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Cheng L, Wu M, Yu L. Health-related quality of life in Chinese children and adolescents with cancer. Jpn J Nurs Sci 2024; 21:e12564. [PMID: 37817416 DOI: 10.1111/jjns.12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/04/2023] [Accepted: 09/06/2023] [Indexed: 10/12/2023]
Abstract
AIM Cancer diagnosis and related treatment can have multiple impacts on children's health-related quality of life (HRQoL). This study aimed to determine profiles of HRQoL in Chinese children and adolescents with cancer based on patient-reported outcomes. METHODS This cross-sectional study recruited 310 pediatric patients with cancer (in treatment and survivorship) aged 8-17 years old and their family caregivers from four hospitals in China. The participants were asked to complete the PROMIS Pediatric-25 Profile 2.0, along with a demographic and clinical characteristics questionnaire, fatigue screening item, and an item assessing the family caregiver's coping style. Latent profile analysis was used to identify profiles. RESULTS Two profiles were identified: Profile 1, "low symptom and high function" (n = 147, 47.4%); and Profile 2, "high symptom and low function" (n = 163, 52.5%). Children reporting ≥3 on the five-point Symptom Distress Scale fatigue screening item were more likely to be in Profile 2 (OR = 1.961; 95% CI: 1.098-3.501). Participants were less likely to be in Profile 2 if they were in survivorship (OR = 0.494; 95% CI: 0.271-0.903), or their caregiver's coping style was identified as facing positively (OR = 0.439; 95% CI: 0.274-0.703). CONCLUSION The identified profiles demonstrate the heterogeneity in HRQoL among pediatric patients with cancer, and the importance of supporting caregivers' coping as a means of supporting the child. Knowledge of these profiles can assist clinicians in better identifying and targeting interventions for children with cancer.
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Affiliation(s)
- Lei Cheng
- School of Nursing, Fudan University, Shanghai, China
| | - Min Wu
- Oncology department, Children's Hospital of Fudan University, Shanghai, China
| | - Ling Yu
- Hematology&Oncology department, Children's Hospital of Fudan University, Shanghai, China
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2
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Liu Y, Li D, Shen N, Zhang W, Zhou F, Yuan C. Patient-Reported Outcomes Measurement Information System Pediatric Symptom Profiles of Children With Cancer in China: A Latent Profile Analysis. Cancer Nurs 2023:00002820-990000000-00182. [PMID: 37903304 DOI: 10.1097/ncc.0000000000001283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
BACKGROUND Unpleasant symptoms are common in children with cancer. However, research identifying subgroups of children with cancer who experience similar levels of self-reported symptoms in China is limited. OBJECTIVES This study aimed to classify the symptom profiles of children with cancer and detect the possible predictors of the profiles and their effect on children's quality of life (QoL). METHODS A total of 272 children aged 8 to 17 years completed the Chinese version of the Pediatric Patient-Reported Outcomes Measurement Information System short form measures, the Pediatric QOL Inventory general core and cancer modules. Latent profile analysis was used to identify symptom profiles, and ordinal logistic regression and analysis of variance were used to examine predictors of symptom profile membership and profile differences on QoL. RESULTS The best fit was a 3-profile model: low, moderate, and severe symptom distress. Children who had been inpatients in the past 7 days and were currently under treatment are more likely to have severe symptoms. Participants in the low symptom distress profile reported significantly greater QoL than those in the other profiles. CONCLUSIONS Children with cancer are heterogeneous in their experience of symptoms. Children's characteristics, such as inpatient history and treatment status, are predictors of profiles; different symptom profiles are associated with QoL. IMPLICATIONS FOR PRACTICE This study identified distinct groups of patients who predictably experience higher symptoms and their predictors, which could help to place children within a profile and perhaps allow nurses to provide targeted supportive care to match children's specific symptom profile.
