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Holmen H, Winger A, Steindal SA, Riiser K, Castor C, Kvarme LG, Mariussen KL, Lee A. Patient-reported outcome measures in children, adolescents, and young adults with palliative care needs-a scoping review. BMC Palliat Care 2023; 22:148. [PMID: 37798706 PMCID: PMC10557323 DOI: 10.1186/s12904-023-01271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Measuring outcomes facilitates evaluation of palliative services for children, adolescents, and young adults (CAYAs) with life-limiting and/or life-threatening (LL/LT) conditions. Implementation of patient-reported, proxy-reported, or patient-centered outcome measures (hereafter PROMs) is recommended to ensure palliative services. The purpose of this scoping review was to provide an overview of PROMs relevant for CAYAs living with LL/LT conditions eligible for pediatric palliative care (PPC). METHODS Arksey and O'Malley's 6-stage scoping review framework was used to guide the review. The identified citations had to report on PROMs in any context including CAYAs with LL/LT conditions up to 25 years of age. A systematic search of Medline, EMBASE, CINAHL, APA PsycInfo, Health and Psychosocial Instruments, and AMED took place in January 2021 and was updated in June 2022. Citations were screened independently by pairs of researchers. The scoping review protocol was registered, and peer-review published. RESULTS Of 3690 identified citations, 98 reports were included, of which the majority were from Western countries and about PROMs in CAYAs living with cancer or organ failure. A total of 80 PROMs were identified, assessing a range of phenomena, where quality of life and symptoms (especially pain) during the stage of ongoing care were the most frequent. There were only a few reports about outcome measures at time of diagnosis or in end-of-life care. CAYAs self-reported on the PROMs or collaborated with their parents in about half of the reports, while the remaining had proxies answering on behalf of the CAYAs. In the identified reports, PROMs were used to characterize a sample through cross-sectional or longitudinal research, and less often to assess effects of interventions. CONCLUSION The identified PROMs in the CAYA population eligible for PPC is characterized by studies in high-income countries during ongoing care, primarily in patients with cancer or organ failure. More research is needed in patients living with other LL/LT conditions, and during different stages of the disease course, especially at time of diagnosis, during transition to adulthood, and in end-of-life care. This scoping review of PROMs relevant for young patients eligible for PPC may inform future research about patient-/proxy-reported or patient-centered outcome measures in PPC. TRIAL REGISTRATION Review registration: ( https://osf.io/yfch2/ ) and published protocol (Holmen et al. Syst Rev. 10:237, 2021).
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway.
| | - Anette Winger
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt, 15B, 0456, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Kirsti Riiser
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Charlotte Castor
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Kari L Mariussen
- Lovisenberg Diaconal University College, Lovisenberggt, 15B, 0456, Oslo, Norway
| | - Anja Lee
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital HF, Nydalen, Box 4950, 0424, Oslo, Norway
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Zang W, Fang M, Chen H, Huang X, Li D, Yan J, Shu H, Zhao M. Effect of concurrent training on physical performance and quality of life in children with malignancy: A systematic review and meta-analysis. Front Public Health 2023; 11:1127255. [PMID: 37006540 PMCID: PMC10063894 DOI: 10.3389/fpubh.2023.1127255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
ObjectiveThis study aims to evaluate the intervention effect of concurrent training on children with malignant tumors to provide evidence for prescribing exercise for children with malignant tumors.MethodsTwelve databases were searched from inception to October 15, 2022. Two researchers independently screened the literature, evaluated the quality, extracted the data, and performed the meta-analysis using R.ResultA total of nine randomized controlled trials involving 371 children were included in this study. The meta-analysis revealed that muscle strength was significantly greater in the exercise group compared to the usual care group [SMD = 0.26, 95% CI (0.04, 0.48), P = 0.023], with subgroup analysis showing no significant difference in upper limb [SMD = 0.13, 95% CI (−0.17, 0.43), P = 0.318] and a considerable difference in lower limb strength [SMD = 0.41, 95% CI (0.08, 0.74), P = 0.015]. Physical activity [SMD = 0.57, 95% CI (0.03, 1.1), P = 0.038], timed up and down stairs test [SMD = −1.22, 95% CI (−2.04, −0.4), P = 0.004], 6-min walking ability [SMD = 0.75, 95% CI (0.38, 1.11), P < 0.01], quality of life [SMD = 0.28, 95% CI (0.02, 0.53), P = 0.033], and cancer-related fatigue [SMD = −0.53, 95% CI (−0.86, −0.19), P = 0.002] were significantly better than the usual care group. There were no significant differences in peak oxygen uptake [SMD = 0.13, 95% CI (−0.18, 0.44), P = 0.397], depression [SMD = 0.06, 95% CI (−0.38, 0.5), P = 0.791], and withdrawal rates [RR = 0.59, 95% CI (0.21, 1.63), P = 0.308] between the two groups.ConclusionConcurrent training could improve physical performance for children with malignancy but had no significant effect on mental health. Because the quality level of evidence is mostly very low, future high-quality randomized controlled trials are required to confirm these findings.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=364140, identifier CRD42022308176.
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Affiliation(s)
- Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Mingqing Fang
- Xiangya Hospital, Central South University, Changsha, China
| | - Haohao Chen
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Xinmeng Huang
- Norman Bethune Health Science Center, Jilin University, Changchun, China
| | - Dong Li
- Department of International Culture Education, Chodang University, Muan-gun, Republic of Korea
| | - Jin Yan
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
- College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
| | - Heng Shu
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Mingyuan Zhao
- Winter Olympic School, Harbin Sport University, Harbin, China
- *Correspondence: Mingyuan Zhao
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3
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Clews C, Davis C, Loades M, Jordan A. Parental Experiences of Adolescent Cancer-Related Pain: A Qualitative Study. J Pediatr Psychol 2022; 47:1071-1080. [PMID: 35595307 PMCID: PMC9487609 DOI: 10.1093/jpepsy/jsac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Despite advancing medical treatments, pain remains a significant outcome of adolescent cancer, as both a problematic and distressing symptom. With adolescents spending substantial periods of time at home during cancer treatment, parents perceive themselves as central to the experience and management of adolescents’ pain. The present study aimed to explore parental experiences of adolescent cancer-related pain during, and recently after, completing cancer treatment. Methods We interviewed 21 parents of adolescents (aged 12–18 years) with cancer, recruited through a hospital in South West England. Interviews were analyzed using reflexive inductive thematic analysis. Results Two themes were generated. The first theme, “Parental perceptions of being at the heart of pain management,” focused on the role of parents in adolescents’ pain journeys, and the vast knowledge they gained. The second, “Adapting and readjusting expectations,” captured parents’ journeys in learning to adjust their lives according to adolescents’ pain and difficulties they faced throughout this process. Conclusions Findings highlighted parents’ crucial role throughout adolescents’ pain experiences; learning how to manage adolescents’ pain, and supporting them with the detrimental impact on their lives. The findings emphasize the importance of a multidisciplinary approach to supporting families to manage pain. They also indicate a need for targeted research studies investigating parental experiences of adolescent cancer-related pain. This will help professionals understand how best to support parents and adolescents throughout the cancer journey and ultimately improve the physical and psychological outcomes of young people in the longer term.
