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Pouplier A, Fridh MK, Christensen J, Høyer A, Schmidt-Andersen P, Winther H, Larsen HB. Rehabilitation including structured active play intervention for preschoolers with cancer during treatment: A RePlay qualitative study of parents' experiences. Eur J Oncol Nurs 2024; 71:102639. [PMID: 38878692 DOI: 10.1016/j.ejon.2024.102639] [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: 12/01/2023] [Revised: 05/31/2024] [Accepted: 06/06/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE Preschool children receiving cancer treatment experience decreased gross motor function and challenges in personal and social development. For preschoolers, parents are critical for their child's cancer treatment trajectory, including their participation in physical activity. This study aimed to explore the parents' experiences with a novel rehabilitation intervention, including structured active play for preschoolers with cancer during treatment. METHOD Through criterion sampling, 23 parents of 18 preschool children diagnosed with cancer were interviewed from August 2021 until April 2023. A hermeneutic-phenomenological-inspired inductive thematic analysis was performed. RESULTS Based on 19 interviews with parents, three themes emerged: 1) pushing in the right direction, 2) sharing the responsibility, and 3) creating joyful experiences. The parents experienced that participation in the intervention resulted in physical progress for their child, and the child generally could develop personally and socially. The parents shared a common goal with a healthcare professional, who led the way in their child's physical development and gave them the space to participate with their child. The child actively chose to participate in structured active play, resulting in an altered perception of the hospital experience for both parents and children. CONCLUSION The parents' experiences showed that with the support, knowledge, and expertise of an exercise professional, rehabilitation including structured active play can be a way to integrate movement and physical activity for preschoolers in their cancer treatment trajectory. The repetitive structure of the active play sessions was experienced as motivating for the children and simultaneously challenging their physical, social, and personal development. TRIAL AND PROTOCOL REGISTRATION ClinicalTrials.gov: NCT04672681. Registered December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.
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Affiliation(s)
- Anna Pouplier
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Martin Kaj Fridh
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Public Health, Section of Social Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Amalie Høyer
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Peter Schmidt-Andersen
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helle Winther
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Demirbağ S, Ergin D. 'A voice of children: I would like a hospital just for children' - Children's perspectives on hospitalization: A phenomenological study. J Pediatr Nurs 2024; 77:e125-e131. [PMID: 38582668 DOI: 10.1016/j.pedn.2024.03.040] [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: 01/11/2024] [Revised: 03/15/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE This study aimed to explore children's perception of hospital experience and interpretations of hospitalization. DESIGN AND METHODS Phenomenological qualitative study design was used. The sample consisted of 18 participants (seven-18 years old) from a general paediatric ward in a university hospital recruited using criterion sampling, a purposive sampling method. Individual semi-structured interviews were conducted face-to-face and were audio recorded. Inductive thematic analysis was used to analyze the data. RESULTS The participants talked about the symptoms, limitations and treatments of their diseases, as well as the team communication, lack of activity and physical conditions regarding the hospital. It was seen that the children reported each expression with positive or negative emotions. Finally, they did not neglect to mention their desires regarding the hospital and their daily life. Four main themes emerged "hospital, disease, mood, and desires". CONCLUSIONS Health professionals should care about the needs of children during hospitalization and children should be allowed to express themselves. PRACTICE IMPLICATIONS Knowing and understanding the needs of hospitalized children can guide the planning and implementation of quality nursing care processes.
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Affiliation(s)
- Selin Demirbağ
- Manisa Celal Bayar University, Faculty of Health Sciences, Department of Child Health and Diseases Nursing, Manisa, Turkey.
| | - Dilek Ergin
- Manisa Celal Bayar University, Faculty of Health Sciences, Department of Child Health and Diseases Nursing, Manisa, Turkey
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Demetriou EA, Boulton KA, Bowden MR, Guastella AJ. Adjustment and homesickness in hospitalised children: A systematic review. Clin Psychol Rev 2024; 110:102431. [PMID: 38626645 DOI: 10.1016/j.cpr.2024.102431] [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: 06/25/2022] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024]
Abstract
Children can experience significant distress during hospitalisation, as a result of the treatment process and due to psychosocial factors impacting their adjustment to the hospital environment. Such factors can contribute to negative outcomes for the child. Despite this, limited research focus has been placed on understanding the psychosocial factors that contribute to a child's distress to inform support strategies that can improve the experience of hospitalisation across paediatric conditions. The objectives of this review were to synthesise the qualitative and quantitative literature on psychosocial factors associated with hospital adjustment and to identify risk and protective factors that influence the adjustment process. The literature search (1980 to February 2024: CINAHL / Embase / Medline / PsychINFO and Web of Science databases) identified thirty-four studies. Poor hospital adjustment, anxiety, depression and homesickness, were reported by the majority of hospitalised children. Several demographic and psychosocial factors were identified in the quantitative synthesis to contribute to poor adjustment. Child age, temperament, attachment style, past negative hospital experiences, homesickness and fear cognitions, were all associated with adjustment to the hospital environment. Homesickness was identified as a particularly understudied and important construct. Theoretical and methodological considerations are discussed, and recommendations made for future research that can further support inpatient children and their families.
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Affiliation(s)
- Eleni Andrea Demetriou
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Kelsie Anne Boulton
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Michael Russell Bowden
- Mental Health Branch, NSW Health; Sydney Children's Hospitals Network; Discipline of Psychiatry, Westmead Clinical School and The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Australia
| | - Adam John Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia.
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McPoland P, Grossoehme DH, Sheehan DC, Stephenson P, Downing J, Deshommes T, Gassant PYH, Friebert S. Children's understanding of dying and death: A multinational grounded theory study. Palliat Support Care 2024; 22:213-220. [PMID: 36960605 DOI: 10.1017/s1478951523000287] [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] [Indexed: 03/25/2023]
Abstract
OBJECTIVES The ways in which children understand dying and death remain poorly understood; most studies have been carried out with samples other than persons with an illness. The objective of this study was to understand the process by which children directly involved with life-limiting conditions understand dying and death. METHODS This qualitative study obtained interview data from N = 44 5-18-year-old children in the USA, Haiti, and Uganda who were pediatric palliative care patients or siblings of patients. Of these, 32 were children with a serious condition and 12 were siblings of a child with a serious condition. Interviews were recorded, transcribed, verified, and analyzed using grounded theory methodology. RESULTS Loss of normalcy and of relationships emerged as central themes described by both ill children and siblings. Resilience, altruism, and spirituality had a bidirectional relationship with loss, being strategies to manage both losses and anticipated death, but also being affected by losses. Resiliency and spirituality, but not altruism, had a bidirectional relationship with anticipating death. Themes were consistent across the 3 samples, although the beliefs and behaviors expressing them varied by country. SIGNIFICANCE OF RESULTS This study partially fills an identified gap in research knowledge about ways in which children in 3 nations understand dying and death. While children often lack an adult vocabulary to express thoughts about dying and death, results show that they are thinking about these topics. A proactive approach to address issues is warranted, and the data identify themes of concern to children.
