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Tran Thi TH, Lin CY, Huang MC. Agreement between quality of life assessed using family proxy and child self-reports among children with hematologic malignancy. Eur J Pediatr 2024; 183:3377-3388. [PMID: 38755309 DOI: 10.1007/s00431-024-05613-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
Evidence-based literature recognizes that the different degrees of agreement between a child self-report and a proxy-report depend on the characteristics of the domains, the child's age and illness, the proxy's own perspective on QoL, and family attendance during the child's hospitalization. This study aims to determine the degree of agreement between proxy-reports and child self-reports on quality of life (QoL) for children with hematologic malignancy ranging in age from 5 to 18 years who are undergoing treatment. We retrieved clinical QoL data from a study titled "Dynamic change in QoL for Vietnamese children with hematologic malignancy" from April 2021 to December 2022. To evaluate the magnitude of agreement between self-reports and proxy-reports, intraclass correlation coefficients (ICCs) for 259 pairs of measurements were quantified. Using independent t tests, the mean differences between self-reports and proxy-reports were tested. Moderate agreement was consistent through all age groups for five subscales, including physical, psychosocial, pain, nausea, and procedural anxiety (ICCs ranged from 0.53 to 0.74). The weakest agreement appeared in two groups, subjects aged 5-7 years and 13-18 years on six domains (school, treatment anxiety, worry, cognitive problems, perceived physical appearance, and communication) (-0.01 to 0.49). Child self-rating was consistently higher than that of proxies for the physical, emotional, and nausea domains among children aged 5-7 years and for procedural anxiety, treatment anxiety, and cognitive problems among children aged 8-12 years. Conclusion: The agreement level of self-reports and proxy-reports was differently distributed by child age and the PedsQL domains. The proxy children agreement on QoL among children with hematologic malignancy was divergent according to the different age groups, which could potentially be explained by proxy-child bonding at different stages of childhood development. Our recommendation for future studies is to explore children's age as a potential factor influencing proxy agreement on QoL among children with cancer. What is Known: • Children and their proxies may think differently about quality of life (QoL). • Comparing two sources of data (i.e., child and proxy) on aspects of QoL can help identify the discrepancies between children's perceptions of their QoL and their parents' perceptions. This can be useful in terms of identifying potential areas for improvement or concern and may also be helpful in making decisions about treatment and care. What is New: • Our study results demonstrated that proxies who comprised children aged 5-7 years or 13-18 years reported differently among domains that cannot be expressed verbally or with body language, including cognitive problems, perceived physical appearance, and communication. • Children generally perceived their QoL to be better than their proxies. Therefore, a more comprehensive understanding of children's QoL may require the consideration of multiple sources of data from various perspectives.
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Affiliation(s)
- Thu Hang Tran Thi
- Faculty of Nursing and Medical Technology, The Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei-Chih Huang
- National Tainan Junior College of Nursing, No. 78, Sec. 2, Minzu Rd, Tainan, 700007, Taiwan.
- Department of Nursing, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 701401, Taiwan.
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Alelayan H, Zhao Y, Lin K, Meng J, Huang H, Liao X. Can performance status mediate the relationship between therapy-related symptoms and health-related quality of life in children with cancer? A mediation model. Eur J Oncol Nurs 2024; 68:102513. [PMID: 38309256 DOI: 10.1016/j.ejon.2024.102513] [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: 08/12/2023] [Revised: 10/15/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
PURPOSE Understanding the interplay among health-related quality of life (HRQoL), therapy-related symptoms, and performance status can offer insights into potential strategies to enhance HRQoL for pediatric cancer patients. This study aimed to examine the mediating effect of performance status on the relationship between symptom burden and HRQoL in children and adolescents with cancer. METHOD A cross-sectional study was conducted. Participants were recruited from two tertiary hospitals located in Guangzhou, China. HRQoL, therapy-related symptoms, and performance status were assessed using the DISAKIDS Chronic Generic Measure (DCGM-37), Therapy-Related Symptom Checklist for Children (TRSC-C), and Lansky Play Performance Scale (LPPS), respectively. RESULTS A total of 287 children with cancer (aged 11.08 ± 2.34 years) were included. The DCGM-37 scores were 59.70 ± 9.64. Emotion (56.45 ± 14.56) and physical limitations (58.59 ± 15.38) were the most affected domains. The number of symptoms experienced was 12.49 ± 5.95. The DCGM-37 demonstrated strong negative correlations with the TRSC-C (r = -0.60, P < 0.001) and number of symptoms (r = -0.62, P < 0.001), but mild-to-moderate negative correlations (r -0.16∼ -0.42, P < 0.05) with individual symptoms. The TRSC-C demonstrated an indirect effect on the DCGM-37 via the LPPS (Bootstrap-corrected standardized β = -0.05, 95 % CI -0.10∼ -0.01; SE = 0.02). Additional analysis showed that tripping/falling (OR = 4.02, 95 % CI 2.02-7.98; P < 0.001) and sore mouth (OR = 2.38, 95 % CI 1.56-3.64; P < 0.001) were associated factors for presenting poor performance status in children undergoing acute chemotherapy. CONCLUSIONS The accumulated symptom burden, rather than individual symptoms, weighs heavily on the HRQoL. Performance status partially mediated the relationship between symptom burdens and HRQoL among these patients.
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Affiliation(s)
- Hasan Alelayan
- School of Nursing, Southern Medical University, China; Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China
| | - Yuxuan Zhao
- School of Nursing, Southern Medical University, China; Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China
| | - Kai Lin
- Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China
| | - Jiangnan Meng
- Pediatric Department, Nanfang Hospital, Southern Medical University, China
| | - Haiying Huang
- Hematology and Oncology of Pediatric Department, Guangzhou Women's and Children's Medical Center, China
| | - Xiaoyan Liao
- School of Nursing, Southern Medical University, China; Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China; School of Nursing, Guangzhou Medical University, China.