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Affiliation(s)
| | - Cara Davis
- Department of Psychology, University of Bath, UK
| | - Maria Loades
- Department of Psychology, University of Bath, UK.,Bristol Medical School, University of Bristol, UK
| | - Abbie Jordan
- Department of Psychology, University of Bath, UK.,Centre for Pain Research, University of Bath, UK
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Walker H, Miller MC, Cowfer B, Akard T, Gilmer MJ. The effects of animal-assisted interactions on quality of life in children with life-threatening conditions and their parents. Int J Palliat Nurs 2021; 27:524-530. [PMID: 34919414 DOI: 10.12968/ijpn.2021.27.10.524] [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: 11/11/2022]
Abstract
BACKGROUND Children with advanced cancer and their primary caregivers may experience severe stress and anxiety in coping with their life-threatening condition. As a way to help reduce these stressors and increase overall quality of life, research suggests that animal-assisted interactions may be beneficial when integrated into palliative care. AIMS This pilot study aims to provide evidence for the feasibility and efficacy of a randomised clinical trial using animal-assisted interactions to help improve the quality of life for children with an advanced life-threatening condition and their primary caregivers. This protocol paper outlines the basis of the research, goals, experimental design and methodology.
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Affiliation(s)
- Haley Walker
- Research Assistant at Monroe Carell Junior Children's Hospital at Vanderbilt
| | - Mary Chapman Miller
- Research Assistant at Monroe Carell Junior Children's Hospital at Vanderbilt
| | - Brittany Cowfer
- Paediatric Haematology-Oncology Fellow, Monroe Carell Junior Children's Hospital at Vanderbilt
| | - Terrah Akard
- Associate Professor, Director of PhD programme, Co-Director of Paediatric Palliative Care Research Team, Vanderbilt University School of Nursing
| | - Mary Jo Gilmer
- Professor and Co-Director of Paediatric Palliative Care Research Team, Vanderbilt University School of Nursing
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Ospina PA, McComb A, Pritchard-Wiart LE, Eisenstat DD, McNeely ML. Physical therapy interventions, other than general physical exercise interventions, in children and adolescents before, during and following treatment for cancer. Cochrane Database Syst Rev 2021; 8:CD012924. [PMID: 34343340 PMCID: PMC8407387 DOI: 10.1002/14651858.cd012924.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Children and adolescents diagnosed with cancer are at high risk of experiencing severe side effects from cancer treatment, many of which are amenable to physical therapy. These side effects can negatively impact a child's quality of life and ability to participate in daily activities (e.g. play and attendance at school). Researchers have evaluated physical therapy interventions in children with cancer and childhood cancer survivors. However, factors such as small sample sizes, varying intervention protocols and differences in cancer types among trials make it difficult to draw conclusions about efficacy. OBJECTIVES The primary aim of this review was to evaluate the efficacy of physical therapy interventions - with a specific focus on symptom relief and compensation of therapy-related side effects - on the quality of life of children and adolescents diagnosed with cancer. Participants must be between the ages of 0 and 19 years at the time of the physical therapy intervention study. The intervention may occur prior to, during or following cancer treatment. The intervention must be compared to a control group of children receiving standard care, no physical therapy intervention or a comparison intervention. We have excluded general physical exercise studies where the primary aim was to improve physical fitness through aerobic, anaerobic, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens). We have also intended to record the occurrence of any adverse effects resulting from physical therapy interventions. The secondary aims were to evaluate the efficacy of physical therapy on impairments of pain, peripheral neuropathy, balance, gait, functional abilities and mobility, motor function and performance, range of motion, strength and fatigue. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PEDro, ongoing trial registries, conference proceedings and the reference lists of relevant studies and reviews in March 2020. We also contacted oncology rehabilitation researchers working in paediatrics in March 2020 to identify additional studies. SELECTION CRITERIA The review included randomised controlled trials (RCTs), cross-over trials, and controlled clinical trials (CCTs) that compared the effects of physical therapy interventions to a control group, and involved children and adolescents diagnosed with cancer between the ages of 0 and 19 years at the time of the intervention. We excluded studies examining general physical exercise interventions where the primary aim was to improve physical fitness through aerobic exercise, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens). DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We found no RCTs, cross-over trials or CCTs comparing the effects of physical therapy interventions with a focus on symptom relief and compensation of therapy-related side effects for children and adolescents between the ages of 0 and 19 years. AUTHORS' CONCLUSIONS Results demonstrate that the evidence to date is inadequate to inform clinical practice. Recommendations for future research include the need for large-scale, high-quality designs that examine: (1) paediatric populations with same cancer types; (2) similar intervention protocols; (3) long-term outcomes; (4) physical therapy interventions (e.g. electrophysical modalities and sensory interventions); and (5) outcomes commonly impaired in children with cancer (e.g. peripheral neuropathy and gait deficits).
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Affiliation(s)
- Paula A Ospina
- Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Alyssa McComb
- Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | | | - Margaret L McNeely
- Department of Physical Therapy/ Department of Oncology, University of Alberta, Edmonton, Canada
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Leahy AB, Schwartz LA, Li Y, Reeve BB, Bekelman JE, Aplenc R, Basch EM. Electronic symptom monitoring in pediatric patients hospitalized for chemotherapy. Cancer 2021; 127:2980-2989. [PMID: 33945640 DOI: 10.1002/cncr.33617] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Using patient-reported outcomes for symptom monitoring in oncology has resulted in significant benefits for adult patients with cancer. The feasibility of this approach has not been established in the routine care of children with cancer. METHODS The Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE) is an item library that enables children and caregivers to self-report symptoms. Ten symptom items from the Ped-PRO-CTCAE were uploaded to an online platform. Patients at least 7 years old and their caregivers were prompted by text/email message to electronically self-report daily during a planned hospitalization for chemotherapy administration. Symptom reports were emailed to the clinical team caring for the patient, but no instructions were given regarding the use of this information. Rates of patient participation and clinician responses to reports were systematically tracked. RESULTS The median age of the participating patients (n = 52) was 11 years (range, 7-18 years). All patients and caregivers completed an initial login, with 92% of dyads completing at least 1 additional symptom assessment during hospitalization (median, 3 assessments; range, 0-40). Eighty-one percent of participating dyads submitted symptom reports on at least half of hospital days, and 54% submitted reports on all hospital days. Clinical actions were taken in response to symptom reports 21% of the time. Most patients felt that the system was easy (73%) and important (79%). Most clinicians found symptom reports easy to understand and useful (97%). CONCLUSIONS Symptom monitoring using patient-reported outcome measures for hospitalized pediatric oncology patients is feasible and generates data valued by clinicians and patients.