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Affiliation(s)
- Paula McPoland
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Daniel H Grossoehme
- Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH, USA
- College of Public Health, Kent State University, Kent, OH, USA
| | | | | | - Julia Downing
- International Children's Palliative Care Network, Assagay, South Africa
- Makerere/Mulago Palliative Care Unit, Kampala, Uganda
| | - Theony Deshommes
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Pascale Y H Gassant
- Department of Pediatric Oncology, Saint-Damien Pediatric Hospital, Tabarre, Haiti
| | - Sarah Friebert
- Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH, USA
- Department of Pediatrics, Northeast Ohio Medical University, Rootstown, OH, USA
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Pouplier A, Fridh MK, Christensen J, Ruiz-Molsgaard H, Høyer A, Schmidt-Andersen P, Winther H, Larsen HB. The potential of structured active play for social and personal development in preschoolers during cancer treatment: A qualitative RePlay study. J Adv Nurs 2024; 80:1607-1618. [PMID: 37950393 DOI: 10.1111/jan.15923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/06/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023]
Abstract
AIM To explore the potential of a structured active play intervention to promote social and personal development in preschoolers during cancer treatment. DESIGN A hermeneutic-phenomenological inspired explorative study. METHODS Participant observations were conducted on 15 consecutively sampled children (aged 1-5 years) from April 2021 to April 2022. Observations were written as narrative scenic descriptions from field notes and were analysed inspired by hermeneutic-phenomenological analysis and using a thematic analysis structure. RESULTS Observations were carried out during 67 group or individual structured active play sessions, resulting in 129 scenic descriptions. Observations of the children's emotional, verbal and bodily expressions and social interactions resulted in three main themes: (1) wanting to play, (2) gaining confidence in movement and (3) being part of a group. The findings showed how children, irrespective of age and the severity of their illness, wanted to play and expressed joy of movement. The children's daily physical state fluctuated and influenced their motivation to participate as well as their confidence in their physical abilities. Through structured active play and with support from their parents and healthcare professionals, the children had successful movement experiences and regained confidence in movement, supporting their personal development. Playing together with other children and accompanied by their parents, healthcare professionals supported the children's opportunities to practice social skills, such as turn-taking, waiting and taking charge. Familiarity, recognizability and fun were key motivational components for the children. CONCLUSION Participating in structured active play during treatment has the potential to promote personal and social development in preschoolers with cancer. Parents play a crucial role in supporting the participation of their children. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The healthcare system and healthcare professionals should provide opportunities for preschoolers with cancer and other illnesses to participate in structured active play. IMPACT What problem did the study address? Cancer treatment affects the development of preschoolers' gross motor-, personal and social skills-essential skills in childhood development. This study aimed to explore the potential for social and personal development through structured active play. What were the main findings? This study found that preschoolers want to play, and participating in structured active play can support their personal and social development through regained confidence in movement and becoming part of a group. Where and on whom will the research have an impact? The research impacts healthcare professionals working with preschoolers in the healthcare system. Creating opportunities for preschoolers to participate in structured active play throughout treatment can promote personal and social development. REPORTING METHOD The study adheres to relevant EQUATOR guidelines and is reported according to the Standards for Reporting Qualitative Research (SRQR) checklist. PATIENT OR PUBLIC CONTRIBUTION Participants in this study were preschoolers with cancer and their parents. No public or patient involvement in the design of this study. TRIAL AND PROTOCOL REGISTRATION ClinicalTrials.gov: NCT04672681. Registered on December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.
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Affiliation(s)
- Anna Pouplier
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Social Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helena Ruiz-Molsgaard
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Amalie Høyer
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Peter Schmidt-Andersen
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Helle Winther
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department for Pediatric and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Testoni I, Nicoletti AE, Moscato M, De Vincenzo C. A Qualitative Analysis of the Experiences of Young Patients and Caregivers Confronting Pediatric and Adolescent Oncology Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6327. [PMID: 37510561 PMCID: PMC10378996 DOI: 10.3390/ijerph20146327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
Epidemiological studies show that new cases of young oncology patients are increasing by 400,000 every year. Psychological literature has shown that receiving an oncological diagnosis can cause significant psychological stress and discomfort. However, the experiences of young patients and their caregivers as they confront this challenge are not yet fully understood. This paper adopts a qualitative methodological approach to explore how young patients with an oncological diagnosis and their parents make sense of the experiential challenges they face. Thus, the research realized 18 semi-structured interviews, 11 of which were with pediatric and adolescent oncology patients, and 7 of which were with 6 mothers and 1 father. The qualitative thematic analysis revealed that the oncological diagnosis triggers different emotions taking the scene in the attempt to cope with the threats of meaning that the diagnosis poses. However, such intense experience promotes transformative feelings in parents and young patients, leading to important personal growth. Lastly, this article discusses the need to improve palliative psychological care competences in pediatric oncology. By providing comprehensive psychological care to young oncology patients and their families, healthcare providers can mitigate the psychological stress and pain associated with the diagnosis and treatment of cancer.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35131 Padua, Italy
- Sagol Creative Arts Therapies Research Center, Haifa 31905, Israel
| | | | - Matilde Moscato
- Sagol Creative Arts Therapies Research Center, Haifa 31905, Israel
| | - Ciro De Vincenzo
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35131 Padua, Italy
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Lulgjuraj D, Maneval RE. A phenomenological study exploring pediatric hospitalization: The voices of accompanied and unaccompanied hospitalized children. J Pediatr Nurs 2023; 70:68-78. [PMID: 36821913 DOI: 10.1016/j.pedn.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Most children go through their childhood without being hospitalized. For a child, being hospitalized may be a disturbing and unfamiliar experience. Pediatric institutions promote parental presence and family-centered care, yet not all parents are able to stay with their children. Holding the child's voice central to the phenomenon, the aim of this study was to explore how parental accompaniment and absence shape a child's hospitalization experience. DESIGN AND METHODS A phenomenological study was implemented, and children ages 7-11 years old were included if they were in the hospital for at least 24 h with a parent present or 12 h without a parent present. Deriving from the interviews of children, themes were identified to unearth the meaning of children's lived experiences. RESULTS Twelve school-age children shared their hospitalization experiences. The findings of this study are organized around the following themes: (a) participating in care; (b) being on the road to recovery; (c) being a kid, still; (d) being accompanied - having a familiar face; and (e) being unaccompanied - yearning but understanding. CONCLUSIONS Being in the hospital was not significantly different when parents were absent, but children preferred their parents to stay. Being in the hospital was not a negative experience. Hospitalized children were attentive, independent, understanding, and resilient. PRACTICE IMPLICATIONS Children in this study illuminate the need to listen to children's voices. Understanding the experiences of hospitalized children provides pediatric nurses with insight on supporting the patients and families they care for.