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Affiliation(s)
- Yanyan Liu
- Author Affiliations: School of Nursing, Shanghai Jiao Tong University (Dr Liu); School of Nursing, Fudan University (Ms Li, and Drs Zhang and Yuan); Nursing Department, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine (Ms Shen); Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine (Ms Zhou), Shanghai, China
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Li R, Shen X, Zhang L, Chan Y, Yao W, Zhang G, Li H. Effects of Child Life intervention on the symptom cluster of pain-anxiety-fatigue-sleep disturbance in children with acute leukemia undergoing chemotherapy. Asia Pac J Oncol Nurs 2023; 10:100243. [PMID: 37435598 PMCID: PMC10331415 DOI: 10.1016/j.apjon.2023.100243] [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: 02/24/2023] [Accepted: 05/09/2023] [Indexed: 07/13/2023] Open
Abstract
Objective This study aims to explore the application effect of Child Life intervention on pain, anxiety, fatigue, and sleep disturbance in children with acute leukemia. Methods In a single-blinded, parallel-group randomized controlled trial, 96 children with acute leukemia were randomized to either the intervention group, which received Child Life intervention twice a week for 8 weeks, or the control group, which received routine care. Outcomes were evaluated at baseline and day 3 postintervention. Results All of the participants completed the study. Compared with the control group, the intervention group showed a significant reduction in pain, anxiety, fatigue, and sleep disturbance (P < 0.001). However, no significant differences were observed in the disorders of excessive somnolence. Conclusions Child Life intervention can effectively improve pain, anxiety, fatigue, and sleep disturbance in children with acute leukemia undergoing chemotherapy. The results suggest that symptom cluster management intervention based on Child Life provided a promising approach for simultaneously treating multiple symptoms within a cluster.
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Affiliation(s)
- Rongrong Li
- School of Nursing, Suzhou Medical College, Soochow University, Suzhou, China
| | - Xinyi Shen
- School of Nursing, Suzhou Medical College, Soochow University, Suzhou, China
| | - Lin Zhang
- School of Nursing, Suzhou Medical College, Soochow University, Suzhou, China
| | - Yuying Chan
- The Union, Children's Hospital of Soochow University, Suzhou, China
| | - Wenying Yao
- Nursing Department, Children's Hospital of Soochow University, Suzhou, China
| | - Guanxun Zhang
- Physical Education Institute, Huaibei Normal University, Huaibei, China
| | - Huiling Li
- School of Nursing, Suzhou Medical College, Soochow University, Suzhou, China
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China
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Identifying the Distinct Profiles of Transition Readiness in Chinese Pediatric Cancer Survivors. Cancer Nurs 2023; 46:189-197. [PMID: 36693220 DOI: 10.1097/ncc.0000000000001195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Transition readiness is important for pediatric cancer survivors who need to move from pediatric to adult medical care. However, their transition readiness profiles merit further exploration. OBJECTIVES The aim of this study was to use a person-centered approach to identify transition readiness profiles of Chinese pediatric cancer survivors aged 12 to 18 years, diagnosed at least 6 months before the study. METHODS Transition readiness was assessed using the Chinese TRANSITION-Q Scale, and latent class analysis was performed to identify the transition readiness profiles as well as demographic and clinical factors associated with profile classification and to examine how self-efficacy and quality of life may differ between these profiles. RESULTS A total of 139 pediatric cancer survivors were included. Three different transition readiness profiles were identified: high transition readiness, medium transition readiness, and low transition readiness. Age, treatment status, and parental working status were significantly associated with the transition readiness profile classifications. Those who were in the low transition readiness profile were likely to have lower self-efficacy and mobility scores than those in the high or medium transition readiness profiles. CONCLUSIONS Three distinct transition readiness profiles existed in a sample of Chinese pediatric cancer survivors, indicating significant heterogeneity in their transition readiness. IMPLICATIONS FOR PRACTICE Knowledge of transition readiness profiles can assist clinicians in screening pediatric cancer survivors for their profile memberships and provide targeted interventions for those with a low transition profile.
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The Therapy-Related Symptom Checklist for Children as a Method for Monitoring Symptoms in Chinese Children With Cancer: Linguistic Validation and Cross-Cultural Adaptation. Pain Manag Nurs 2022; 23:855-860. [PMID: 35115258 DOI: 10.1016/j.pmn.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 12/11/2021] [Accepted: 12/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Children with cancer commonly experience severe symptoms. These may be managed by routine monitoring of their occurrence andseverity using a validated tool. AIM This study aimed to translate and culturally validate a simplified Chinese version of the Therapy-Related Symptom Checklist for Children (TRSC-C). DESIGN Qualitative method. PARTICIPANTS AND SETTING We recruited children with cancer from a pediatric department of a tertiary hospital in Guangzhou, China. METHODS We used forward and backward translation by bilingual translators and standardized cognitive interviewing for linguistic validation and to check cross-cultural adaptation. A panel of experts assessed content validity. RESULTS Agreement was reached on cultural applicability, suitability for intended purpose, and clarification of the pre-test version. The content validity was good (indices ranged from 0.80-0.90). Fifteen Chinese children with cancer (aged 8-18 years) were included in cognitive interviews. The cognitive debriefing showed that the instrument was easy to understand and appropriate for monitoring symptoms in children with cancer. Some words were adjusted following participants' comments. CONCLUSIONS The simplified Chinese version of the TRSC-C was semantically and conceptually equivalent to the original version. Children between 8-18 years old can use this instrument to report symptoms and share their experiences about their disease and treatment.
