visit. RESULTS Fifty-seven patients/parents completed the study. The majority of patients (93%) and parents (78%) felt it was very/extremely easy to complete SyMon-SAYS; 95% of parents were satisfied with the system; 60% reported it helped deal with their child's fatigue; 70% reported that clinicians didn't discuss fatigue with them; 81% would be willing to use SyMon-SAYS to manage fatigue and other symptoms. Clinicians reported insufficient time to review reports, yet 71% were willing to receive the report on a monthly basis. CONCLUSION SyMon-SAYS is feasible and acceptable to patients and parents. Future efforts should focus on better integrating the system into the clinical workflow to improve clinicians' acceptance.
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Affiliation(s)
- Jin-Shei Lai
- Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.,Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - Susan Yount
- Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - Jennifer L Beaumont
- Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - David Cella
- Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - Jacquie Toia
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Stewart Goldman
- Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.,Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Wesley KM, Fizur PJ. A review of mobile applications to help adolescent and young adult cancer patients. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2015; 6:141-8. [PMID: 26316835 PMCID: PMC4547645 DOI: 10.2147/ahmt.s69209] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To review research articles utilizing mobile applications with adolescent and young adult (AYA) cancer patients. MATERIALS AND METHODS We identified articles via online searches and reference lists (eg, PsycInfo, PubMed). Articles were reviewed by two study team members for target population, stated purpose, technological utilization, sample size, demographic characteristics, and outcome data. Strengths and weaknesses of each study were described. RESULTS Of 19 identified manuscripts, six met full inclusion criteria for this review (four smartphone applications and two tablet applications). One additional article that included an application not specific to oncology but included AYA patients with cancer within the target sample was also reviewed. Uses of these applications included symptom tracking, pain management, monitoring of eating habits following bone marrow transplant, monitoring of mucositis, and improving medication management. Utility results from pilot studies are presented. CONCLUSION Mobile applications are growing in number and increasingly available to AYAs with and without chronic illness. These applications may prove useful in helping to support AYAs throughout their cancer treatment and beyond. However, few applications provide empirical data supporting their utility. Numerous strengths and benefits of these applications include increased accessibility to educational resources and self-management strategies, more frequent physical and emotional symptom tracking, and increased access to peer support. Despite these strengths, numerous limitations are identified, highlighting the need for future research in this area.
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Affiliation(s)
- Kimberly M Wesley
- Department of Psychology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Philip J Fizur
- Department of Psychology, La Salle University, Philadelphia, PA, USA
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Psychometric properties of the RCMAS-2 in pediatric cancer patients. Eur J Oncol Nurs 2015; 20:36-41. [PMID: 26233436 DOI: 10.1016/j.ejon.2015.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/18/2015] [Accepted: 07/16/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE OF THE RESEARCH The Revised Children's Manifest Anxiety Scale, second edition (RCMAS-2) is widely used internationally to assess anxiety. However, there is little data regarding its validity for pediatric cancer patients. This study evaluated the psychometric properties of the RCMAS-2 in pediatric cancer patients. METHODS AND SAMPLE This cross-sectional study included 370 pediatric cancer patients (aged 6-19 years) that were recruited from three medical centers between August 2008 and March 2011 in Taiwan. Reliability was evaluated by internal consistency. Confirmatory factor analysis was performed to examine the factor structure. Construct validity was examined by known-groups analyses. KEY RESULTS The internal consistency of the full scale was good (α = 0.90) but the scores of Physiological Anxiety subscale was low (α = 0.65). Using known-groups validity, significant differences in anxiety were observed between genders and between patients that were on and off treatment. The hypothesized three-factor model did not adequately fit (χ(2)/d.f = 2.4; p < 0.01, GFI = 0.80, CFI = 0.71, RMSEA = 0.06, SRMR = 0.01). CONCLUSIONS The RCMAS-2 demonstrated reliability and validity for use with pediatric cancer patients aged 6 and 19 years. Further structure evaluation of the RCMAS-2 in pediatric oncology population is needed, and the scores of the Physiological Anxiety subscale should be interpreted with caution.