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Li R, Shen X, Yang Q, Zhang L, Li H, Yao W, Chan Y. Stability of Symptom Clusters in Children With Acute Lymphoblastic Leukemia Undergoing Chemotherapy. Cancer Nurs 2023:00002820-990000000-00163. [PMID: 37523732 DOI: 10.1097/ncc.0000000000001261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
BACKGROUND Children with acute lymphoblastic leukemia (ALL) experience multiple symptoms during chemotherapy. Assessing how symptoms cluster together and how these symptom clusters (SCs) change over time may lay a foundation for future research in SC management and the pathophysiological mechanisms of SCs. OBJECTIVES This study aimed to assess the stability of SCs in children with ALL during chemotherapy. METHODS A longitudinal investigation was carried out. The Chinese version of the Memorial Symptom Assessment Scale 10 to 18 was used to assess the occurrence, severity, and distress of symptoms in 134 children with ALL (8-16 years old) at the following 4 separate points: before chemotherapy (T1), start of post-induction therapy (T2), 4 months post-induction therapy (T3), and start of maintenance therapy (T4). Exploratory factor analyses were used to extract SCs. RESULTS Six SCs were identified. Emotional and somatic clusters were identified across all dimensions and time points. Gastrointestinal cluster was all identified except for occurrence at T1. Neurological cluster was identified at T2 and T3 for all dimensions and at T4 for severity and distress. Self-image disorder cluster was all identified except at T1. Skin mucosa cluster was identified at T2 and T3 for all dimensions. Emotional cluster exhibited common symptoms across dimensions and time points. CONCLUSION The number and types of SCs determined by scoring the occurrence, severity, and distress are different, but some SCs are relatively stable. IMPLICATIONS FOR PRACTICE Clinicians should not only focus on the common trajectory of symptoms and SCs, but also assess each child individually.
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Affiliation(s)
- Rongrong Li
- Author Affiliations: Department of Hematology (Dr R. Li and Mss Shen and Yang), Department of Nursing (Ms Yao), and the Union (Ms Chan), Children's Hospital Affiliated to Soochow University; and School of Nursing (Ms Zhang, and Dr H. Li), Soochow University
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Chung JOK, Li WHC, Ho LLK, Cheung AT. The Association of Resilience with Way of Coping, Psychological Well-Being and Quality of Life in Parents of Children with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105765. [PMID: 37239492 DOI: 10.3390/ijerph20105765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Evidence shows that resilience is crucial to maintain psychological well-being and quality of life in the face of stress and adversity. However, the relationships between resilience and psychological well-being and factors associated with quality of life in Hong Kong Chinese parents of children with cancer are underexplored. This study aimed to examine the interrelationships among resilience, ways of coping, psychological well-being, and quality of life among Chinese parents of children with cancer, and identify factors associated with their quality of life. A cross-sectional study was conducted with 119 Chinese parents of children with cancer at the Hong Kong Children's Hospital between January 2020 and March 2022. Parents' resilience level, ways of coping, depressive symptoms, state anxiety scores, perceived social support, and quality of life were assessed. Participating parents (n = 119) included 98 mothers (82.4%) and 11 parents were from single-parent families (9.2%). Almost half (47.9%) of the parents were potentially at risk for depression. The results showed that participants from single-parent families reported statistically significantly lower levels of resilience (p < 0.001), more depressive symptoms (p < 0.001), and poorer quality of life (p < 0.001) than those who lived with their partners (married). In addition, parents who adopted problem-focused coping strategies reported statistically significantly higher levels of resilience (p < 0.001), fewer depressive symptoms (p < 0.001), and better quality of life (p < 0.001) than those who adopted emotion-focused coping strategies. A multiple regression analysis revealed that resilience (p < 0.001) was associated with quality of life among parents of children with cancer. This study provides further support that resilience is an important factor associated with quality of life in parents of children with cancer. Assessing resilience in parents is an important prerequisite for designing appropriate interventions to increase their resilience and enhance their quality of life.
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Affiliation(s)
| | - William Ho Cheung Li
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Laurie Long Kwan Ho
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Ankie Tan Cheung
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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Cheng Q, Ng MS, Choi KC, So WK. Unmet needs, anxiety, depression, and quality of life among caregivers of adolescents and young adults with cancer: A cross-sectional study. Asia Pac J Oncol Nurs 2022; 9:100108. [PMID: 36118621 PMCID: PMC9475260 DOI: 10.1016/j.apjon.2022.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/07/2022] [Indexed: 11/04/2022] Open
Abstract
Objective To assess unmet needs, anxiety, depression, and quality of life of caregivers of adolescents and young adults with cancer and examine their associations. Methods A total of 282 caregivers of adolescents and young adults with cancer were recruited by convenience sampling at a tertiary cancer hospital in Chinese Mainland. The participants’ unmet needs, anxiety, depression, and quality of life were assessed using self-reported questionnaires. Hierarchical regression analyses were conducted to examine associations between unmet needs and health outcomes. Results The five most prevalent high unmet needs were related to ‘worries about future’ and ‘information’, including dealing with not knowing what lies in the future (n = 161, 57.1%), dealing with worry about the cancer getting worse (n = 151, 53.5%), dealing with worry about the cancer coming back (n = 147, 52.1%), finding information about complementary or alternative therapies (n = 137, 48.6%), and finding information about the long-term side effects of treatments and medicines (n = 126, 44.7%). Around 40% of the caregivers reported moderate to severe anxiety and depression. After adjusting for sociodemographic and clinical characteristics, personal and emotional needs, healthcare access and continuity, and financial needs remained significantly associated with anxiety, depression, or quality of life. Conclusions Nurses need to be aware of the unmet needs of caregivers of adolescents and young adults with cancer. More effort is needed to identify services and interventions that address the unmet needs, particularly personal and emotional, healthcare access and continuity, and financial needs, to improve the caregivers’ health outcomes.