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Affiliation(s)
- Allison Barz Leahy
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Penn Center for Cancer Care Innovation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lisa A Schwartz
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Yimei Li
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Justin E Bekelman
- Penn Center for Cancer Care Innovation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Richard Aplenc
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ethan M Basch
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
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7
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Abstract
BACKGROUND Children with advanced cancer experience symptoms despite access to quality care. Symptom research has previously relied upon retrospective designs and parent proxy rather than prospective measurement with self-report. OBJECTIVE This study evaluated the feasibility of electronic data collection in children with advanced cancer using self-report of symptom frequency, severity, and distress. METHODS A multisite prospective cohort design was used for this study. Children who were 7 to 18 years of age and English-speaking and had a diagnosis of advanced cancer were included. Symptom frequency, severity, and level of distress were measured every 2 weeks. RESULTS Forty-six children completed 563 of 622 (91%) administered electronic symptom assessments. Pain, fatigue, nausea, and sleeping difficulties were the most reported symptoms across all assessments and during the last 12 weeks of life. Symptoms with the highest composite scores included pain, fatigue, nausea, and sleeping difficulties. During the last 12 weeks of life, pain, fatigue, diarrhea, and sleeping difficulties had the highest composite scores. When the domains of frequency, severity, and distress were compared between groups, children reported significantly higher frequency of pain and eating difficulty during the last 12 weeks of life. CONCLUSIONS Electronic data collection is a feasible way to evaluate the constellation of symptoms. Children with advanced cancer continue to experience physical and psychological symptoms, especially during the last 12 weeks of life despite quality care. IMPLICATIONS FOR PRACTICE Assessment of symptom domains, including frequency, severity, and distress when symptoms are present may allow clinicians to better understand and manage symptoms of most concern to the patient.
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8
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Cheng KKF, Tan LML. A pilot study of the effect of a home-based multimodal symptom-management program in children and adolescents undergoing chemotherapy. Cancer Rep (Hoboken) 2021; 4:e1336. [PMID: 33586920 PMCID: PMC8222554 DOI: 10.1002/cnr2.1336] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/28/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Prevalent symptoms that affect children and adolescents throughout the process of cancer diagnosis and treatment include nausea and vomiting, fatigue, pain, mucositis, and anxiety. Aim To examine the effect of a home‐based multimodal symptom‐management program for alleviation of nausea and vomiting, fatigue, pain, mucositis, and anxiety in children and adolescents undergoing chemotherapy for hematological malignancies or solid tumors. Methods In an exploratory pilot randomized study with qualitative interview, patients between 10 and 18 years of age were randomly assigned to either the symptom‐management program plus usual care (intervention group) or usual care (control group). The program consisted of multiple nonpharmacological interventional components. The targeted symptoms were measured at baseline (after diagnosis), at the first 2 weeks of each cycle of chemotherapy, and at 6 months after baseline, using the Memorial Symptom Assessment Scale 10‐18 and the State Anxiety Scale for Children. Results Fifty children (31 boys; mean age, 13.7 years) were randomized either to the intervention group or the control group (25 each) and underwent baseline assessment. A comparison between the groups showed that the intervention group had a significant less fatigue over time (P < .05). However, no differences were found with respect to nausea and vomiting, pain, mucositis, and anxiety between groups. Both children and parents reported a positive experience with the symptom‐management program. Conclusion The home‐based symptom‐management program may have helped to reduce fatigue in children and adolescents undergoing chemotherapy. In addition, qualitative data support the importance of improving children and parents' knowledge, coping skills, and psychological preparation for symptoms associated with chemotherapy.
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Affiliation(s)
- Karis Kin-Fong Cheng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Laura Mei Lian Tan
- Paediatric Oncology, Department of Paediatrics, Khoo Teck Puat National University Children's Medical Institute, Singapore, Singapore
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9
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Rostagno E, Bergadano A, Piredda M, De Marinis MG. Italian nurses knowledge and attitudes towards fatigue in pediatric onco-hematology: A cross-sectional nationwide survey. Int J Pediatr Adolesc Med 2020; 7:161-165. [PMID: 33319013 PMCID: PMC7729244 DOI: 10.1016/j.ijpam.2020.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/28/2020] [Indexed: 12/17/2022]
Abstract
Background and Objective Fatigue is one of the most debilitating and prevalent symptoms in pediatric cancer patients and it is important to know if nurses are able to recognize and manage it. The aim of this study was to investigate the knowledge and attitudes towards fatigue of nurses working in Italian pediatric onco-hematology centers. Methods Cross-sectional online survey. An existing questionnaire was adapted to the Italian context, extended with a section on attitudes, and psychometrically tested. The questionnaire was sent to all nurses working in Italian pediatric onco-hematology centers. Results Respondents (n = 189), who were working in 37/53 (∼70%) centers, reported 42% of children and 68% of adolescents experiencing fatigue, with intensity increasing with age. Contributing factors were treatments and co-morbidities; frequent symptoms were mood changes and lack of energy. Among respondents who did not assess fatigue, 36.2% did not know an appropriate tool. Nurses recognized fatigue as an important problem and their knowledge and attitudes towards fatigue seemed satisfactory. Conclusion This study provides nurses with an instrument to investigate their knowledge and attitudes about fatigue. Nurses' awareness of the significance of fatigue is a fundamental step towards improving its management and offering strategies that can help both the child and their family.
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Affiliation(s)
- Elena Rostagno
- Pediatric Oncology and Hematology Unit, S.Orsola-Malpighi Hospital, Via Massarenti, 40138, Bologna, Italy
| | - Anna Bergadano
- Pediatric Onco-Hematology Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Piazza Polonia, 94 - 10100, Torino, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 21 - 00128, Roma, Italy
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 21 - 00128, Roma, Italy
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Simon JDHP, Van Loon FRAA, Van Amstel J, Elmont GS, Zwaan CM, Fiocco M, Schepers SA, Tissing WJE, Michiels EMC. Pain at home during childhood cancer treatment: Severity, prevalence, analgesic use, and interference with daily life. Pediatr Blood Cancer 2020; 67:e28699. [PMID: 32926551 DOI: 10.1002/pbc.28699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pain is a common symptom in childhood cancer. Since children spend more time at home, families are increasingly responsible for pain management. This study aimed at assessing pain at home. PROCEDURE In this longitudinal observational study (April 2016-January 2017), pain severity and prevalence, analgesic use, and pain interference with daily life (Brief Pain Inventory Short Form) were assessed for 4 consecutive days around the time of multiple chemotherapy appointments. Descriptive statistics (frequencies and percentages) were used to report pain severity (with clinically significant pain defined as: score ≥ 4 on "worst pain" or "average pain in the last 24 h"), pain prevalence, and analgesic use. Mixed models were estimated to assess whether patient characteristics were associated with pain severity, and whether pain severity was associated with interference with daily life. RESULTS Seventy-three children (50.7% male) participated (1-18 years). A majority (N = 57, 78%) experienced clinically significant pain at least once, and 30% reported clinically significant pain at least half the time. In 33.6% of scores ≥ 4, no medication was used. We found an association between pain severity and interference with daily life: the higher the pain, the bigger the interference (estimated regression coefficient = 1.01 [95% CI 0.98-1.13]). CONCLUSIONS The majority of children experienced clinically significant pain at home, and families frequently indicated no medication use. A stronger focus on education and coaching of families seems essential, as well as routine screening for pain in the home setting.