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Affiliation(s)
- Diana Lulgjuraj
- Children's Hospital at Montefiore, Department of Nursing, 3415 Bainbridge Avenue, Bronx, NY 10467, United States of America.
| | - Rhonda E Maneval
- Carlow University, College of Health and Wellness, 3333 Fifth Ave, Pittsburgh, PA 15213, United States of America
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Debelić I, Mikolčić A, Tihomirović J, Barić I, Lendić Đ, Nikšić Ž, Šencaj B, Lovrić R. Stressful Experiences of Parents in the Paediatric Intensive Care Unit: Searching for the Most Intensive PICU Stressors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11450. [PMID: 36141723 PMCID: PMC9517134 DOI: 10.3390/ijerph191811450] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Hospitalization of a child in the paediatric intensive care unit (PICU) is extremely stressful, both for the child and for his or her family. The purpose of this study was to gain deeper insight into the stressful experiences of parents of children hospitalized in the PICU. This study included 96 parents. The data were collected using a translated and standardized scale "The Parental Stressor Scale: Paediatric Intensive Care Unit (PSS: PICU)". This study confirms high exposure of parents to numerous PICU stressors. The most intense PICU stressor for parents was child's breathing depending on the ventilator (4.22 ± 1.17), and the least intense was child's demanding behaviour (1.17 ± 0.33). A significant positive correlation between the level of parents' perceived stress and the number of their children was recorded (r = 0.240, p = 0.02), while there was no significant correlation between the level of stress and other sociodemographic variables. A significantly higher level of stress was experienced by parents with primary school education (p = 0.032) and parents who are not healthcare professionals (p < 0.01). It is necessary to establish a system that will enable continuous assessment of parents' stress levels and timely prevention of stressful experiences for parents in the PICU.
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Affiliation(s)
- Ivana Debelić
- School of Nursing, Medicinska Škola Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Anamaria Mikolčić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jovana Tihomirović
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Iva Barić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Specialist Practice of Occupational and Sports Medicine, Ilija Celebic, 31000 Osijek, Croatia
| | - Đurđica Lendić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Paediatric Clinic, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Željka Nikšić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Paediatric Clinic, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Barbara Šencaj
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of School Medicine, Teaching Institute of Public Health for the Osijek-Baranya County, 31000 Osijek, Croatia
| | - Robert Lovrić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Jibb LA, Ameringer S, Macpherson CF, Sivaratnam S. The Symptom Experience in Pediatric Cancer: Current Conceptualizations and Future Directions. Curr Oncol Rep 2022; 24:443-450. [PMID: 35150393 DOI: 10.1007/s11912-022-01222-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW We aimed to review the recent research on the childhood cancer symptom experience pertaining to socioeconomic factors, biology and genetics, growth and development, family psychosocial dynamics, and social and treating environments to begin to formulate recommendations for a personalized approach to symptom management. RECENT FINDINGS Cancer symptoms are common and distressing in children and negatively impact child and family quality of life. Many interacting factors influence children's cancer symptoms experiences, including the assessment and management of such symptoms. This paper highlights several gaps in the research related to the cancer symptom experience including routine symptom assessment, the impact of socioeconomic, biological, and genetic factors on symptoms, and the establishment of effective symptom management partnerships with families. Based on our findings, we provide recommendations related to that research which is ready to be implemented into clinical practice and areas for needed future efforts.
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Affiliation(s)
- Lindsay A Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, M5T 1P8, Toronto, Canada. .,Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, M5G 0A4, Canada.
| | | | | | - Surabhi Sivaratnam
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, M5G 0A4, Canada.,Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, Hamilton, L8S 4K1, Canada
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Leibring I, Anderzén‐Carlsson A. Young children's experiences of support when fearful during treatment for acute lymphoblastic leukaemia-A longitudinal interview study. Nurs Open 2022; 9:527-540. [PMID: 34651461 PMCID: PMC8685861 DOI: 10.1002/nop2.1092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022] Open
Abstract
AIM AND OBJECTIVES To describe young children's experiences of valuable support in managing their fears about treatment for acute lymphoblastic leukaemia. The focus was specifically on support from parents and healthcare professionals. DESIGN The study had a qualitative descriptive longitudinal design. METHODS The study analysed 35 interviews with 13 children at three different times during their treatment period. Data were analysed using a matrix-based method. The Consolidated criteria for reporting qualitative research (COREQ) guidelines have been followed. RESULTS Parents and healthcare professionals provide important support to children undergoing treatment for acute lymphoblastic leukaemia, although their roles differ. Children valued their parents' closeness and advocacy, being able to participate in their own care, and being given pain relief during procedures known to create pain. Valued support from healthcare professionals changed over time, from providing information and showing the tools that would be used in procedures, to paying attention to the child's needs and desires. It was more important for children to be able to choose between different alternatives in medical procedures than deciding on major treatment issues.