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Cheung AT, Li WHC, Ho LLK, Chan GCF, Lam HS, Chung JOK. Efficacy of Mobile Instant Messaging-Delivered Brief Motivational Interviewing for Parents to Promote Physical Activity in Pediatric Cancer Survivors: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2214600. [PMID: 35699959 PMCID: PMC9198728 DOI: 10.1001/jamanetworkopen.2022.14600] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Physical activity has beneficial effects that mitigate cancer- and treatment-related late effects. However, children who survive cancer are often physically inactive. Brief motivational interviewing may be an effective approach for increasing children's physical activity levels. OBJECTIVE To examine the effects of mobile instant messaging-delivered brief motivational interviewing for parents in promoting regular physical activity in children who have survived cancer. DESIGN, SETTING, AND PARTICIPANTS An assessor-blinded randomized clinical trial was conducted at 2 Hong Kong pediatric oncology outpatient clinics from March 1, 2019, to January 29, 2021. A total of 161 children who had survived cancer, aged 9 to 16 years, and their parents were randomized (1:1) to an intervention or control group. INTERVENTIONS The intervention group received a 6-month mobile instant messaging-delivered brief motivational interviewing using a strategy menu. Parent-child dyads in both groups received a health advice session and were directed to a physical activity website at baseline. MAIN OUTCOMES AND MEASURES The primary outcome was the children's physical activity levels at 12-month follow-up, measured by the Chinese University of Hong Kong: Physical Activity Rating for Children and Youth (total sores: 0-10, higher scores indicate greater physical activity levels). Secondary outcomes were cancer-related fatigue levels, handgrip strength, peak expiratory flow rate, and quality of life. Intention-to-treat analysis was performed. RESULTS Of the 161 children included in the study, 93 were boys (57.8%), and the mean (SD) age was 12.4 (2.4) years. Generalized estimating equation analyses showed a significant improvement in outcomes in the intervention group compared with the control group: physical activity levels (group-by-time interaction, 6 months: β = 3.09; 95% CI, 2.65-3.53; P < .001; 12 months: β = 3.91; 95% CI, 3.45-4.36; P < .001), cancer-related fatigue (6 months: β = -5.69; 95% CI, -8.03 to -3.35; P < .001; 12 months: β = -9.16; 95% CI, -11.31 to -7.00; P < .001), left handgrip strength (6 months: β = 2.69; 95% CI, 0.96-4.43; P = .002; 12 months: β = 5.52; 95% CI, 3.70-7.33; P < .001), right handgrip strength (6 months: β = 2.75; 95% CI, 1.01-4.50; P = .002; 12 months: β = 5.45; 95% CI, 3.62-7.27; P < .001), peak expiratory flow rate (12 months: β = 28.51; 95% CI, 16.10-40.92; P < .001), and quality of life (6 months: β = 5.01; 95% CI, 1.19-8.82; P = .01); 12 months: β = 14.19; 95% CI, 10.84-17.54; P < .001). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, mobile instant messaging-delivered brief motivational interviewing was effective in promoting the adoption and maintenance of regular physical activity and ameliorating cancer- or treatment-related adverse effects in children who survived cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03859271.
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Affiliation(s)
- Ankie Tan Cheung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - William Ho Cheung Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Laurie Long Kwan Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Godfrey Chi-Fung Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Children’s Hospital, Hong Kong
| | - Huen Sum Lam
- Hong Kong Council for Accreditation of Academic and Vocational Qualifications, Hong Kong
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Al-Saadi LS, Chan MF, Al-Azri M. Prevalence of Anxiety, Depression, and Post-Traumatic Stress Disorder among Children and Adolescents with Cancer: A Systematic Review and Meta-Analysis. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:114-131. [PMID: 35722683 DOI: 10.1177/27527530211056001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Assessment of psychological and emotional disorders is an important indicator of well-being among children and adolescents with cancer. This review aimed to determine the prevalence rates of three major psychological disorders in this population, including anxiety, depression, and post-traumatic stress disorder (PTSD). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Various databases were searched to identify cross-sectional studies assessing anxiety, depression, and PTSD among children and adolescents with cancer. The Joanna Briggs Institute checklist was used to assess research quality. Of the 40 studies included in the literature review, 33 measured anxiety, 28 focused on depression, and nine assessed PTSD. A total of 18 studies were incorporated into the meta-analysis, with pooled prevalence rates of anxiety, depression and PTSD found to be 13.92% (n = 1,971; 95% confidence interval [CI] = 10.23-18.07%), 20.43% (n = 1,990, 95% CI = 13.85-27.93%), and 20.90% (n = 755, 95% CI = 13.28-29.73%), respectively. Mental health and psychological interventions are essential for children and adolescents diagnosed with cancer. Future work should be undertaken in different regions, such as the Middle East or Africa, or South America when assessing the prevalence of psychological disorders in children and adolescents diagnosed with cancer.