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Alelayan H, Liang L, Ye R, Aldosari N, Liao X. Translation and linguistic validation of the DISABKIDS chronic generic module into simplified Chinese (DCGM-37) for use among children with cancer. J SPEC PEDIATR NURS 2022; 27:e12374. [PMID: 35415867 DOI: 10.1111/jspn.12374] [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: 02/07/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To develop a simplified Chinese version of the DISABKIDS chronic generic module-37 (DCGM-37), and to test the translated measures in children with cancer by employing a cognitive interviewing technique. DESIGN AND METHODS The English version of DCGM-37 was translated forward and backward into simplified Chinese by bilingual translators, following the guidelines from its copyright holders, which also involved a cultural adaptation component. Twelve Chinese children aged 8-18 years and eight parents were cognitively interviewed. RESULTS The findings support the relevance, comprehensibility, and efficacy of the Chinese version. Consideration was given, and improvements were made, to the language, cultural concerns, and content, which improved functionality and increased validation. The patients/caregivers understood the instructions, questions, and answer choices. Some revisions, however, were made to address patient/caregiver feedback obtained through cognitive interviews. Conceptually and semantically, the simplified Chinese version of the DCGM-37 version was identical to the original. Conclusions The simplified Chinese version of the DCGM-37 was semantically and conceptually equivalent to the English version. Chinese children aged 8 to 18 years were able to comprehend this instrument. CONCLUSIONS The simplified Chinese version of the DCGM-37 was semantically and conceptually equivalent to the English version. Chinese children aged 8 to 18 years were able to comprehend this instrument and express their experiences and feelings about their life. PRACTICE IMPLICATIONS The simplified Chinese version of the DCGM-37 was translated, and cross-cultural adaptation and validation were performed. Chinese children found the tool easy to use and were able to express their experiences and feelings about their health-related quality of life.
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Affiliation(s)
- Hasan Alelayan
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Nursing, Southern Medical University, Guangzhou, China
| | - Lizhu Liang
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Nursing, Southern Medical University, Guangzhou, China
| | - Rui Ye
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China.,School of Nursing, Southern Medical University, Guangzhou, China
| | - Nasser Aldosari
- Division of Nursing, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Xiaoyan Liao
- Nursing Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Zhou H, Yao M, Gu X, Liu M, Zeng R, Li Q, Chen T, He W, Chen X, Yuan G. Application of Patient-Reported Outcome Measurements in Clinical Trials in China. JAMA Netw Open 2022; 5:e2211644. [PMID: 35544134 PMCID: PMC9096600 DOI: 10.1001/jamanetworkopen.2022.11644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Regulatory authorities, industry peers, and international health policies have emphasized the value of assessing patient-reported outcomes (PROs) in clinical studies. Despite the increase in the number of clinical studies in the last decade in China, little is known about the extent of the use of PROs. OBJECTIVE To evaluate the application and characteristics of PRO instruments as primary and secondary outcomes in randomized clinical trials in China. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of interventional clinical trials conducted in China from January 1, 2010, to December 31, 2020, was performed. Data obtained from the Chinese Clinical Trial Registry and ClinicalTrials.gov databases were evaluated. MAIN OUTCOMES AND MEASURES Trials were categorized according to those that (1) precisely listed PRO tools as outcomes, (2) mentioned patient subjective feelings in outcomes but did not clarify which tools were used for assessment, and (3) did not mention any PRO measurements. Data on study phase, setting, participant age, and sex were extracted from trials that considered patient feelings, along with the target diseases and names of the PRO tools. RESULTS Among a total of 34 033 trials, 6915 (20.3%) listed the explicit PRO instruments used and 3178 (9.3%) included PRO in their outcomes but did not include the names of the assessment tools. From more than 32 million people included in the registered trials, data on 1.5 million (4.7%) patients were scientifically collected by PRO instruments, and subjective feelings were assessed for 693 867 (2.1%) participants. Pain (16.8%), cancer (15.6%), and musculoskeletal symptoms (13.3%) were the most common conditions for which PROs were precisely collected by tools. The most common tools for PRO measurements were the visual analog scale, Short-Form 36, and Hamilton Depression Scale. CONCLUSIONS AND RELEVANCE In this cross-sectional study, the use of PROs increased during the study period in clinical trials conducted in China. However, patient opinion appears to still be rarely measured. The application of PRO is geographically unevenly distributed. Development of PRO instruments, especially those suitable for the Chinese population, may be useful. Further expansion of PROs with respect to the scope of diseases is needed to avoid missing important data.
