Determine the difficulties of home care in children following haematopoietic stem cell transplantation

Home experiences of parents of children undergoing hematopoietic stem cell transplantation: A qualitative study

PURPOSE

This study aimed to describe the home experiences of parents of children undergoing hematopoietic stem cell transplantation.

DESIGN AND METHODS

This study was conducted using a descriptive qualitative research design. The study sample consisted of 12 parents with a child treated with hematopoietic stem cell transplantation (HSCT) at a university hospital in Turkey. Semi-structured individual interviews and researcher observations were used for data collection. The interview transcripts of the study were analyzed using content analysis.

RESULTS

Five main themes were obtained, each of which had associated sub-themes: difficulties faced in home experiences, changes in family life, feelings about home experiences, parents' ways of coping with difficulties, and parents' suggestions.

CONCLUSIONS

Parents faced various difficulties in their own home experiences, and they felt fear, anxiety and stress during this period. Following the child's HSCT, there were changes in health, physical, psychological and social aspects of family life. Some parents used distraction techniques, and the support of their spouses and health professionals to cope with difficulties.

PRACTICE IMPLICATIONS

For pediatric nurses to comprehensively assess and support the home care needs of the child and parents, they should understand the difficulties parents face in home experiences, as well as their feelings, changes in their lives, suggestions regarding home experiences, and ways of coping. Regular health screening and psychosocial support can be provided for parents of children after HSCT, and regular training can be given for parents' management of care-related problems and increasing their self-efficacy for this management.

The Use of a Video for Discharge Education for Parents After Pediatric Stem Cell Transplantation

Background: Caring for a child at home after hematopoietic stem cell transplant (HSCT) is challenging for parents, and discharge education is critical to ensure parents are prepared. The purpose of this study is to evaluate the feasibility and effectiveness of a discharge video intervention (DVI) as an adjunct to standard discharge teaching (SDT). Method: A two-phase study was conducted at an urban children’s hospital in the western United States. Phase 1 involved SDT alone followed by nurse-administered proficiency testing of parent knowledge in caring for their children at home using a 4-point Likert-type scale of parents of children post-allogeneic HSCT. These results informed the DVI, created in English and Spanish in Phase 2. The DVI content included topics on home cleaning, notifying the medical team, graft-versus-host disease (GVHD), diet and visitor restrictions, and outpatient visits. In Phase 2, the DVI was viewable by parents who also received SDT. Parents’ proficiency was evaluated using the same procedure as in Phase 1. Results: Thirty-four parents participated: 17 in Phase 1 (SDT), 17 in Phase 2 (SDT + DVI). The DVI was viewed by parents in Phase 2 approximately twice prior to discharge. Parents in Phase 2 had higher proficiency scores on home cleaning, signs/symptoms of GVHD, and diet restriction. Parents in Phase 1 had higher proficiency regarding notifying the team. Conclusions: The DVI was feasible and demonstrated incremental increases in parent’s proficiency related to some discharge topics.

New Trends and Recent Care Approaches in Pediatric Oncology Nursing

Increased incidence of children diagnosed with cancer and survivors was an impact on changes in pediatric hemato-oncology nursing care. In this review article, it is aimed to investigate the new trends and recent care approaches in pediatric oncology nursing. The recent care topics were common in the literature as family-centered care, technology-based care, program development, primary care of child, health-care provider, survivors and home care, and nonpharmacological care. All of the topics contribute to perform evidence-based care for health promotion and well-being in pediatric hemato-oncology nursing. Research reviews showed that many current topics for the care of children and their parents have entered in the literature. There is a need for more randomized controlled studies to improve the level of evidence of new nursing approaches.