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Affiliation(s)
- Laila S Al-Saadi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, 37611Sultan Qaboos University, PO Box 38, Postal Code 123, Al Khoud, Muscat, Oman
| | - Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, 37611Sultan Qaboos University, PO Box 38, Postal Code 123, Al Khoud, Muscat, Oman
| | - Mohammed Al-Azri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, 37611Sultan Qaboos University, PO Box 38, Postal Code 123, Al Khoud, Muscat, Oman
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Chung JOK, Li WHC, Wei X, Cheung AT, Ho LLK, Chan GCF. Translation and psychometric evaluation of the Chinese version of the resilience scale for children with cancer. Health Qual Life Outcomes 2021; 19:232. [PMID: 34600543 PMCID: PMC8487328 DOI: 10.1186/s12955-021-01865-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To test the psychometric properties of a traditional Chinese version of the Resilience Scale for Children (RS-10) and examine its factorial structure via a confirmatory factor analysis (CFA). METHODS One hundred and eighty-six Hong Kong Chinese children with cancer were recruited in the paediatric oncology units of two public acute-care hospitals in Hong Kong to participate in this cross-sectional study. The psychometric properties of the traditional Chinese version of the RS-10 were assessed, namely its content equivalence, convergent and discriminant validity, construct validity, internal consistency and test-retest reliability. RESULTS The newly translated traditional Chinese version of the RS-10 demonstrated adequate internal consistency (Cronbach's α = .83, McDonald's Ω = .80), excellent test-retest reliability (.89), good content equivalence (CVI = 96%) and appropriate convergent (r = - .52, P = .01) and discriminant validity (r = .61, P = .01). The CFA results demonstrated that there was a good fit between the factor structure of the Chinese version of the RS-10 and the observed data (χ2/df = 2.34, TLI = .951, RMSEA = .053, CFI = .962, GFI = .948, SRMR = .052), thereby confirming the construct validity of this instrument. CONCLUSIONS The traditional Chinese version of the RS-10 was found to be a reliable and valid tool for assessing the resilience of Hong Kong Chinese children with cancer. The newly developed traditional Chinese version of the RS-10 is an appropriate clinical research tool for evaluating the effectiveness of nursing interventions in enhancing the resilience of and promoting mental well-being in children with cancer. Trial registration NCT03544190.
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Affiliation(s)
- Joyce Oi Kwan Chung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - William Ho Cheung Li
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, Hong Kong.
| | - Xia Wei
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, Hong Kong
| | - Laurie Long Kwan Ho
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, Hong Kong
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Hinds PS, Weaver MS, Withycombe JS, Baker JN, Jacobs SS, Mack JW, Maurer SH, McFatrich M, Pinheiro LC, Reeve BB, Wang J. Subjective Toxicity Profiles of Children in Treatment for Cancer: A New Guide to Supportive Care? J Pain Symptom Manage 2021; 61:1188-1195.e2. [PMID: 33096220 PMCID: PMC8055722 DOI: 10.1016/j.jpainsymman.2020.10.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Children and adolescents with cancer experience treatment-related, subjective adverse events (AEs). Identifying distinct groups of patients who predictably experience higher prevalence of AEs could guide patient care. OBJECTIVES Study aims were to 1) identify groups of children and adolescents reporting AEs using the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE); 2) determine whether demographic and clinical characteristics predict AE group membership; and 3) examine whether AE group membership was related to the distal outcome of psychological stress. METHODS Four hundred seventy-seven patients self-reported AEs via the Ped-PRO-CTCAE at T1 (beginning of treatment) and the PROMIS Pediatric Psychological Stress measure at T2 (7-28 days later). Latent class analysis was conducted to identify groups of patients and the relationships of the groups with demographic and clinical characteristics, and with stress. RESULTS Three distinct a priori unknown AE groups were identified (high AE prevalence, moderate AE prevalence, and low AE prevalence). Females, blacks, patients with high psychological stress, and patients more recently diagnosed were more likely to be in the high AE prevalence group. Gender, age, race, and time since diagnosis were associated with psychological stress. CONCLUSION Children with cancer are heterogeneous in experiencing subjective AEs. Gender, race, and time since diagnosis were significantly associated with higher subjective AE prevalence that may lead to psychological stress.
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Affiliation(s)
- Pamela S Hinds
- Department of Nursing Science, Professional Practice and Quality, Children's National Hospital, Washington, District of Columbia, USA; Department of Pediatrics, The George Washington University, Washington, District of Columbia, USA.
| | - Meaghann S Weaver
- Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska, USA; Division of Pediatric Oncology, Children's Hospital and Medical Center, Omaha, Nebraska, USA
| | | | - Justin N Baker
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Shana S Jacobs
- Department of Pediatrics, Children's National Hospital, The George Washington University, Washington, District of Columbia, USA
| | - Jennifer W Mack
- Department of Pediatric Oncology and Center for Population Sciences, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, Massachusetts, USA
| | - Scott H Maurer
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Division of Palliative Medicine and Supportive Care, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Molly McFatrich
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Laura C Pinheiro
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA; Department of Pediatrics, Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jichuan Wang
- Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, District of Columbia, USA; Epidemiology and Biostatistics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Correlation Between Symptom Clusters and Quality of Life in Children With Acute Leukemia During Chemotherapy. Cancer Nurs 2021; 45:96-104. [PMID: 33481411 DOI: 10.1097/ncc.0000000000000920] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children with acute leukemia experience various distressing symptoms due to the disease and its treatment during chemotherapy. These symptoms cluster together and have negative impacts on patient outcomes. OBJECTIVE The aim of this study was to examine symptom clusters that children with acute leukemia undergoing chemotherapy are experiencing and the impact of these symptom clusters on their quality of life. METHODS A cross-sectional study design was used, and 184 Chinese children with acute leukemia who were undergoing chemotherapy were invited to participate in the study. Memorial Symptom Assessment Scale 10-18 and Pediatric Quality of Life Inventory General Core Module version 4.0 were applied. Exploratory factor analysis and multiple regression were used to identify symptom clusters and their influence on the quality of life. RESULTS Six symptom clusters were identified as gastrointestinal, emotional, neurological, skin mucosal, self-image disorder, and somatic cluster. The severity of each symptom cluster was negatively correlated with quality of life. Among them, gastrointestinal, emotional, and somatic clusters were significant predictors of quality of life. CONCLUSIONS There are multiple symptom clusters in children with acute leukemia, which seriously affect children's quality of life. To relieve symptom burden and improve quality of life, nursing and medical staff should pay attention to the symptom management and control in a symptom cluster perspective. IMPLICATIONS FOR PRACTICE The results of this study will provide suggestions for the healthcare provider to plan for these symptoms and manage any concurrent symptoms for the successful promotion of children's quality of life.