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Affiliation(s)
- Ingela Leibring
- Institution for HealthFaculty of Health, Science and TechnologyKarlstad UniversityKarlstadSweden
| | - Agneta Anderzén‐Carlsson
- University Health Care Research CenterFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
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Pouplier A, Winther H, Christensen J, Schmidt-Andersen P, Zhang H, Frandsen TL, Schmiegelow K, Fridh MK, Larsen HB. Rehabilitation Including Structured Active Play for Preschoolers With Cancer (RePlay)-Study Protocol for a Randomized Controlled Trial. Front Pediatr 2022; 10:834512. [PMID: 35615627 PMCID: PMC9124960 DOI: 10.3389/fped.2022.834512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Children diagnosed with cancer experience muscle weakness and impaired physical function caused by treatment and related immobility. The situation forces them into a negative cycle of diminished participation in physical and leisure activities and isolation from peers; inhibiting the natural development of social and gross motor skills. This manuscript presents a protocol for a study that explores the effects of using structured active play to maintain preschoolers' age specific gross motor function and social and personal skills while undertaking intensive cancer treatment. METHODS The study is a two-arm, superiority randomized controlled trial with an intervention and a control group designed to evaluate the effects of a structured active play intervention on gross motor function. Gross motor subtests of the Peabody Developmental Motor Scales, Second Edition (PDMS-2) are used for measurement; with the primary end-point at 6 months post-treatment initiation. Eighty-four preschool children (aged 1-5 years), newly diagnosed with cancer at the Copenhagen University Hospital are randomly assigned to either an intervention or control group, using a 1:1 allocation. The intervention group receives a combined in-hospital and home-based program that includes structured active play activities, while the control group receives standard care, including physiotherapy. During hospital admission, the intervention group undertakes 45-min structured active play group sessions three times weekly, conducted by exercise professionals. Parents receive training and supervision to facilitate daily individual sessions outside of group sessions. Secondary study outcomes target the children's overall function level in everyday life, general physical performance, and health-related quality of life. As well, children's and parents' experiences within the intervention are explored and the children's social and personal development is observed. DISCUSSION Limited evidence exists regarding the effectiveness of rehabilitation interventions, particularly those including active play, for preschoolers diagnosed with cancer. This manuscript reporting on a study protocol will enhance clarity and transparency in reporting and offer insights for others with interest in this same topic. Once completed, findings from this study could extend knowledge about the conduct and measurement of effectiveness in rehabilitation initiatives. If study findings suggest that the intervention is effective, structured active play may become a standard part of rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov: NCT04672681. Registered December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.
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Affiliation(s)
- Anna Pouplier
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helle Winther
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Schmidt-Andersen
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - He Zhang
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Leth Frandsen
- Mary Elizabeth's Hospital, Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Wennick A, Schoug D, Ekwall A, Axelsson M. Translation, adaptation and testing of an emergency care satisfaction scale in Swedish pediatric emergency departments. BMC Pediatr 2021; 21:486. [PMID: 34727922 PMCID: PMC8564961 DOI: 10.1186/s12887-021-02961-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric healthcare today shows a rising demand for research focusing on children's perspectives on and consumer satisfaction with the nursing care they receive. Therefore, the purpose of this study was to translate and adapt the Consumer Emergency Care Satisfaction Scale (CECSS), a paper-based, self-administered 19-item questionnaire originally developed in the United States and targeted towards adults, and then test the new version in Swedish pediatric emergency departments. METHODS The study was designed with a two-phase approach. Firstly, a forward-backward translation of the CECSS, involving expert consensus, was performed, and then the questionnaire was adapted for children aged 10-18 and assessed for face and content validity. Secondly, the translated and adapted questionnaire was tested with a clinical sample for construct validity, internal consistency, and reliability. This last aspect was assessed using a structured telephone interview 7-10 days after the participant visited a pediatric emergency department. All children participating in this study gave their assent (< 15 years) or consent (≥ 15 years), and their guardian's written informed consent was also obtained. RESULTS The paper-based, self-administered 19-item Swedish version of the CECSS was tested on a clinical sample consisting of 203 nonurgent children (boys: n = 109, 53.7 % and girls: n = 94, 46.3 %) between 10 and 18 years (mean age 13.8, SD 2.29). The factor analysis revealed three factors that explain 63.1 % of the total variation in the 15 items. The Cronbach's alphas for the three dimensions (caring, teaching, and clinical competence) varied between 0.79 and 0.88. The intraclass correlation coefficient (ICC) for the entire Swedish version of the CECSS was 0.58, and the ICCs for the three dimensions varied between 0.56 and 0.71. CONCLUSIONS The results show that the developed Swedish Pediatric Consumer Emergency Care Satisfaction Scale (p-CECSS-S) is a valid, stable and easy-to-use-questionnaire that can be used to assess children's satisfaction with nursing care.
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Affiliation(s)
- Anne Wennick
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden.
| | - Dorota Schoug
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - Anna Ekwall
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden
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13
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Lulgjuraj D, Maneval RE. Unaccompanied Hospitalized Children: An Integrative Review. J Pediatr Nurs 2021; 56:38-46. [PMID: 33181372 DOI: 10.1016/j.pedn.2020.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/27/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022]
Abstract
PROBLEM A child's hospitalization is often associated with stress that is exacerbated when the child is left unaccompanied by parents/caregivers. Parental presence, as part of a family-centered approach to care, is a strategy to mitigate the stressors and negative effects of hospitalization. However, due to a variety of circumstances, some children continue to remain unaccompanied in the hospital. This integrative review explored the phenomenon of unaccompanied hospitalized children. ELIGIBILITY CRITERIA Relevant articles available in full-text and written in English were identified through electronic searches of CINAHL, PubMed, and PsycINFO and through hand searches of reference lists. SAMPLE Eleven studies were included, analyzed, and synthesized into themes. Study quality was assessed using Bowling and Pearson's appraisal checklists. RESULTS Distress of hospitalized children is evident when children are unaccompanied in the hospital and left to experience the stressors of hospitalization alone. The compounding effects of hospitalization and separation can cause distress and psychological trauma during and after the hospitalization period. Pediatric nurses strive to provide care to unaccompanied children that lessens these negative effects. CONCLUSIONS Unaccompanied hospitalized children represent a vulnerable population. While the literature provides some insight into the experiences, research does not adequately explore the unaccompanied hospitalized child's experience. IMPLICATIONS Pediatric nurses hold a position that enable them to support the physical and psychosocial needs of unaccompanied hospitalized children. By recognizing and addressing the stressors and distress unaccompanied children experience, nurses can help alleviate the subsequent effects resulting from separation and hospitalization.
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Affiliation(s)
- Diana Lulgjuraj
- College of Health Professions, Lienhard School of Nursing, Pace University, NY, USA.
| | - Rhonda E Maneval
- College of Health Professions, Lienhard School of Nursing, Pace University, NY, USA.