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Affiliation(s)
- Julia D H P Simon
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Femke R A A Van Loon
- Erasmus Medical Center, Department of Pediatric Oncology, Rotterdam, The Netherlands
| | - Juul Van Amstel
- Erasmus Medical Center, Department of Pediatric Oncology, Rotterdam, The Netherlands
| | - Gina S Elmont
- Erasmus Medical Center, Department of Pediatric Oncology, Rotterdam, The Netherlands
| | - C Michel Zwaan
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Erasmus Medical Center, Department of Pediatric Oncology, Rotterdam, The Netherlands
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Mathematical Institute, Leiden University, Leiden, The Netherlands
| | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Erna M C Michiels
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Erasmus Medical Center, Department of Pediatric Oncology, Rotterdam, The Netherlands
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11
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Parker R, Wiseman T, Twycross A, McKeever S. Manifestation and parental assessment of children's cancer pain at home: An exploratory mixed-methods study. J Clin Nurs 2020; 29:4128-4147. [PMID: 32767621 DOI: 10.1111/jocn.15442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 12/17/2022]
Abstract
AIMS AND OBJECTIVES To describe pain manifestation in children with cancer at home and understand how parents assess this pain. BACKGROUND Pain is experienced by children with cancer throughout their cancer journey. Short-term, and into survivorship, pain has negative physical and psychological consequences. Changes in treatment location mean children with cancer spend more time at home. Little is known about pain experienced by children at home or how parents assess this pain. DESIGN A mixed-methods convergent parallel study was reported using STROBE. METHOD Parents of children with cancer on active treatment were recruited from one tertiary cancer centre. Parental attitudes towards pain expression were assessed using surveys. Parents recorded their child's pain manifestation in pain diaries kept for one month. Interviews captured a deeper understanding of pain manifestation and how parents assess this pain at home. Integration occurred after each data collection method was analysed separately. RESULTS Predominantly children were not in pain at home. However, most children experienced at least one episode of problematic pain over the pain diary period. Surveys showed parents held misconceptions regarding children's pain expression. Interviews diverge from surveys and suggest parents used a range of information sources to assess pain. CONCLUSION Children with cancer may differ from one another in the manifestation of pain at home resulting in multiple pain trajectories. Parents of children with cancer are able to adequately assess their child's pain using information from multiple sources. RELEVANCE TO CLINICAL PRACTICE It is not currently possible to predict which children will experience problematic pain at home, so all parents require pain management education prior to discharge. Teaching parents to use bundled approaches to pain assessment may accelerate their learning. Healthcare professionals may benefit from using multiple information sources to assess pain.
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Affiliation(s)
- Roses Parker
- School of Health and Social Care, London South Bank University, London, UK
| | - Theresa Wiseman
- The Royal Marsden NHS Foundation Trust, London, UK.,Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Stephen McKeever
- Faculty of Health, Social Care and Education, Kingston University and St George's, University London, London, UK
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12
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Ospina PA, Wiart L, Eisenstat DD, McNeely ML. Physical Rehabilitation Practices for Children and Adolescents with Cancer in Canada. Physiother Can 2020; 72:207-216. [PMID: 32494104 DOI: 10.3138/ptc-2018-0077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Children and adolescents with cancer who undergo cancer treatment are at high risk of developing adverse effects, many of which may be amenable to physical rehabilitation. We aimed to identify the current clinical physical rehabilitation practice patterns, services, and programmes available for children and adolescents with cancer in Canada. Method: A cross-sectional survey in English and French was conducted. Participants were health care professionals (HCPs) who provided physical rehabilitation services to children and adolescents with cancer in Canada. The survey included questions on the HCPs' practice patterns and the programmes and services they provided. Results: A total of 35 HCPs responded: 27 physical therapists (77%), 6 occupational therapists (17%), 1 exercise professional (3%), and 1 speech-language pathologist (3%). Overall, they reported activity limitations, alterations in motor performance, muscle weakness, peripheral neuropathy, and fatigue as the top priorities for rehabilitation services. HCPs believed that interventions were valuable in reducing the burden of cancer effects; however, issues such as space, resources, and lack of clinical practice guidelines were viewed as barriers to providing services. Conclusions: Paediatric oncology rehabilitation services exist in some regions in Canada. HCPs strongly support the need to develop clinical practice guidelines for paediatric oncology rehabilitation.
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Affiliation(s)
- Paula A Ospina
- Department of Physical Therapy, Faculty of Rehabilitation Medicine
| | - Lesley Wiart
- Department of Physical Therapy, Faculty of Rehabilitation Medicine
| | - David D Eisenstat
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta.,Department of Oncology, Cross Cancer Institute, Edmonton, Alta
| | - Margaret L McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine.,Department of Oncology, Cross Cancer Institute, Edmonton, Alta
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Quality of Life and Pain Experienced by Children and Adolescents With Cancer at Home Following Discharge From the Hospital. J Pediatr Hematol Oncol 2020; 42:46-52. [PMID: 31725538 PMCID: PMC6920561 DOI: 10.1097/mph.0000000000001605] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
An exploratory study was conducted to examine the quality of life and pain experienced by patients with pediatric cancer at home after discharge. Physical, cognitive, social, and emotional aspects of quality of life were measured and how these may be affected by age, sex, diagnosis, and pain status. The authors also characterized intensity, location, and quality of pain experienced. A sample of 33 patients participating in a larger study was selected on the basis of having pain on the day of discharge and having completed the Pediatric Quality of Life Inventory Generic, Cancer Module, Multidimensional Fatigue Scale, and the Adolescent Pediatric Pain Tool at home. Cancer diagnoses were leukemias/lymphomas (42.4%), brain/central nervous system tumors (27.3%), sarcomas (24.2%), or other (6.1%). More than half of patients reported pain (n=17; 51.5%). Patients with pain had more fatigue affecting the quality of life (P=0.01), and lower physical and emotional functioning, leading to lower overall health-related quality of life scores (P=0.011). Female individuals and adolescents reported worse emotional functioning (P=0.02 and P=0.05, respectively). Physical, cognitive, and social functioning were lowest among patients diagnosed with sarcomas (P=0.00, P=0.01, and P=0.04, respectively). It is important to understand the symptom experience of patients at home as a first step in moving towards optimal discharge teaching and treatment.