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Chung JOK, Li WHC, Cheung AT, Ho LLK, Xia W, Chan GCF, Lopez V. Relationships among resilience, depressive symptoms, self-esteem, and quality of life in children with cancer. Psychooncology 2020; 30:194-201. [PMID: 32916019 DOI: 10.1002/pon.5548] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/16/2020] [Accepted: 09/07/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the interrelationships among resilience, self-esteem, and depressive symptoms and determine whether resilience was a factor associated with quality of life for Hong Kong Chinese children with cancer. METHODS We used a cross-sectional study design. Participants were 138 Hong Kong Chinese children (aged 7-14 years) who were admitted to the pediatric oncology units of an acute public hospital. The resilience, depressive symptoms, self-esteem, and quality of life of participating children were assessed. The primary outcome was the association between resilience and quality of life in children with cancer. RESULTS In total, 72 boys and 66 girls were recruited for this study (mean age 10.6 years). The mean levels of resilience, depressive symptoms, self-esteem, and quality of life were 23.4, 30.0, 23.0, and 63.6, respectively. There was a statistically significant strong positive correlation between resilience and quality of life (r = 0.60, p < 0.01), indicating that greater resilience was associated with better quality of life. Children with cancer from single-parent families, those diagnosed with a brain tumor, and those who received multiple treatments reported significantly lower levels of resilience, self-esteem, and quality of life, and greater depressive symptoms than other children (all p's < 0.001). Results of a multiple regression analysis revealed that resilience (p < 0.001) was a strong factor associated with quality of life among children with cancer. CONCLUSIONS It is essential that healthcare professionals implement interventions to boost the resilience of children with cancer, thereby enhancing their quality of life.
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Affiliation(s)
| | | | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Wei Xia
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, China
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12
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Linder LA, Hooke MC. Symptoms in Children Receiving Treatment for Cancer-Part II: Pain, Sadness, and Symptom Clusters. J Pediatr Oncol Nurs 2020; 36:262-279. [PMID: 31307323 PMCID: PMC7197222 DOI: 10.1177/1043454219849578] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Children and adolescents receiving treatment for cancer experience multiple symptoms as a consequence of their disease and its treatment that interfere with the child's quality of life. Understanding of symptom assessment in children with cancer is foundational to the work of the Children's Oncology Group Nursing Discipline, whose research aims are to address knowledge gaps including understanding illness-related distress. This article is the second of a two-part summary of current evidence addressing the assessment of symptoms frequently reported by children and adolescents receiving treatment for cancer. Studies reporting assessment of pain, sadness, and symptom clusters published between January 2008 and May 2018 were included. Forty-three publications addressed pain. Pain was highly prevalent and distressing, varied in its trajectory across a cycle of chemotherapy and across multiple cycles of treatment, and correlated with biomarkers associated with the pain response. Consequences of pain were poorer functional status and emotional health. Twenty publications addressed sadness. Sadness was the most prevalent psychosocial symptom. Its prevalence decreased over the course of treatment and over a cycle of chemotherapy. Persistent sadness was of greater severity and distress. Eight publications addressed symptom clusters. These studies identified both groups of co-occurring symptoms and groups of patients with common symptom profiles. This two-article series provides evidence for the distressing nature of symptoms among children receiving cancer treatment. Efforts to support clinicians in routine symptom assessment are needed. Additional research directed at alleviating symptoms and building resilience among the child experiencing symptoms is needed.
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Affiliation(s)
- Lauri A Linder
- 1 University of Utah College of Nursing, Salt Lake City, UT, USA
- 2 Cancer Transplant Service, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Mary C Hooke
- 3 University of Minnesota School of Nursing, Minneapolis, MN, USA
- 4 Children's Minnesota, Minneapolis, MN, USA
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Ho KY, Lam KKW, Chung JOK, Xia W, Cheung AT, Ho LK, Chiu SY, Chan GCF, Li HCW. Systematic review of the effectiveness of complementary and alternative medicine on nausea and vomiting in children with cancer: a study protocol. BMJ Open 2019; 9:e031834. [PMID: 31628132 PMCID: PMC6803108 DOI: 10.1136/bmjopen-2019-031834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Nausea and vomiting are two most common symptoms reported by children with cancer when they undergo active treatment. However, pharmacological treatment is not sufficient to manage these two symptoms, with over 40% of children still experience nausea and vomiting after receiving antiemetics. There has been an exponential growth of studies to demonstrate the effectiveness of different complementary complementary medicine (CAM) to control nausea and vomiting during cancer treatment. Appropriate application of CAM enhances the effectiveness of antiemetics, thus reducing the symptom burden on children as well as improving their general condition and quality of life during cancer treatment. Nevertheless, it remains unclear which CAM is the best approach to help children to prevent or reduce nausea and vomiting during and after cancer treatment. This paper describes a protocol for identifying, analysing and synthesising research evidence on the effectiveness of CAM on nausea and vomiting in children with cancer. METHODS AND ANALYSIS A total of 10 databases will be searched to identify appropriate literature: MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, PsycINFO, LILACS, OpenSIGLE, the Chinese Biomedical Literature Database, the Chinese Medical Current Contents and the Chinese National Knowledge Infrastructure. All randomised controlled trials which meet the inclusion criteria will be included. The primary outcome is the changes in nausea and vomiting either assessed by self-reported and/or objective measures. Review Manager 5.3 will be used to synthesise the data, calculate the treatment effects, perform any subgroup analysis and assess the risk of bias. ETHICAL AND DISSEMINATION The results will be presented at international conferences and published in peer-reviewed journals. As no individual data will be involved in this review, ethical approval is not required. PROSPERO REGISTRATION NUMBER CRD42019135404.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | | | | | - Wei Xia