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14
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Sjöberg C, Svedberg P, Carlsson IM, Nygren JM. The Importance of the Setting during Sedation for Intrathecal Chemotherapy in Pediatric Oncology Care: A Case Study. Healthcare (Basel) 2020; 8:healthcare8030314. [PMID: 32887243 PMCID: PMC7551382 DOI: 10.3390/healthcare8030314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/22/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Increasing survival rates for childhood cancer have brought attention to the high level of burden of cancer and its treatment. Improving supportive care for children throughout their cancer trajectory is thus important and could reduce the difficulties related to treatment, including time-consuming treatments and the waiting time associated with treatment procedures. The aim of this study is to describe time intervals and the Propofol dose used during sedation for intrathecal chemotherapy in three different settings. The study is based on retrospective data from repeated treatment sessions recorded in operation planning programs and hospital records in the period 2011–2018 (n = 164). Children, 1–12 years old (n = 22), undergoing a varying number of treatments, were included in the study. The most crucial finding in this study is that the time from the child’s first meeting with the nurse anesthetist to the induction of sedation is significantly reduced if the procedure is performed in the children’s ward. The study highlights the importance of the setting for sedation for intrathecal chemotherapy when implementing a child-centered approach in pediatric oncology care.
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15
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Darcy L, Granlund M, Enskär K, Björk M. The development of the clinical assessment tool "Health and Everyday Functioning in Young Children with Cancer". Child Care Health Dev 2020; 46:445-456. [PMID: 31944353 DOI: 10.1111/cch.12744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 01/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Young children's experiences of everyday life with cancer are vital in guiding care. The universal and interdisciplinary language of the International Classification of Functioning (ICF) and the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) has wide reaching effects for the care of young children in need. The aim of this study was to select and validate the content of a clinical assessment tool (CAT) for health and everyday functioning in young children with cancer. METHODS A comprehensive set of ICF-CY codes (n = 70) mapping everyday function and health was previously identified from the transcripts of 12 interviews with young children with cancer and their parents at a paediatric oncology centre in the west of Sweden. Three transcripts were from data collected shortly after diagnosis, three transcripts from 6 months after diagnosis, three transcripts from 12 months after diagnosis, and three transcripts from 18 months after diagnosis. The present study involved the development of items based on the ICF-CY codes. RESULTS The CAT consists of 52 items grouped in four dimensions: "the child herself/himself," "the child's everyday life," "the child's need for support," and "the child's contacts with health care." CONCLUSION The questions correlate well with known research results and highlight areas that are important for health and everyday life for young children with cancer. This tool, based on children's experiences, can be used by both parents and health care personnel such as nurses to highlight aspects of health and function in everyday life for the young child with cancer that otherwise might be missed. This novel approach using the ICF-CY could be used to guide the delivery of care towards living an everyday life with a long-term illness.
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Affiliation(s)
- Laura Darcy
- Department of Caring Science, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Mats Granlund
- CHILD Research Group, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Karin Enskär
- CHILD Research Group, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Maria Björk
- CHILD Research Group, School of Health Sciences, Jönköping University, Jönköping, Sweden
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16
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Lindström Nilsson M, Funkquist E, Edner A, Engvall G. Children report positive experiences of animal-assisted therapy in paediatric hospital care. Acta Paediatr 2020; 109:1049-1056. [PMID: 31597211 DOI: 10.1111/apa.15047] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022]
Abstract
AIM To evaluate children's experiences of and responses to animal-assisted therapy using a therapy dog as complementary treatment in paediatric hospital care. METHODS The study was performed using mixed methods, by means of qualitative and quantitative data. Fifty children in a paediatric surgery ward, at a tertiary hospital in Sweden, were included between February 2016 to May 2017. Children answered questions about feelings of well-being and experiences of the hospital stay before and after animal-assisted therapy, and experiences of their interaction with a therapy dog. RESULTS The children's well-being increased from moderately good before to very good after animal-assisted therapy, and the children assessed the hospital stay as better after than before. The vast majority of the children (93%) assessed the interaction with the dog as very good. The children described mixed experiences before and mainly positive aspects of joy, satisfaction and pain relief after animal-assisted therapy. CONCLUSION The children's responses before interaction, of both a positive and negative nature, show a focus shift after the interaction with a therapy dog to mainly positive nature regarding self-reported feeling of well-being and experiences of the hospital stay. Using a therapy dog in paediatric hospital care is suitable complementary treatment.
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Affiliation(s)
| | - Eva‐Lotta Funkquist
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Ann Edner
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Gunn Engvall
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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17
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Sjöberg C, Carlsson IM, Källstrand J, Svedberg P, Nygren JM. Creating a shielding place for children with leukaemia during sedation for intrathecal chemotherapy: A grounded theory study. Eur J Oncol Nurs 2020; 44:101711. [DOI: 10.1016/j.ejon.2019.101711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 11/10/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
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18
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Jepsen SL, Haahr A, Eg M, Jørgensen LB. Coping with the unfamiliar: How do children cope with hospitalization in relation to acute and/or critical illness? A qualitative metasynthesis. J Child Health Care 2019; 23:534-550. [PMID: 30453743 DOI: 10.1177/1367493518804097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The aim of this study was to identify and describe how young children cope with hospitalization in relation to acute and/or critical illness. The study is a qualitative metasynthesis inspired by the approach described by Sandelowski and Barroso. Based on an exhaustive literature search, six studies were included. Data were analyzed through a taxonomic analysis. The findings revealed that the hospitalized children face a variety of challenges during admission to the hospital due to acute and/or critical illness. The main challenge was that hospitalized children strive to cope with different aspects of 'the unfamiliar' that emerge in their illness treatment and hospital stay. The unfamiliar refers to unknown experiences on a physical, emotional, and relational level. Subsequently, children cope with the unfamiliar by striving to convert the hospital stay into something more similar to everyday life, using strategies to secure basic needs and constructing familiarity in the hospital stay. The consequences of the children's coping behavior are discussed and how children strive to keep their integrity intact during illness and hospitalization are revealed.