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14
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Kudubes AA, Bektas M, Mutafoğlu K. The Effect of Fatigue-Related Education on Pediatric Oncology Patients' Fatigue and Quality of Life. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1130-1141. [PMID: 30132265 DOI: 10.1007/s13187-018-1419-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The identification of cancer-related fatigue as a clinical problem in pediatric oncology is an important phenomenon, and there are limited number of studies about raising the awareness of pediatric oncology patients and their parents. Fatigue-related education for patients and their parents before and during cancer treatment reduces the fatigue levels of patients. This study aims to analyze the effect of fatigue-related education for pediatric oncology patients aged 7-12 and their parents on their fatigue and quality of life. This study was conducted with 80 children with cancer and their parents who were assigned to either the control group (n = 40) or the experimental group (n = 40). The experimental group received a fatigue-related educational program. The data were collected three times: prior to the program, 3 months later, and 6 months afterwards. Multidimensional variance analysis, the Bonferroni adjusted t test and regression analysis were used to analyze the data. A significant difference was found among the experimental and the control group for total mean scores and the mean scores of subdimensions of the Scale for the Assessment of Fatigue-Child Form in terms of the interactions of group, time, and group*time (p < 0.05). Significant differences were found among the experimental and control groups' mean scores on the Scale for the Quality of Life-Child and Parents Form in terms of the interactions of group, time, and group*time (p < 0.05). Fatigue-related education is an effective education model as a way to reduce fatigue and increase the quality of life of children with cancer. The use of fatigue-related education by nurses in pediatric oncology clinics will have positive effects on children and their parents.
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Affiliation(s)
- Aslı Akdeniz Kudubes
- Department of Pediatric Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, 35340, Izmir, Turkey.
| | - Murat Bektas
- Department of Pediatric Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, 35340, Izmir, Turkey
| | - Kamer Mutafoğlu
- Department of Pediatrics, Izmir University of Economics Faculty of Medicine, Izmir, Turkey
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15
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Torres V, Nunes MDR, Silva-Rodrigues FM, Bravo L, Adlard K, Secola R, Fernandes AM, Nascimento LC, Jacob E. Frequency, Severity, and Distress Associated With Physical and Psychosocial Symptoms at Home in Children and Adolescents With Cancer. J Pediatr Health Care 2019; 33:404-414. [PMID: 30846334 PMCID: PMC6589157 DOI: 10.1016/j.pedhc.2018.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/10/2018] [Accepted: 11/25/2018] [Indexed: 11/19/2022]
Abstract
Malignancy- and cancer-related treatments lead to multiple symptoms. Although treatments focus on cure, few research studies have examined the symptoms that accompany these aggressive and complicated treatments. The purpose of the study was to evaluate the symptoms experienced by children at home. Children (n = 25) and adolescents (n = 33) diagnosed with cancer completed the Memorial Symptoms Assessment Scale during the 5 days at home after discharge from the hospital. The most frequent physical symptoms were fatigue (52.1%), nausea (50.7%), lack of appetite (43.7%), and pain (42.3%). The most frequent psychological symptoms were difficulty sleeping (21.1%), worrying (18.3%), feeling sad (18.3%), and feeling nervous (16.9%). Significant differences were found in the overall physical and psychosocial symptoms and Global Distress Index in patients with and without pain, fatigue, and nausea. Results indicated that physical and psychosocial symptoms and Global Distress Index increased as severity of pain, nausea, and fatigue increased. Children and adolescents were experiencing many symptoms at home but were often not reporting them.
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16
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Ospina PA, McNeely ML. A Scoping Review of Physical Therapy Interventions for Childhood Cancers. Physiother Can 2019; 71:287-296. [PMID: 31719724 PMCID: PMC6830414 DOI: 10.3138/ptc.2018-13.pp] [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: 12/16/2022]
Abstract
Purpose: Children and adolescents undergoing cancer treatment are at high risk of developing serious adverse effects, many of which respond to physical therapy (PT). This scoping review aims to (1) outline the state of the research involving PT for children with cancer and (2) identify gaps in the literature for future research. Method: From January 2002 to October 2017, we conducted electronic searches of three major databases and conference proceedings and checked references of screened articles. Results: A total of 12 articles were included in the review: one randomized controlled trial, one pilot randomized trial, five pilot or feasibility studies, two prospective studies, one case series, one case report, and one retrospective study. The research to date supports the feasibility of PT interventions for children with cancer, but the current evidence is not yet at a level to inform clinical practice. To better elucidate treatment protocols and assess their benefits for tumour-specific impairments, research needs to examine the effects of PT on specific impairments or for specific cancer tumour types. Conclusions: Collaborative efforts to conduct multi-centre trials are needed to further the field of paediatric oncology PT.
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Affiliation(s)
- Paula A. Ospina
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta
| | - Margaret L. McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta
- Department of Rehabilitation Medicine/Department of Oncology, Cross Cancer Institute, Edmonton, Alta
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17
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Díaz-Morales K, Reyes-Arvizu J, Morgado-Nájera K, Everardo-Domínguez D. Síntomas en niños con cáncer y estrategias de cuidado familiar. REVISTA CUIDARTE 2018. [DOI: 10.15649/cuidarte.v10i1.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Los síntomas de dolor y náusea vómito en los niños con cáncer son ocasionados por la enfermedad o tratamiento de quimioterapia. El manejo de estos síntomas es un reto en los familiares. Objetivos: Describir y analizar la relación entre los síntomas de dolor y náusea vómito en los niños con cáncer y describir las estrategias de cuidado familiar ante estos síntomas. Materiales y Métodos: Estudio descriptivo correlacional, con muestra de 31 niños y familiares de una clínica oncopediatrica de Veracruz México. Diligenciaron los instrumentos Escala de dolor con caras-Revisada, Clasificación de Náusea-Vómito Inducido por Quimioterapia y Cuestionario de estrategias de cuidado familiar para el manejo de síntomas. Los datos se analizaron con estadística descriptiva e inferencial con Rho de Spearman, utilizando el programa SPSS 20.0. Resultados: Los niños padecen dolor moderado (48%), leve (29%) e intenso (23%). Tienen náusea-vómito agudo (74%), anticipatorio (16%) y retardado (10%). Existe asociación entre la náusea-vómito retardado con el anticipatorio (r =435<0,05). Los familiares contrarrestan el dolor del niño con estrategias de espiritualidad, distracción y fármacos. Ante la náusea-vómito evitan ambientes con olor a comida y consumo de líquidos calientes. Discusión: Según el tipo de cáncer y tratamiento, es la intensidad del dolor en el niño. La náusea-vómito se considera el síntoma más problemático durante la quimioterapia. Conclusiones: La investigación aporta datos científicos para indagar a futuro estos síntomas y posibles secuelas físicas y psicológicas (depresión, ansiedad) en los niños con cáncer, así como la efectividad de las estrategias familiares para tratar estos síntomas.Como citar este artículo: Díaz-Morales K, Reyes-Arvizu J, Morgado-Nájera K, Everardo-Domínguez D. Síntomas en niños con cáncer y estrategias de cuidado familiar. Rev Cuid. 2019; 10(1): e597. http://dx.doi.org/10.15649/cuidarte.v10i1.597
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18
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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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19
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Ullrich CK, Dussel V, Orellana L, Kang TI, Rosenberg AR, Feudtner C, Wolfe J. Self-reported fatigue in children with advanced cancer: Results of the PediQUEST study. Cancer 2018; 124:3776-3783. [PMID: 30291811 DOI: 10.1002/cncr.31639] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/10/2018] [Accepted: 05/21/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Pediatric cancer-related fatigue is prevalent and significantly impairs health-related quality of life, yet its patterns and correlates are poorly understood. The objectives of this study were to describe fatigue as prospectively reported by children with advanced cancer and to identify the factors associated with fatigue and associated distress. METHODS Children (age ≥2 years) with advanced cancer (N = 104) or their parents at 3 academic hospitals reported symptoms at most weekly over 9 months using the computer-based Pediatric Quality of Life Evaluation of Symptoms Technology (PediQUEST) system. PediQUEST administered a modified version of the Memorial Symptom Assessment Scale (PQ-MSAS) as part of a randomized controlled trial. Clinical information was abstracted from medical records. Primary outcomes were: 1) fatigue prevalence (yes/no response to PQ-MSAS fatigue item) and 2) fatigue distress (composite score of severity, frequency, and bother). Multivariable models were constructed to identify factors independently associated with fatigue prevalence and scores reflecting fatigue distress (ie, burden). RESULTS Of 920 reports, 46% (n = 425) noted fatigue. When reported, fatigue was of high frequency in 41% of respondents (n = 174), severity in 25%of respondents (n = 107), and bother in 34%of respondents (n = 143). Most reports (84%; n = 358) were associated with scores indicating fatigue distress. In multivariable analyses, fatigue was associated with older age, lower hemoglobin, and distress from particular symptoms (anorexia, nausea, sleep disturbance, sadness, and irritability). In contrast, fatigue distress was associated with distress from nausea, cough, and pain. CONCLUSIONS Fatigue is common among children with advanced cancer and is often highly distressing. Interventions focused on uncontrolled symptoms may ease fatigue distress in children with advanced cancer.