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Long Kwan Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Sau Ying Chiu
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
| | - Godfrey Chi Fung Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
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Comparing the Impact of Cancer and Treatment-Related Effects on Psychological Well-being and Quality of Life Between Hong Kong Survivors of Childhood Solid Tumors and Leukemia. Cancer Nurs 2019; 43:446-454. [PMID: 31361673 DOI: 10.1097/ncc.0000000000000736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Evidence shows that survivors of solid tumors have a lower survival rate and shorter disease-free survival time than survivors of leukemia. However, the psychological well-being and health-related quality of life (HRQOL) of these 2 groups of cancer survivors have not been compared. OBJECTIVE To examine and compare the impact of cancer and treatment-related effects on psychological well-being and HRQOL between survivors of childhood solid tumors and leukemia. METHODS We conducted a cross-sectional study involving 65 Hong Kong survivors of solid tumors and 70 survivors of leukemia aged 8 to 18 years who had their medical follow-up in a pediatric outpatient clinic. Participants' depressive symptoms, self-esteem, and HRQOL were assessed. Twenty-two survivors of childhood solid tumors and 15 survivors of childhood leukemia were then selected for semistructured interviews. RESULTS Survivors of childhood solid tumors reported significantly higher mean scores for depressive symptoms, and lower mean self-esteem and HRQOL scores than survivors of childhood leukemia. Qualitative data revealed that survivors of childhood solid tumors faced more challenges in their daily life than survivors of childhood leukemia. CONCLUSIONS Survivors of childhood solid tumors reported poorer psychological well-being and HRQOL than survivors of childhood leukemia. This vulnerable group warrants more attention and support. IMPLICATIONS FOR PRACTICE It is vital for healthcare professionals to understand the impact of cancer and treatment-related effects in the context of different types of cancer. This will facilitate development and evaluation of appropriate psychological interventions to promote psychological well-being and HRQOL among childhood cancer survivors.
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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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Sousa ADRSE, Silva LFD, Paiva ED. Nursing interventions in palliative care in Pediatric Oncology: an integrative review. Rev Bras Enferm 2019; 72:531-540. [PMID: 31017219 DOI: 10.1590/0034-7167-2018-0121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/26/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer. METHOD integrative review of the literature through the databases: CINAHL, MEDLINE, IBECS, LILACS and SCIELO, carried out in October and November 2017. RESULTS we analyzed 18 articles that met the inclusion criteria. The results showed that, among the articles selected, Brazil is the country with the largest number of publications and that interventions such as music therapy, massage, ludic application, early consultation of palliative care, social interventions and physical exercises aimed at the resolution of a specific symptom obtained better results when compared to interventions that aimed at the comprehensiveness of palliative care. FINAL CONSIDERATION we conclude that greater emphasis should be given to palliative care in academic and professional training and that further studies in search of the best evidence should be conducted to support nursing Evidence-Based Practices.
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Affiliation(s)
| | | | - Eny Dórea Paiva
- Universidade Federal Fluminense, Faculdade de Enfermagem. Niterói-RJ, Brasil
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17
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Cheung AT, Li WHC, Ho KY, Lam KKW, Ho LLK, Chiu SY, Chan GCF, Chung JOK. Efficacy of musical training on psychological outcomes and quality of life in Chinese pediatric brain tumor survivors. Psychooncology 2018; 28:174-180. [DOI: 10.1002/pon.4929] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Ka Yan Ho
- School of Nursing; The University of Hong Kong; Hong Kong
| | | | | | - Sau Ying Chiu
- Paediatric Oncology Unit; Queen Mary Hospital; Hong Kong
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18
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The Impact of Hematologic Cancer and Its Treatment on Physical Activity Level and Quality of Life Among Children in Mainland China. Cancer Nurs 2018; 42:492-500. [DOI: 10.1097/ncc.0000000000000661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Lam KKW, Li WHC, Chung OK, Ho KY, Chiu SY, Lam HS, Chan GCF. An integrated experiential training programme with coaching to promote physical activity, and reduce fatigue among children with cancer: A randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2018; 101:1947-1956. [PMID: 30007765 DOI: 10.1016/j.pec.2018.07.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/14/2018] [Accepted: 07/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study examined the effectiveness of an integrated programme in promoting physical activity, reducing fatigue, enhancing physical activity self-efficacy, muscle strength and quality of life among Chinese children with cancer. METHODS A randomised controlled trial was conducted in a Hong Kong public hospital. Seventy eligible children were randomly assigned to an experimental group (n = 37) or a control group (n = 33). The experimental group received an integrated programme with 28 home visits from coaches over a 6-month period. The control group received a placebo intervention. The primary outcome was fatigue at 9 months (3 months after intervention completion). Secondary outcomes were physical activity levels, physical activity self-efficacy, muscle strength and quality of life at 9 months, assessed at baseline, and 6 and 9 months after starting the intervention. RESULTS The experimental group reported significantly lower levels of cancer-related fatigue, higher levels of physical activity and physical activity self-efficacy, greater right- and left-hand grip strength and better quality of life than the control group at 9 months. CONCLUSION The programme is effective and feasible to implement among children with cancer and offers an alternative means of ameliorating the healthcare burden. PRACTICE IMPLICATIONS Healthcare professionals should build multidisciplinary partnerships to sustain such programmes.
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Affiliation(s)
- Katherine K W Lam
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - William H C Li
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - O K Chung
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - K Y Ho
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - S Y Chiu
- Department of Adolescent Medicine, Queen Mary Hospital, Hong Kong, China.
| | - H S Lam
- Hong Kong Council for Accreditation of Academic and Vocational Qualifications, Hong Kong, China.
| | - Godfrey C F Chan
- Department of Adolescent Medicine, Queen Mary Hospital, Hong Kong, China.