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Affiliation(s)
- Hui Zhou
- Phase I Clinical Trial Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Pharmacy, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mi Yao
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Xiaodan Gu
- Phase I Clinical Trial Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingrui Liu
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China
| | - Ruifeng Zeng
- Phase I Clinical Trial Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qin Li
- Department of Geriatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tingjia Chen
- Healthcare Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wen He
- Department of Geriatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao Chen
- Department of Pharmacy, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Gang Yuan
- Phase I Clinical Trial Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Geriatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Huang L, Zhang J, Duan W, He L. Peer relationship increasing the risk of social media addiction among Chinese adolescents who have negative emotions. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01997-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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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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Zhang W, Stinson J, Huang Q, Makkar M, Wang J, Jibb L, Cheng L, Yuan C. Identification and Characteristics of the Three Subgroups of Pain in Chinese Children and Adolescents with Cancer. J Pediatr Nurs 2021; 59:e13-e19. [PMID: 33752933 DOI: 10.1016/j.pedn.2021.01.015] [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: 09/03/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Pain is a distressing symptom for children and adolescents with cancer and is experienced by individuals differently. This study sought to determine subgroups according to their pain experiences, and how demographic, clinical, and quality of life (QOL)-related characteristics might differ across subgroups. DESIGN AND METHODS This cross-sectional study recruited 187 pediatric patients with cancer aged 8 to 17 years old and asked them to complete measures of pain intensity, pain duration, pain interference and pain control using the Chinese translation of the validated questionnaire from the Pain Squad app, as well as 7 PROMIS measures assessing QOL-related outcomes. Latent profile analysis (LPA) was used to identify latent subgroups. RESULTS Three subgroups of children were identified: low-pain/low-duration (69.5%), moderate-pain/high-duration (19.8%), and high-pain/moderate-duration (10.7%). Hospitalized children were more likely to be in the moderate-pain/high-duration subgroup. Children in the high-pain/moderate-duration subgroup were more likely to be cared for by unemployed caregivers. Scores on depressive symptoms (p = 0.002), anger (p < 0.001), anxiety (p = 0.045), fatigue (p = 0.044), and mobility (p = 0.008) questionnaire were significantly worse in the high-pain/moderate-duration subgroup than the other two subgroup. PRACTICE IMPLICATIONS This study provides a scientific foundation for further studies exploring predictive factors related to pain experiences. More targeted treatment strategies targeting the specific characteristics of each subgroup will help improve patients' QOL and use of medical resources. CONCLUSIONS The 3 identified pain subgroups demonstrate the heterogeneity in pain experiences among pediatric patients with cancer. Knowledge of these subgroups can assist clinicians in better identifying and targeting pain treatment for children with cancer.