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Wolfe J, Orellana L, Ullrich C, Cook EF, Kang TI, Rosenberg A, Geyer R, Feudtner C, Dussel V. Symptoms and Distress in Children With Advanced Cancer: Prospective Patient-Reported Outcomes From the PediQUEST Study. J Clin Oncol 2015; 33:1928-35. [PMID: 25918277 DOI: 10.1200/jco.2014.59.1222] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Thousands of children are living with advanced cancer; yet patient-reported outcomes (PROs) have rarely been used to describe their experiences. We aimed to describe symptom distress in 104 children age 2 years or older with advanced cancer enrolled onto the Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) Study (multisite clinical trial evaluating an electronic PRO system). METHODS Symptom data were collected using age- and respondent-adapted versions of the PediQUEST Memorial Symptom Assessment Scale (PQ-MSAS) at most once per week. Clinical and treatment data were obtained from medical records. Individual symptom scores were dichotomized into high/low distress. Determinants of PQ-MSAS scores were explored using linear mixed-effects models. RESULTS During 9 months of follow-up, PQ-MSAS was administered 920 times: 459 times in teens (99% self-report), 249 times in children ages 7 to 12 years (96% child/parent report), and 212 times in those ages 2 to 6 years (parent reports). Common symptoms included pain (48%), fatigue (46%), drowsiness (39%), and irritability (37%); most scores indicated high distress. Among the 73 PQ-MSAS surveys administered in the last 12 weeks of life, pain was highly prevalent (62%; 58% with high distress). Being female, having a brain tumor, experiencing recent disease progression, and receiving moderate- or high-intensity cancer-directed therapy in the prior 10 days were associated with worse PQ-MSAS scores. In the final 12 weeks of life, receiving mild cancer-directed therapy was associated with improved psychological PQ-MSAS scores. CONCLUSION Children with advanced cancer experience high symptom distress. Strategies to promote intensive symptom management are indicated, especially with disease progression or administration of intensive treatments.
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Affiliation(s)
- Joanne Wolfe
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
| | - Liliana Orellana
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Christina Ullrich
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - E Francis Cook
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Tammy I Kang
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Abby Rosenberg
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Russ Geyer
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Chris Feudtner
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Veronica Dussel
- Joanne Wolfe, Christine Ullrich, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute; Veronica Dussel, Dana-Farber Cancer Institute; Joanne Wolfe, Christine Ullrich, Boston Children's Hospital and Harvard Medical School; E. Francis Cook, Harvard School of Public Health, Boston, MA; Liliana Orellana, Deakin University, Victoria, Australia; Tammy I. Kang, Chris Feudtner, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Abby Rosenberg and Russ Geyer Seattle Children's Hospital and Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and Veronica Dussel, Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
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Evaluation of Sisom: A computer-based animated tool to elicit symptoms and psychosocial concerns from children with cancer. Eur J Oncol Nurs 2015; 19:359-69. [PMID: 25691300 DOI: 10.1016/j.ejon.2015.01.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 11/03/2014] [Accepted: 01/19/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE In pediatric oncology, clear communication regarding symptom occurrence between clinicians and children is essential in order to provide safe and effective care. Mobile technology provides a means to enhance the standard clinician-patient interview, particularly among children, who are well versed in the use of technology. To help children identify and voice their concerns in the health care setting, researchers created Sisom, an animated computer tool for children and young people with serious and chronic illnesses. The purposes of this study of 100 dyads of patients 7-12 years of age and their parents were to: compare participants' reports of symptom occurrence using Sisom to a standard symptom checklist and determine the time requirements, ease of use, and perceived usefulness of the Sisom tool by children with cancer and their parents. METHODS Child and parent participants completed both Sisom and the Memorial Symptom Assessment Scale. Symptoms on the two tools were compared and 20 items were similar to allow for comparisons. RESULTS Children reported a significantly higher number of these 20 symptoms using Sisom as compared to the MSAS (i.e., 6.8 versus 4.9 symptoms, p < 0.001). A similar pattern was noted for parental proxy reports (i.e., 8.7 versus 5.7 symptoms, p < 0.001). Sisom was completed in less than 30 min, with high ratings of ease of use and perceived usefulness from parent participants. CONCLUSIONS Sisom provides a systematic and engaging method to elicit symptom reports from children for use in clinical care and research.
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