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Narendran G, Tomfohr L, Schulte F. Inflammatory cytokines and depression in children with cancer: A review of the literature. Pediatr Hematol Oncol 2018; 35:11-19. [PMID: 29648904 DOI: 10.1080/08880018.2018.1440335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Compared to the general pediatric population, pediatric cancer patients are at increased risk of experiencing depressive symptoms during and after their treatment. Clinically, there exist few resources to guide health care professionals in the care of children with cancer who report depressive symptomatology. Pediatric cancer patients experience unique inflammatory changes secondary to their disease and accompanying treatments. It has been reported that inflammatory changes in the context of illness are related to cytokine dysregulation which in turn may influence the expression of depressive symptoms. In this review of current literature, we summarize the existing knowledge, relevant models and studies in progress with respect to this concept.
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Affiliation(s)
- Gaya Narendran
- a Division of Pediatric Oncology, Alberta Children's Hospital , Calgary , Alberta , Canada
| | - Lianne Tomfohr
- b Department of Psychology , Faculty of Arts, University of Calgary , Calgary , Alberta , Canada
| | - Fiona Schulte
- a Division of Pediatric Oncology, Alberta Children's Hospital , Calgary , Alberta , Canada
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21
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Lam KKW, Ho Cheung William L, Ho KYE, Chung OKJ, Chan CFG. Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer: an exploratory study. J Clin Nurs 2016; 26:190-201. [DOI: 10.1111/jocn.13495] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Ka Yan Eva Ho
- School of Nursing; The University of Hong Kong; Hong Kong China
| | | | - Chi Fung Godfrey Chan
- Department of Paediatrics and Adolescent Medicine; LKS Faculty of Medicine; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
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Gonzalez-Mercado VJ, Williams PD, Williams AR, Pedro E, Colon G. The symptom experiences of Puerto Rican children undergoing cancer treatments and alleviation practices as reported by their mothers. Int J Nurs Pract 2016; 23. [DOI: 10.1111/ijn.12500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 08/13/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Arthur R. Williams
- Department of Health Administration and Policy; George Mason University; Fairfax Virginia USA
| | - Elsa Pedro
- School of Pharmacy; University of Puerto Rico Medical Sciences Campus; San Juan Puerto Rico
| | - Gloria Colon
- Pediatric Hematology and Oncology; University of Puerto Rico School of Medicine; San Juan Puerto Rico
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Zhou Y, Cui Y, Wang H, Wang F, Lu C, Shen Y. Developing a tool for nurses to assess risk of infection in pediatric oncology patients in China: a modified Delphi study. J Biomed Res 2016; 30:386-392. [PMID: 27845302 PMCID: PMC5044711 DOI: 10.7555/jbr.30.20160014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 02/24/2016] [Accepted: 05/24/2016] [Indexed: 11/23/2022] Open
Abstract
Infections are identified as the most common preventable cause of death in pediatric oncology patients. Assessing and stratifying risk of infections are essential to prevent infection in these patients. To date, no tool can fulfill this demand in China. This study aimed to develop a nursing work-based and Chinese-specific tool for pediatric nurses to assess risk of infection in oncology patients. This research was a modified Delphi study. Based on a literature review, a 37-item questionnaire rating on a 0–5 scale was developed. Twenty-four experts from 8 hospitals in 6 provinces of China were consulted for three rounds. Consensus for each item in the first round was defined as: the rating mean was > 3 and the coefficient of variation (CV) was < 0.5. Consensus for each item in the second round was defined as CV < 0.3. Consensus among experts was defined as: P value of Kendall's coefficient of concordance (W) < 0.05. After three rounds of consultation, a two-part tool was developed: the Immune Status Scale (ISS) and the Checklist of Risk Factors of Infection (CRFI). There were 5 items in the ISS and 14 in the CRFI. Based on the ISS score, nurses could stratify children into the low-risk and high-risk groups. For high-risk children, nurses should screen risk factors of infection every day by the CRFI, and twice weekly for low-risk children. Further study is needed to verify this tool's efficacy.
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Affiliation(s)
- Yufeng Zhou
- Department of Basic and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, JIangsu 211166, China
| | - Yan Cui
- Department of Basic and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, JIangsu 211166, China;
| | - Hong Wang
- Department of Respiratory, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China;
| | - Fang Wang
- Department of Paediatric, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Chao Lu
- Department of Paediatric, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yan Shen
- Department of Paediatric, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
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Lin H, Zhou S, Zhang D, Huang L. Evaluation of a nurse-led management program to complement the treatment of adolescent acute lymphoblastic leukemia patients. Appl Nurs Res 2016; 32:e1-e5. [DOI: 10.1016/j.apnr.2016.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 08/04/2016] [Accepted: 08/07/2016] [Indexed: 01/08/2023]
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Lam KK, Li WH, Chiu S, Chan GC. The impact of cancer and its treatment on physical activity levels and quality of life among young Hong Kong Chinese cancer patients. Eur J Oncol Nurs 2016; 21:83-9. [DOI: 10.1016/j.ejon.2016.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 09/11/2015] [Accepted: 01/28/2016] [Indexed: 11/26/2022]
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Ho KY, Li WHC, Lam KWK, Chui SY, Chan CFG. Psychometric properties of the Chinese version of the fatigue scale-adolescent. BMC Cancer 2015; 15:938. [PMID: 26614348 PMCID: PMC4662819 DOI: 10.1186/s12885-015-1945-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 11/20/2015] [Indexed: 12/18/2022] Open
Abstract
Background The availability of a valid and reliable instrument that accurately assesses the level of fatigue among adolescent cancer survivors is crucial before any appropriate interventions to reduce their fatigue can be appropriately planned and evaluated. The study aimed to test the psychometric properties of the Chinese version of the Fatigue Scale for Adolescents. In particular, confirmatory factor analysis was conducted to examine its factorial structure. Methods A cross-sectional study was employed. Adolescents (13- to 18-year-olds) who had survived cancer and attended medical follow-up at the outpatient clinic in Hong Kong were invited to participate. The internal consistency, content validity and construct validity and test-retest reliability of the Chinese version of the Fatigue Scale for Adolescents were assessed. Results The content validity index was 0.92. There was a strong positive correlation between adolescents’ levels of fatigue and depressive symptoms (r = 0.53) and a strong negative correlation between adolescents’ levels of fatigue and quality of life (r = –0.58). The mean levels of fatigue of the survivors group was significantly lower than that of those still receiving treatment in hospital, but significantly higher than that of their healthy counterparts. Confirmatory factor analysis indicated that there were 4 factors underlying the Chinese version of the Cancer Module. Conclusions The findings of the study add further evidence that the Chinese version of the Fatigue Scale for Adolescents (12-item) can be used as a reliable and valid tool in assessing cancer-related fatigue among Hong Kong Chinese adolescents who have survived cancer.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, The University of Hong Kong, 4/F, William MW Mong Block, No 21 Sassoon Road, Pokfulam, Hong Kong.