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Affiliation(s)
- Wen Zhang
- School of Nursing, Fudan University, Shanghai, China
| | - Jennifer Stinson
- Child Health Evaluation Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Qingmei Huang
- School of Nursing, Fudan University, Shanghai, China
| | - Mallika Makkar
- Child Health Evaluation Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jiashu Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Lindsay Jibb
- Child Health Evaluation Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Lei Cheng
- School of Nursing, Fudan University, Shanghai, China
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Pain Reported by Chinese Children During Cancer Treatment: Prevalence, Intensity, Interference, and Management. Cancer Nurs 2021; 45:E345-E354. [PMID: 34010216 DOI: 10.1097/ncc.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pain is a frequently reported and distressing symptoms during cancer treatment. However, there is limited evidence on pain reported by Chinese children with cancer. OBJECTIVES This study aimed to investigate the prevalence, intensity, interference, and management of pain reported by Chinese children during cancer treatment and explore the predictors of pain interference. METHODS We conducted a cross-sectional survey to investigate the pain intensity, pain interference, co-occurring symptoms (anger, anxiety, depression, fatigue), and pain management strategies reported by children 8 years and older undergoing active cancer treatment in 4 Chinese hospitals. RESULTS Data were analyzed for 187 children. The prevalence of moderate to severe pain (≥4/10) was 38.50%, with an average pain interference score of 52.97 out of 100. Approximately 24% of children were prescribed pain medicine. Pain interference and pain intensity were marginally correlated (r = 0.047, P < .01) and were both positively correlated with pain duration and co-occurring symptoms and negatively correlated with perceived pain alleviation (all P < .01). Multiple regression analyses suggested that severe pain intensity (B = 2.028, P = .003) and fatigue (B = 0.440, P < .001) significantly predicted higher levels of pain interference (R2 = 0.547, F = 23.102, P < .001). CONCLUSION Chinese children with cancer reported a low pain intensity score but a relatively high level of pain interference. According to the children's reports, pain has not been sufficiently addressed through Chinese pediatric oncology supportive care. IMPLICATIONS FOR PRACTICE There is an urgent requirement for comprehensive pain assessment and standardized, targeted interventions in Chinese pediatric oncology pain management.
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Chan SWW, Chien CW, Wong AYL, Pang MYC. Translation and psychometric validation of the traditional Chinese version of patient-reported outcomes measurement information system Pediatric-25 Profile version 2.0 (PROMIS-25) in Chinese Children with Cancer in Hong Kong. Qual Life Res 2021; 30:1779-1791. [PMID: 33770335 DOI: 10.1007/s11136-021-02759-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To translate and cross-cultural validate the PROMIS Pediatric-25 Profile 2.0 (PROMIS-25) into traditional Chinese, and to investigate its psychometric properties in children with cancer in Hong Kong. METHODS The Functional Assessment of Chronic Illness Therapy translation methodology was adopted in this study. Three panel members evaluated the semantic equivalence and content validity. The psychometric properties were tested with 103 children with cancer (10-18 years). Internal consistency and structural validity were examined by Cronbach's alpha and Rasch analysis. Convergent and divergent validity were assessed by correlating it with traditional Chinese pediatric quality of life inventory™ 4.0 domains (traditional Chinese PedsQL™ 4.0), traditional Chinese Health Questionnaire-9 (C-PHQ-9), and the numeric pain rating scale (NPRS). RESULTS The semantic equivalence score and content validity index were both 100%. All domains indicated good internal consistency (α = 0.83-0.88) and unidimensionality (variance explained > 55.5% and 1st contrast eigenvalues < 2.0). All items showed good item fit (0.6-1.4). For convergent validity, the traditional Chinese PROMIS-25 domains demonstrated moderate-to-large correlations with traditional Chinese PedsQL™ 4.0 domains (r ≥ ± 0.69), C-PHQ-9 Item-4 and total score (r = 0.75-0.80), except NPRS (r = 0.44). For divergent validity, traditional Chinese PROMIS-25 had low correlations with traditional Chinese PedsQL™ 4.0 domains (r < ± 0.21), C-PHQ-9 item-4 (r = 0.3), and NPRS (r = - 0.12). The traditional Chinese PROMIS-25 fatigue domain was weakly correlated with NPRS (r = 0.39). CONCLUSION The traditional Chinese PROMIS-25 is semantically and conceptually like the original PROMIS-25 with satisfactory internal consistency, structural validity, and construct validity.
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Affiliation(s)
- Stephen W W Chan
- Allied Health Department (Physiotherapy), Hong Kong Children's Hospital, HKSAR, China.,Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, HKSAR, China
| | - C W Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, HKSAR, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, HKSAR, China.