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Affiliation(s)
- Christina K Ullrich
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Veronica Dussel
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Tammy I Kang
- Palliative Care Section, Texas Children's Hospital, Baylor School of Medicine, Houston, Texas
| | - Abby R Rosenberg
- Seattle Children's Hospital Cancer and Blood Disorders Center, Seattle, Washington.,Fred Hutchinson Cancer Research Center, Seattle, Washington.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Chris Feudtner
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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20
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Silva TPD, Silva LJD, Ferreira MJC, Silva ÍR, Rodrigues BMRD, Leite JL. ASPECTOS CONTEXTUAIS SOBRE O GERENCIAMENTO DO CUIDADO DE ENFERMAGEM À CRIANÇA COM DOR ONCOLÓGICA CRÔNICA. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-070720180003400017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: discutir os aspectos contextuais relacionados ao gerenciamento do cuidado de enfermagem à criança hospitalizada com dor oncológica crônica. Método: pesquisa de abordagem qualitativa, desenvolvida com base no referencial metodológico da Teoria Fundamentada em Dados e no referencial teórico do Pensamento Complexo, a partir de Edgar Morin. A coleta de dados ocorreu por meio da entrevista semiestruturada e da observação não participante. Os 21 participantes da pesquisa foram organizados em três grupos amostrais: o primeiro foi composto por sete enfermeiros; o segundo foi constituído por sete técnicos de enfermagem e o terceiro foi formado por sete profissionais da equipe multiprofissional de saúde. Os resultados da pesquisa foram validados por cinco examinadores, dos quais três apresentavam expertise no método de pesquisa. Resultados: a categoria intitulada “Desvelando aspectos contextuais sobre o gerenciamento do cuidado de enfermagem à criança com dor oncológica crônica” revelou por meio de suas subcategorias que a hospitalização dessa criança é longa, marcada por mudanças na dinâmica familiar, perdas e limitações impostas pela doença e/ou tratamento. O gerenciamento do cuidado de enfermagem é complexo, realizado por meio do trabalho em equipe e da demanda um planejamento que valorize as múltiplas necessidades da criança e do familiar. Conclusão: os resultados apontam para a necessidade do profissional de enfermagem contextualizar suas relações de cuidado, a partir da valorização de aspectos que transcendem a dimensão biológica da criança hospitalizada com dor oncológica crônica.
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21
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Cheng L, Wang L, He M, Feng S, Zhu Y, Rodgers C. Perspectives of children, family caregivers, and health professionals about pediatric oncology symptoms: a systematic review. Support Care Cancer 2018; 26:2957-2971. [PMID: 29774474 DOI: 10.1007/s00520-018-4257-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 05/06/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the existing body of evidence to determine the current state of knowledge regarding the perspectives of the following groups: (1) children with cancer, (2) family caregivers, and (3) healthcare professionals, about symptoms, as well as factors that may influence the symptom reports. METHODS A systematic search was performed for all types of studies that included the perspectives of at least two groups of participants' symptom reports. Children included anyone younger than 19 years of age who was diagnosed with any type of cancer. Electronic searches were conducted in five English databases and four Chinese databases. The appraisal of methodological quality was conducted using the GRADE criteria. Data were extracted into matrix tables. RESULTS Thirty-three studies were included. The pediatric oncology symptoms reported by children, family caregivers, and healthcare professionals were synthesized. Findings suggested that family caregivers' symptom reports were more closely aligned with children's reports than with the healthcare professionals' reports. Influencing factors on the different symptom reports included the children's diagnosis, symptom characteristics, social-demographic factors, and family caregivers' psychosocial status. CONCLUSIONS Children with cancer should be the primary reporters for their symptoms. When there are reporters other than the children, the potential discrepancy between the different perspectives needs to be carefully considered.
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Affiliation(s)
- Lei Cheng
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China.