| | - William H C Li
- School of Nursing, The University of Hong Kong, 4/F, William MW Mong Block, No 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Ka Wai Katherine Lam
- School of Nursing, The University of Hong Kong, 4/F, William MW Mong Block, No 21 Sassoon Road, Pokfulam, Hong Kong.
| | - S Y Chui
- Department of Adolescent Medicine, Queen Mary Hospital, Room 115, New Clinical Building, 102 Pokfulam Road, Hong Kong, Hong Kong.
| | - Chi-Fung Godfrey Chan
- Department of Adolescent Medicine, Queen Mary Hospital, Room 115, New Clinical Building, 102 Pokfulam Road, Hong Kong, Hong Kong.
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Williams PD, Piamjariyakul U, Shanberg R, Williams AR. Monitoring and Alleviation of Symptom Occurrence and Severity Among Thai Children and Adolescents During Cancer Treatments. J Pediatr Oncol Nurs 2015; 32:417-28. [PMID: 25616370 DOI: 10.1177/1043454214563754] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Symptom monitoring and alleviation are important during pediatric cancer treatments. AIMS To examine the use of the Therapy-Related Symptom Checklist for Children (TRSC-C; Thai version) for reported occurrence, severity, and management of treatment-related symptoms within a cohort of Thai pediatric oncology patients/parents METHOD Cross-sectional study; convenience sample: 100 parents of 71 male children/29 females, 63% with leukemia, 37%, other diagnoses; age-groups: <5 years, n = 33; 5 to 11 years, n = 44; 12 to 17 years, n = 25. Parents reported children's symptom occurrence/severity on the TRSC-C; and complementary care methods on the Symptom Alleviation: Self-Care Methods and their symptom alleviation methods. All tools had good psychometric properties. RESULTS 18 symptoms on the 30-item TRSC-C occurred in 42% to 95% of children. Mean severity of symptoms was between 1.0 ("a bit") and 2.0 ("quite a bit"); 5-month to 11-year-old children had higher (worse) TRSC-C total scores. Complementary care was used and reported. CONCLUSIONS Monitoring of multiple symptoms with the TRSC-C and parental symptom alleviation helped children. CLINICAL IMPLICATIONS Thai parents/patients need and accept assistance in monitoring/managing side effects of pediatric cancer therapy.
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Affiliation(s)
| | | | - Rachel Shanberg
- University of Chicago, Comer Children's Hospital, Chicago, IL, USA
| | - Arthur R Williams
- James A. Haley Veterans Affairs Medical Center, Tampa, FL, USA George Mason University, Washington, DC, USA
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Wu WW, Tsai SY, Liang SY, Liu CY, Jou ST, Berry DL. The Mediating Role of Resilience on Quality of Life and Cancer Symptom Distress in Adolescent Patients With Cancer. J Pediatr Oncol Nurs 2015; 32:304-13. [PMID: 25612835 DOI: 10.1177/1043454214563758] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Understanding how cancer symptom distress and resilience contribute to quality of life (QoL) in adolescent cancer and may potentially help these patients achieve better health-related outcomes. The objective of this study was to describe cancer symptom distress, QoL, and resilience in adolescents with cancer and to determine whether resilience is a mediating variable. Forty adolescent cancer patients were recruited, and data were collected via a demographic questionnaire, the Cancer Symptom Distress Scale, the Resilience Scale, and the Minneapolis-Manchester Quality of Life Scale. Pearson's correlation, multiple regressions, and the Sobel test were conducted. Both resilience and cancer symptom distress were regressed against QoL, accounting for 62.1% of observed variation in QoL scores. The bootstrap result estimated the true indirect effect between -.0189 and -.0024, with a 95% confidence interval. Resilience mediates the relationship between cancer symptom distress and QoL. Clinical use of a resilience measure, for example to use in developing and evaluating interventions focused on enhancing resilience, may be practical for nurses.
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Affiliation(s)
- Wei-Wen Wu
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Shu-Yuan Liang
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chieh-Yu Liu
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Li HCW, Chung OKJ, Tam CJ, Chiu SY. Effective Prevention and Management of Tumor Lysis Syndrome in Children With Cancer. J Pediatr Oncol Nurs 2015; 32:209-18. [PMID: 25556106 DOI: 10.1177/1043454214555551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The practice guidelines aimed to identify appropriate nursing management for the prevention and treatment of tumor lysis syndrome, in line with the current evidence-based medical guidelines. Using a systematic approach, 15 relevant articles were identified for the review. The evaluation of patient risk factors for tumor lysis syndrome and the appropriate medical and nursing assessment were identified. The treatment algorithms for the prevention of tumor lysis syndrome from both the medical and nursing perspectives have been established. In particular, the guidelines highlight the importance of pediatric oncology nurses in contributing to the prevention and management of tumor lysis syndrome.
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