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Affiliation(s)
| | - Anita Haahr
- VIA Health Promotion & Rehabilitation, Centre for Research and Development, VIA University College, Denmark
| | - Marianne Eg
- Department of Paediatrics, Regional Hospital Viborg, Viborg, Denmark.,The Centre for Nursing Research, Viborg, Denmark
| | - Lene Bastrup Jørgensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Cairos A/S, Copenhagen, Denmark
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19
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Karlsson K, Galvin K, Darcy L. Medical procedures in children using a conceptual framework that keeps a focus on human dimensions of care - a discussion paper. Int J Qual Stud Health Well-being 2019; 14:1675354. [PMID: 31621530 PMCID: PMC6807864 DOI: 10.1080/17482631.2019.1675354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Purpose: Children’s perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation. Method: The present paper illustrates children’s experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework. Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation. Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children’s own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings.
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Affiliation(s)
- Katarina Karlsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Boras , Boras , Sweden
| | - Kathleen Galvin
- Faculty of Caring Science, Work Life and Social Welfare, University of Boras , Boras , Sweden.,School of Health Science, University of Brighton , Brighton , UK
| | - Laura Darcy
- Faculty of Caring Science, Work Life and Social Welfare, University of Boras , Boras , Sweden
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20
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Enskär K, Darcy L, Björk M, Knutsson S, Huus K. Experiences of Young Children With Cancer and Their Parents With Nurses' Caring Practices During the Cancer Trajectory. J Pediatr Oncol Nurs 2019; 37:21-34. [PMID: 31526068 DOI: 10.1177/1043454219874007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Children with cancer require repeated hospitalizations and the family's everyday life and routines undergo change. Concrete descriptions of how nurses act when caring for children with cancer throughout the various phases of care and treatment are sparsely highlighted in the literature. The aim of this study was to describe young children with cancer and their parents' experiences of nurses' caring practices over a 3-year period, from diagnosis to follow-up. This study is based on semistructured interviews with 25 children newly diagnosed with cancer, aged 1 to 6 years, and their parents, connected to a pediatric oncology unit in Sweden. Child and parent data were analyzed with a deductive content analysis using Swanson's theory of caring. The result shows that nurse care practices directed toward young children with cancer and their parents are to some extent similar across a 3-year period from diagnosis to follow-up but also differ in some ways. Nurses' caring practices aim to support children and parents in the transition to a "new normal." Child- and family-friendly care processes include the following: creating hope and a trustful relationship, asking rather than assuming, providing knowledge and information, performing tasks skillfully, displaying an interest in the child's and parents' life outside the hospital, and helping the family to trust in the future and other health care providers. Based on these results, we recommend the development of a standardized and structured nursing care plan or clinical guideline with detailed information on how to carry out clinical nurse care practices in the different phases.
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Affiliation(s)
- Karin Enskär
- CHILD Research Group, Jönköping University, Sweden
| | | | - Maria Björk
- CHILD Research Group, Jönköping University, Sweden
| | | | - Karina Huus
- CHILD Research Group, Jönköping University, Sweden
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21
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Maslak K, Favara-Scacco C, Barchitta M, Agodi A, Astuto M, Scalisi R, Italia S, Bellia F, Bertuna G, D'Amico S, La Spina M, Licciardello M, Lo Nigro L, Samperi P, Miraglia V, Cannata E, Meli M, Puglisi F, Parisi GF, Russo G, Di Cataldo A. General anesthesia, conscious sedation, or nothing: Decision-making by children during painful procedures. Pediatr Blood Cancer 2019; 66:e27600. [PMID: 30604464 DOI: 10.1002/pbc.27600] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Following diagnosis, children with cancer suddenly find themselves in an unknown world where unfamiliar adults make all the important decisions. Children typically experience increasing levels of anxiety with repeated invasive procedures and do not adapt to the discomfort. The aim of the present study is to explore the possibility of asking children directly about their medical support preferences during invasive procedures. PROCEDURE Each patient was offered a choice of medical support on the day of the procedure, specifically general anesthesia (GA), conscious sedation (CS), or nothing. An ad hoc assessment tool was prepared in order to measure child discomfort before, during, and after each procedure, and caregiver adequacy was measured. Both instruments were completed at each procedure by the attending psychologist. RESULTS We monitored 247 consecutive invasive procedures in 85 children and found that children in the 4 to 7 year age group showed significantly higher distress levels. GA was chosen 66 times (26.7%), CS was chosen 97 times (39.3%), and nothing was chosen 5 times and exclusively by adolescents. The child did not choose in 79 procedures (32%). The selection of medical support differed between age groups and distress level was reduced at succeeding procedures. CONCLUSIONS Offering children the choice of medical support during invasive procedures allows for tailored support based on individual needs and is an effective modality to return active control to young patients, limiting the emotional trauma of cancer and treatment.
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Affiliation(s)
- Karolina Maslak
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Cinzia Favara-Scacco
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | | | - Antonella Agodi
- Department "GF Ingrassia", University of Catania, Catania, Italy
| | - Marinella Astuto
- Intensive Care Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Rita Scalisi
- Intensive Care Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Simona Italia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Francesco Bellia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Gregoria Bertuna
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Salvatore D'Amico
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Milena La Spina
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Maria Licciardello
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Luca Lo Nigro
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Piera Samperi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Vito Miraglia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Emanuela Cannata
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Mariaclaudia Meli
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Federica Puglisi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giuseppe Fabio Parisi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanna Russo
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Di Cataldo
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
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22
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Darcy L, Enskär K, Björk M. Young children's experiences of living an everyday life with cancer - A three year interview study. Eur J Oncol Nurs 2018; 39:1-9. [PMID: 30850132 DOI: 10.1016/j.ejon.2018.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE The young child's experiences of living with cancer are crucial to providing evidence based care. This study explores and describes experiences of everyday life of young children with cancer, over a three year period from diagnosis. METHOD This is a longitudinal, inductive interview study with young children with cancer, and their parents. Interviews from shortly after diagnosis, six and 12 months after diagnosis have been reanalysed. Interviews with the same children and their parents from 18 to 36 months after diagnosis have been analysed for the first time in the present paper. A longitudinal temporal analysis at category level for five synchronic data sets forms the basis for the results. RESULTS The child living with cancer over a three year period is described as a child apart, striving to live an everyday life. This description is built on three categories: I want to be a child like any other, I need security and control and I feel lonely and left out. Young children with cancer actively strive to understand their illness, participate in care and live an ordinary everyday life- but with ongoing feelings of social isolation and loneliness. CONCLUSIONS Young children with cancer need access to and ongoing contact with peers and preschool. A structured follow-up throughout the cancer trajectory and not just during active treatment, is necessary. A child-centred philosophy of care would guide the child towards attainment of health and wellbeing.