| | - Liying Wang
- Nursing Department, Fudan University Cancer Hospital, 270 Dongan Road, Shanghai, 200000, China
| | - Mengxue He
- Pediatric Hematology/Oncology Unit, Shanghai Children's Medical Center (SCMC) affiliated to Shanghai Jiaotong University School of Medicine, 1678, Dongfang Road, Shanghai, 200127, China
| | - Sheng Feng
- Pediatric Intensive Care Unit, Shanghai Children's Medical Center (SCMC) affiliated to Shanghai Jiaotong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China
| | - Yehui Zhu
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, 15261, USA
| | - Cheryl Rodgers
- School of Nursing, Duke University, 307 Trent Drive, Durham, NC, 27710, USA
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22
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23
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Ospina PA, McComb A, Wiart LE, Eisenstat DD, McNeely ML. Physical therapy interventions, other than general physical exercise interventions, in children and adolescents before, during and following treatment for cancer. Hippokratia 2018. [DOI: 10.1002/14651858.cd012924] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Paula A Ospina
- University of Alberta; Physical Therapy, Faculty of Rehabilitation Medicine; 2-50 Corbett Hall Edmonton Canada T6G 2G4
| | - Alyssa McComb
- University of Alberta; Physical Therapy, Faculty of Rehabilitation Medicine; 2-50 Corbett Hall Edmonton Canada T6G 2G4
| | - Lesley E Wiart
- University of Alberta; Physical Therapy, Faculty of Rehabilitation Medicine; 2-50 Corbett Hall Edmonton Canada T6G 2G4
| | - David D Eisenstat
- University of Alberta; Pediatrics; 11405 - 87 Avenue Edmonton Canada T6G 1C9
| | - Margaret L McNeely
- University of Alberta; Department of Physical Therapy/ Department of Oncology; 2-50, Corbett Hall Edmonton AB Canada T6G 2G4
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24
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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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25
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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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26
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Plummer K, McCarthy M, McKenzie I, Newall F, Manias E. Pain assessment and management in paediatric oncology: a cross-sectional audit. J Clin Nurs 2016; 26:2995-3006. [PMID: 27862499 DOI: 10.1111/jocn.13643] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 01/04/2023]
Abstract
AIMS AND OBJECTIVES To describe the pain assessment and management practices documented by health professionals within a tertiary-level Children's Cancer Centre and to evaluate how these practices were compared with international recommendations. BACKGROUND Children with cancer are vulnerable to pain due to the intensity of antineoplastic therapy. Therefore, it is imperative to ensure that current pain management practices provided to paediatric oncology inpatients are of a high quality. DESIGN A single-site cross-sectional audit. METHODS A 24-hour period of documented pain-related care in randomly selected inpatients of an Australian tertiary-level Children's Cancer Centre was examined. The current pain management practices were audited over a two-month period resulting in 258 episodes of pain-related care being reviewed. RESULTS Pain related to medical treatment for cancer was common (n = 146/258, 57%) and persistent. The presence of pain was not consistently recorded by health professionals (n = 75/146, 51%). Pain was mild (n = 26/75, 35%) and opioids were the mainstay of pain management interventions (n = 63/112, 56%). Adjuvants were an important component of pain management (n = 47/112, 42%), and nonpharmacological methods of managing pain were under-represented in this audit (n = 38/146, 26%). According to the Pain Management Index, pain was appropriately managed for the majority of children (n = 65/76, 87%). CONCLUSIONS Pain management practices did not fully reflect the recommendations of contemporary paediatric pain management. Due to limitations in the documentation of children's pain, it was difficult to determine the effectiveness of pain management interventions. RELEVANCE TO CLINICAL PRACTICE This study highlights the ongoing problem of pain for children receiving antineoplastic therapy. It is recommended that health professionals routinely screen for the presence of pain during hospitalisation and assess the efficacy of pain-related care.
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Affiliation(s)
- Karin Plummer
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Melbourne, Vic., Australia.,Social and Mental Health Aspects of Serious Illness, Critical Care and Neurosciences, Murdoch Children's Research Institute, Parkville, Melbourne, Vic., Australia.,Department of Nursing, University of Melbourne, Parkville, Melbourne, Vic., Australia.,Department of Anaesthesia and Pain Management, Royal Children's Hospital, Parkville, Melbourne, Vic., Australia
| | - Maria McCarthy
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Melbourne, Vic., Australia.,Social and Mental Health Aspects of Serious Illness, Critical Care and Neurosciences, Murdoch Children's Research Institute, Parkville, Melbourne, Vic., Australia
| | - Ian McKenzie
- Department of Anaesthesia and Pain Management, Royal Children's Hospital, Parkville, Melbourne, Vic., Australia
| | - Fiona Newall
- Department of Nursing, University of Melbourne, Parkville, Melbourne, Vic., Australia.,Critical Care and Neurosciences, Murdoch Children's Research Institute, Parkville, Melbourne, Vic., Australia.,Department of Pediatrics, University of Melbourne, Parkville, Melbourne, Vic., Australia.,Department of Nursing Research, Royal Children's Hospital, Parkville, Melbourne, Vic., Australia
| | - Elizabeth Manias
- Departments of Nursing, Deakin University, Burwood, Melbourne, Vic., Australia.,Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Melbourne, Vic., Australia.,Melbourne School of Health Sciences, University of Melbourne, Parkville, Melbourne, Vic., Australia.,Faculty of Health, School of Nursing and Midwifery, Deakin University, Burwood, Melbourne, Vic., Australia
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27
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Björk M, Sundler AJ, Hallström I, Hammarlund K. Like being covered in a wet and dark blanket – Parents' lived experiences of losing a child to cancer. Eur J Oncol Nurs 2016; 25:40-45. [DOI: 10.1016/j.ejon.2016.08.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 07/13/2016] [Accepted: 08/18/2016] [Indexed: 11/26/2022]
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Allen JM, Graef DM, Ehrentraut JH, Tynes BL, Crabtree VM. Sleep and Pain in Pediatric Illness: A Conceptual Review. CNS Neurosci Ther 2016; 22:880-893. [PMID: 27421251 DOI: 10.1111/cns.12583] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sleep disruption is a common comorbidity of pediatric pain. Consequences of pain and disrupted sleep, evidence for the pain-sleep relation, and how aspects of illness, treatment, and pharmacological pain management may contribute to or exacerbate these issues are presented. AIMS This conceptual review explored the relation between pain and sleep in children diagnosed with chronic medical or developmental conditions. The goal of this review is to expand upon the literature by examining common themes in sleep disturbances associated with painful conditions across multiple pediatric illnesses. Populations reviewed include youth with intellectual and developmental disabilities (IDD), migraines, cystic fibrosis (CF), sickle cell disease (SCD), cancer, juvenile idiopathic arthritis (JIA), juvenile fibromyalgia (JFM), and functional gastrointestinal disorders (FGIDs). RESULTS Consistent evidence demonstrates that children with medical or developmental conditions are more vulnerable to experiencing pain and subjective sleep complaints than healthy peers. Objective sleep concerns are common but often under-studied. Evidence of the pain-sleep relationship exists, particularly in pediatric SCD, IDD, and JIA, with a dearth of studies directly examining this relation in pediatric cancer, JFM, CF, and FGIDs. Findings suggest that assessing and treating pain and sleep disruption is important when optimizing functional outcomes. CONCLUSION It is essential that research further examine objective sleep, elucidate the pain-sleep relationship, consider physiological and psychosocial mechanisms of this relationship, and investigate nonpharmacological interventions aimed at improving pain and sleep in vulnerable pediatric populations.
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Affiliation(s)
- Jennifer M Allen
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Danielle M Graef
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Brooklee L Tynes
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Valerie M Crabtree
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.