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, HKSAR, China
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Cheng L, Wang Y, Duan M, Wang J, Wang Y, Huang H, Yuan C. Self-Reported Fatigue in Chinese Children and Adolescents During Cancer Treatment. J Pediatr Oncol Nurs 2021; 38:262-270. [PMID: 33686896 DOI: 10.1177/1043454221992304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Fatigue is a prevalent and distressing symptom in children and adolescents with cancer. Objectives: This study aimed to (1) investigate the current fatigue status reported by Chinese children and adolescents with cancer during active cancer treatment and (2) examine whether sociodemographic information, disease and treatment information, co-occurring symptoms, function and related clinical data are significantly associated with fatigue according to the biopsychosocial model. Methods: Participants were children aged 8-17 years, who had undergone treatment for cancer at four hospitals in China. Children completed the Chinese version of the Pediatric Patient-Reported Outcomes Measurement Information System short forms. Results: In total, 187 children (33.16% female, mean age 10.28 years) participated. The mean T-score for child-reported fatigue was 48.52 (34-72). Multiple linear regression analysis showed that fatigue in pediatric active cancer treatment could be significantly predicted by greater child-reported pain interference (β = 0.391, p < .001), greater depressive symptoms (β = 0.443, p < .001), and reduced mobility (β = -0.226, p = .004) (adjusted R2 = 0.613, F = 16.476, p < .001). Conclusions: Children and adolescents with cancer experience multiple, intersecting troubling symptoms during their treatment. There is a need to attend to the biopsychosocial aspects of care for children and adolescents during active cancer treatment. To reduce pediatric oncology patients' fatigue level, clinicians could develop culturally sensitive interventions to alleviate children's pain interference, treat depressive symptoms, and maximize their physical mobility.
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Affiliation(s)
- Lei Cheng
- School of Nursing, 12478Fudan University, Shanghai, China
| | - Yingwen Wang
- Hemotology & Oncology Unit, Children's Hospital of Fudan University, Shanghai, China
| | - Mingxia Duan
- Hemotology & Oncology Unit, Anhui Provincial Children's Hospital, Anhui, China
| | - Jiashu Wang
- School of Nursing, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yanqing Wang
- School of Medicine, Children's Hospital of Zhejiang University, Zhejiang, China
| | - Haiying Huang
- Hemotology & Oncology Unit, Guangzhou Women and Children's Medical Center, Guangdong, China
| | - Changrong Yuan
- School of Nursing, 12478Fudan University, Shanghai, China
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Associations between Self-Determined Motivation, Accelerometer-Determined Physical Activity, and Quality of Life in Chinese College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162941. [PMID: 31426280 PMCID: PMC6719152 DOI: 10.3390/ijerph16162941] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 01/05/2023]
Abstract
Purpose: To better promote college students’ physical activity (PA) and quality of life (QoL), it is imperative to understand this population’s PA correlates, such as self-determined motivation and perceived competence. However, few studies existed in this area of inquiry among Chinese college students. Thus, the purpose of this study was to examine the relationships among Chinese college students’ self-determined motivation, PA, and QoL. Method: A total of 220 college students (115 females; Mage = 20.29 years, SD = 2.37; MBMI = 20.67) were recruited from one university in south-central China. Participants were instructed to wear the ActiGraph GT9X Link (ActiGraph, Pensacola, FL, USA) accelerometers for 7 days. A minute-by-minute stepping rate methodology was used to determine participants sedentary behaviors, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Participants’ self-determined motivation (autonomous, controlled, and amotivation), perceived competence, and QoL (physical function, stress, depression, fatigue, sleep, and social issues) were assessed by a battery of validated surveys in June 2017. Results: Participants reported moderate–high levels of PA correlates and QoL as the means ranged from 5.5 to 6 (out of 7) for PA correlates and 2.75 to 4 (out of 4) for QoL. The minute-by-minute stepping rate revealed participants had average 580.51 min/day in sedentary, 134.77 min/day in LPA, and 1.57 min/day in MVPA. Regression analyses for physical function, stress, depression, and social issues suggested that the models explained 4%–8% of the variances. Specifically, perceived competence was the negative predictor of the problems with physical function (β = −0.17, p < 0.05) and depression (β = −0.18, p < 0.01), amotivation was positively associated with depression and stress (p < 0.05). Additionally, controlled motivation predicted the ability to participate in social roles and activities (β = 0.22, p < 0.05). No significant predictors emerged for fatigue or for sleep. Conclusions: Findings suggest Chinese college students’ perceived competence and social support are critical for improving PA and QoL. In addition, strategies are needed to motivate Chinese college students to engage in PA participation and improve overall well-being.
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