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Affiliation(s)
- Laura Darcy
- Faculty of Caring Science, Work Life and Social Welfare, University of Boras, S-508 00, Boras, Sweden.
| | - Karin Enskär
- School of Health Science, Jonkoping University, PO Box 1026, S-551 11, Jonkoping, Sweden.
| | - Maria Björk
- School of Health Science, Jonkoping University, PO Box 1026, S-551 11, Jonkoping, Sweden.
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Gårdling J, Törnqvist E, Månsson ME, Hallström IK. Impact of Age-appropriate Preparations for Children With Cancer Undergoing Radiotherapy on Parents and Family Functioning, Parents' Anxiety and Hospital Costs - A Feasibility Study. J Pediatr Nurs 2018; 43:e51-e58. [PMID: 30268713 DOI: 10.1016/j.pedn.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The aim was to evaluate the impact of age-appropriate information and preparation procedures for children with cancer undergoing radiotherapy on 1) parents and family functioning, parents' anxiety and 2) hospital costs compared to traditional care. DESIGN AND METHODS An un-matched quasi-experimental controlled clinical trial was conducted consisting of a control group including 31 parents of 16 children receiving traditional care and an intervention group including 32 parents of 17 children receiving age-appropriate preparation including seven parts. Validated instruments measured parents and family functioning and parents' anxiety. Hospital costs were calculated. RESULTS Parents in the intervention group showed better communication throughout their child's radiotherapy (p = 0.01) and at their child's last fraction, parental social functioning improved (p = 0.02). Parents of children receiving general anesthesia, regardless of group, showed higher levels of anxiety (p = 0.04). In general, results regarding hospital costs lacked statistical significance. Development of the intervention was calculated to be USD 4.624. CONCLUSION Parents who receive age-appropriate information and preparation together with their child benefits in terms of improved communication and social functioning. When children avoid general anesthesia the parents experienced less anxiety and costs for the hospital was lowered. PRACTICE IMPLICATION Age-appropriate preparations consisting of basic, non-costly utilities and a structured approach are important. If more children are able to undergo radiotherapy without general anesthesia, it means for the individual child fewer risks and restrictions, and for the parents decreased anxiety. For the healthcare, it means lower costs, which enables the hospital to prioritize other areas of pediatric care.
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Affiliation(s)
- Jenny Gårdling
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden.
| | - Erna Törnqvist
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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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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Jibb L, Croal L, Wang J, Yuan C, Foster J, Cheung V, Gladstone B, Stinson J. Children’s Experiences of Cancer Care: A Systematic Review and Thematic Synthesis of Qualitative Studies. Oncol Nurs Forum 2018; 45:527-544. [DOI: 10.1188/18.onf.527-544] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The Adaptation and Psychometric Properties of the Kid-KINDL R for Hospitalized Children in Chile. J Pediatr Nurs 2018; 41:e8-e15. [PMID: 29477451 DOI: 10.1016/j.pedn.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE The impact of hospitalization on a child's well-being leads one to consider the health-related quality of life (HRQoL) measure as a fundamental aspect of pediatric care. The aims of the study were to adapt the Spanish version of the Kid-KINDL® to hospitalized children in Chile, to obtain a reduced version of the instrument and to analyze the psychometric properties of the reduced version. DESIGN AND METHODS An expert committee and interviews were carried out for the cross-cultural adaptation process. An exploratory factor analysis was conducted to examine the validity of the construct and to select the items for the reduced version. Cronbach's alpha was used to estimate the internal consistency of the adapted version of the Kid-KINDL® and the reliability of each component. Convergent validity was based on correlations with a pain scale. RESULTS This adapted and shorter instrument, similar to the original version, comprises five components that include the principal dimensions of HRQoL. Evaluating the School dimension in hospitalized children was considered inappropriate in Chilean public hospitals. The study replicates the relationship found between a child with high pain and low reported HRQoL. CONCLUSIONS The hospitalization process impacted the children's perceptions of their HRQoL. The reduced version of the Kid-KINDL® was found to be a valid instrument for assessing children's HRQoL in hospital units. PRACTICE IMPLICATIONS Finding effective ways to measure HRQoL and ultimately mitigate barriers and foster resilience are important clinical and research priorities in the pursuit of HRQoL for hospitalized children and their families.
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Carlsson I, Nygren JM, Svedberg P. Patient participation, a prerequisite for care: A grounded theory study of healthcare professionals' perceptions of what participation means in a paediatric care context. Nurs Open 2018; 5:45-52. [PMID: 29344394 PMCID: PMC5762705 DOI: 10.1002/nop2.106] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/05/2017] [Indexed: 11/11/2022] Open
Abstract
Aims To explore healthcare professionals' perceptions of what patient participation means in a paediatric care context . Design A qualitative explorative design with grounded theory. Methods Fifteen healthcare professionals who worked in paediatric care settings were either interviewed or asked open-ended questions in a survey, during December 2015-May 2016. Grounded theory was used as a method. Results The study results provide a theoretical conceptualization of what patient participation meant for healthcare professionals in paediatric care and how participation was enabled. The core category "participation a prerequisite for care" emerged as the main finding explaining the concept as ethical, practical and integrated in the care givers way of working. However, the concept was implicit in the organization. Four additional categories illustrated the healthcare professionals' different strategies used to enhance patient participation; "meeting each child where the child is," "building a relationship with the child," "showing respect for each individual child" and "making the most of the moment."