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29
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Darezzo Rodrigues Nunes M, Jacob E, Adlard K, Secola R, Nascimento L. Fatigue and Sleep Experiences at Home in Children and Adolescents With Cancer. Oncol Nurs Forum 2016; 42:498-506. [PMID: 26302278 DOI: 10.1188/15.onf.498-506] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To (a) investigate fatigue and sleep patterns of children and adolescents at home and (b) examine factors associated with fatigue and sleep.. DESIGN Descriptive with repeated measures
. SETTING Homes of study participants in Los Angeles and Orange, California
. SAMPLE 35 children and adolescents with cancer. METHODS Data were collected using the PedsQL Multidimensional Fatigue Scale, which was completed once at home by each participant, and sleep actigraphs, which were worn for five days at home following discharge from hospitalization
. MAIN RESEARCH VARIABLES General fatigue, cognitive fatigue, sleep-rest fatigue, sleep duration, sleep quantity, sleep efficiency, and wake after sleep onset
. FINDINGS More than half of the participants had problems with fatigue at home. Significant correlations were found between sleep/rest fatigue and sleep duration. Factors that affected fatigue were age, gender, and cancer diagnosis. Adolescents had more problems with fatigue than children, and female patients had more problems with fatigue than male patients. Patients with sarcoma had more problems with fatigue than those with leukemia, lymphoma, and other cancer diagnoses. Adolescents slept less than children. CONCLUSIONS Children and adolescents with cancer have fatigue and sleep problems at home that vary by age, gender, and cancer diagnosis
. IMPLICATIONS FOR NURSING Data from the current study support the need for nurses to provide teaching about fatigue and sleep at home in children and adolescents with cancer. Future studies are needed to examine interventions that may alleviate fatigue and improve sleep at home
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30
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Taylor EJ, Petersen C, Oyedele O, Haase J. Spirituality and Spiritual Care of Adolescents and Young Adults with Cancer. Semin Oncol Nurs 2015. [PMID: 26210201 DOI: 10.1016/j.soncn.2015.06.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To review research on spiritual perspectives and spiritual care of adolescents and young adults (AYA) living with cancer. DATA SOURCES Peer-reviewed publications, book chapters, and websites of professional organizations. CONCLUSION There is a paucity of research specifically investigating AYA spirituality and lack of AYA-sensitive instruments to measure spirituality. Research that applies robust scientific methods to the study of AYA spirituality is needed. Research that provides evidence on which to base best practices for spiritual care that supports AYA spiritual well-being is likewise necessary. IMPLICATIONS FOR NURSING PRACTICE Nurses can influence AYA health-related outcomes and experiences by providing ethical and evidence-based spiritual nurture.
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31
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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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Hockenberry MJ, Taylor OA, Pasvogel A, Rodgers C, McCarthy K, Gundy P, Montgomery DW, Ribbeck P, Scheurer ME, Moore IMK. The influence of oxidative stress on symptom occurrence, severity, and distress during childhood leukemia treatment. Oncol Nurs Forum 2015; 41:E238-47. [PMID: 24969258 DOI: 10.1188/14.onf.e238-e247] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore the symptom trajectory during the first 16 months of childhood leukemia treatment and any associations with the oxidative stress pathway measured by cerebrospinal fluid (CSF) concentration of oxidized phosphatidylcholine (PC), the predominant glycerophospholipid in the brain and cell membranes. DESIGN Prospective, longitudinal design. SETTING Two cancer centers in the southwestern United States. SAMPLE 36 children (aged 3-14 years) newly diagnosed with acute lymphoblastic leukemia. METHODS Symptoms were measured using the Memorial Symptom Assessment Scale at six specific time points during treatment. Biochemical changes in oxidative stress were measured by oxidized PC in the CSF. MAIN RESEARCH VARIABLES Childhood cancer symptoms, oxidized PC. FINDINGS Significant differences were found in the number of symptoms experienced during the three phases of treatment. Symptom trajectory changes and influence of the oxidative stress pathway on symptom experiences were identified. CONCLUSIONS Symptoms experienced during treatment for childhood leukemia are associated with increased oxidative stress. IMPLICATIONS FOR NURSING Children with leukemia experience symptoms throughout treatment. Physiologic measures indicate the influence of oxidative stress on symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Michael E Scheurer
- Population Sciences Biorepository, College of Medicine at Baylor University
| | - Ida M Ki Moore
- Biobehavioral Health Science Division in the College of Nursing, University of Arizona
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Twycross A, Parker R, Williams A, Gibson F. Cancer-Related Pain and Pain Management: Sources, Prevalence, and the Experiences of Children and Parents. J Pediatr Oncol Nurs 2015; 32:369-84. [PMID: 25736032 DOI: 10.1177/1043454214563751] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Advances in treatment mean children are increasingly cared for by their parents at home, leading to a shift in responsibility from health care professionals to parents. Little is known about parents' pain management experiences and the etiology of pain experienced by children with cancer especially when at home. A rapid review of the literature was undertaken investigating children's cancer-related pain, with emphasis on the management of pain outside the health care setting. Electronic databases were searched and a quality assessment was conducted. Forty-two articles were included. Despite advances in pain management techniques, children with cancer regularly cite pain as the most prevalent symptom throughout the cancer trajectory. The source of pain is usually treatment side effects or painful procedures. Parents find dealing with their child's pain distressing and demanding and may hold misconceptions about pain management. Findings indicate a need for more robust research into parental pain management leading to the development of effective pain management resources for parents.
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Affiliation(s)
| | | | - Anna Williams
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Faith Gibson
- London South Bank University, London, UK Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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34
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Wu LM, Chiou SS, Sheen JM, Lin PC, Liao YM, Chen HM, Hsiao CC. Evaluating the acceptability and efficacy of a psycho-educational intervention for coping and symptom management by children with cancer: a randomized controlled study. J Adv Nurs 2013; 70:1653-62. [DOI: 10.1111/jan.12328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2013] [Indexed: 12/12/2022]
Affiliation(s)
- Li-Min Wu
- School of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Shyh-Shin Chiou
- Department of Pediatrics, Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Pediatrics; College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Jiunn-Ming Sheen
- Department of Pediatrics; Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Kaohsiung Taiwan
| | - Pei-Chin Lin
- Department of Pediatrics, Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Pediatrics; College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Yu Mei Liao
- Department of Pediatrics, Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Hsing-Mei Chen
- Department of Nursing; National Cheng Kung University; Tainan Taiwan
| | - Chih-Cheng Hsiao
- Department of Pediatrics; Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Kaohsiung Taiwan
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Abstract
PURPOSE OF REVIEW Researchers have focused on identifying and describing symptom experiences among children with various diseases but symptoms can have a synergistic and/or an antecedent effect that must be evaluated. This review reports the current knowledge of symptoms among various pediatric diseases and highlights symptom cluster research. RECENT FINDINGS Symptoms of depression and anxiety are the most prevalent variables studied across pediatric disease studies followed by pain, fatigue, and quality of life. Although previous pediatric symptom research provides a foundation for understanding the complexities of these symptoms, there is limited evidence on symptom cluster research in pediatrics. Pain and fatigue are the most common symptoms analyzed for correlations, and relationships among symptoms that have been evaluated in children with juvenile idiopathic arthritis, HIV, cancer, cardiac disease requiring an implantable cardioverter defibrillator, and at end of life. Pain and fatigue have been associated with sleep disturbances, anxiety, depression, anorexia, and nausea/vomiting. SUMMARY Pediatric oncology researchers are leading the way with symptom cluster studies; however, this work remains in the early stages. There is great potential to advance the state of the science with cluster analysis. Future research work should focus on evaluating symptoms and their interactions.
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