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Affiliation(s)
- Ing‐Marie Carlsson
- School of Health and WelfareDepartment of health and nursingHalmstad UniversityHalmstadSweden
| | - Jens M. Nygren
- School of Health and WelfareDepartment of health and nursingHalmstad UniversityHalmstadSweden
| | - Petra Svedberg
- School of Health and WelfareDepartment of health and nursingHalmstad UniversityHalmstadSweden
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Gårdling J, Törnqvist E, Månsson ME, Hallström IK. Age-appropriate preparations for children with cancer undergoing radiotherapy: A feasibility study. J Child Health Care 2017; 21:370-380. [PMID: 29110518 DOI: 10.1177/1367493517727070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to test age-appropriate information and preparation procedures for children with cancer undergoing radiotherapy (RT) for feasibility and effectiveness in terms of the need for general anesthesia (GA) and anxiety. In a quasi-experimental controlled clinical trial, 17 children aged 3-18 years receiving age-appropriate preparation were compared with 16 children in a control group. Feasibility in terms of recruitment, compliance, and acceptability was assessed. Effectiveness was assessed by the number of children who underwent treatment without GA and their respective fractions and validated instruments measured the children's anxiety and emotional behavior. The preparation parts were delivered as intended without any additional personnel and without dropouts in the intervention group (IG) and therefore found feasible and acceptable. No statistic significances were found concerning the number of children receiving GA or anxiety. However, three children planned for GA in the IG completed their treatments, including 73 fractions awake. Children receiving GA, regardless of group, showed significantly higher negative emotional behavior. Giving children individualized preparation may decrease the need for GA during RT, which gives benefits in terms of fewer risks and restrictions in life for the child and lower costs for health care.
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Affiliation(s)
- Jenny Gårdling
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Erna Törnqvist
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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De Clercq E, Elger B, Wangmo T. Missing life stories. The narratives of palliative patients, parents and physicians in paediatric oncology. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12651] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Affiliation(s)
- E. De Clercq
- Institute for Biomedical Ethics; University of Basel; Basel Switzerland
| | - B.S. Elger
- Institute for Biomedical Ethics; University of Basel; Basel Switzerland
| | - T. Wangmo
- Institute for Biomedical Ethics; University of Basel; Basel Switzerland
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Coyne I, Hallström I, Söderbäck M. Reframing the focus from a family-centred to a child-centred care approach for children's healthcare. J Child Health Care 2016; 20:494-502. [PMID: 27141084 DOI: 10.1177/1367493516642744] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this article, we argue for a conceptual move from family-centred care (FCC) to a child-centred care approach and the implications for clinical nursing practice. Firstly, we argue that the parents and professional dominance constructs an asymmetric relationship towards the child, which may take away the focus from the child; Secondly, we need to renew efforts to promote the fundamental principles of protection, promotion and participation rights for children and young people according to the United Nations Convention on the Rights of the Child declaration and thirdly, we need to strengthen the child's perspective and to view the child as an agent representing own experiences and wishes to be respected and negotiated.
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Affiliation(s)
- Imelda Coyne
- 1 School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Inger Hallström
- 2 Department of Heath Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Maja Söderbäck
- 3 School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Jeremic V, Sénécal K, Borry P, Chokoshvili D, Vears DF. Participation of Children in Medical Decision-Making: Challenges and Potential Solutions. JOURNAL OF BIOETHICAL INQUIRY 2016; 13:525-534. [PMID: 27654498 DOI: 10.1007/s11673-016-9747-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 05/22/2016] [Indexed: 06/06/2023]
Abstract
Participation in healthcare decision-making is considered to be an important right of minors, and is highlighted in both international legislation and public policies. However, despite the legal recognition of children's rights to participation, and also the benefits that children experience by their involvement, there is evidence that legislation is not always translated into healthcare practice. There are a number of factors that may impact on the ability of the child to be involved in decisions regarding their medical care. Some of these factors relate to the child, including their capacity to be actively involved in these decisions. Others relate to the family situation, sociocultural context, or the underlying beliefs and practices of the healthcare provider involved. In spite of these challenges to including children in decisions regarding their clinical care, we argue that it is an important factor in their treatment. The extent to which children should participate in this process should be determined on a case-by-case basis, taking all of the potential barriers into account.
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Affiliation(s)
- Vida Jeremic
- School of Medicine of University of Belgrade, Dr Subotica 8, Belgrade, 11000, Serbia.
| | - Karine Sénécal
- Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University, 740, avenue Dr. Penfield, #5202, Montreal, Quebec, Canada, H3A 0G1
| | - Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care Faculty of Medicine, Leuven University, Kapucijnenvoer 35, Box 7001, 3000, Leuven, Belgium
| | - Davit Chokoshvili
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care Faculty of Medicine, Leuven University, Kapucijnenvoer 35, Box 7001, 3000, Leuven, Belgium
| | - Danya F Vears
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care Faculty of Medicine, Leuven University, Kapucijnenvoer 35, Box 7001, 3000, Leuven, Belgium
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Engvall G, Ångström-Brännström C, Mullaney T, Nilsson K, Wickart-Johansson G, Svärd AM, Nyholm T, Lindh J, Lindh V. It Is Tough and Tiring but It Works--Children's Experiences of Undergoing Radiotherapy. PLoS One 2016; 11:e0153029. [PMID: 27055258 PMCID: PMC4824387 DOI: 10.1371/journal.pone.0153029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/22/2016] [Indexed: 01/11/2023] Open
Abstract
Approximately 300 children ages 0 to 18 are diagnosed with cancer in Sweden every year, and 80 to 90 of them undergo radiotherapy treatment. The aim was to describe children's experiences of preparing for and undergoing radiotherapy, and furthermore to describe children's suggestions for improvement. Thirteen children between the ages of 5 and 15 with various cancer diagnoses were interviewed. Data was analyzed using qualitative content analysis. The findings revealed five categories: positive and negative experiences with hospital stays and practical arrangements; age-appropriate information, communication, and guidance to various degrees; struggle with emotions; use of distraction and other suitable coping strategies; and children's suggestions for improvement during radiotherapy. An overarching theme emerged: "It is tough and tiring but it works". Some key areas were: explanatory visits, the need for information and communication, being afraid, discomfort and suffering, the need for media distraction, dealing with emotions, and the need for support. A systematic, family-centered preparation program could possible help families prepare and individualized distraction during radiotherapy could contribute to reducing distress. Further studies with interventions could clarify successful programs.
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Affiliation(s)
- Gunn Engvall
- Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- * E-mail:
| | | | - Tara Mullaney
- Umeå Institute of Design, Umeå University, Umeå, Sweden
| | - Kristina Nilsson
- Section of Oncology, Department of Oncology, Radiology and Clinical Immunology, Uppsala University Hospital, Uppsala, Sweden
| | - Gun Wickart-Johansson
- Department of Oncology, Radiumhemmet, Karolinska University Hospital, Stockholm, Sweden
| | - Anna-Maja Svärd
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Tufve Nyholm
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Jack Lindh
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Viveca Lindh
- Department of Nursing, Umeå University, Umeå, Sweden
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Sposito AMP, de Montigny F, Sparapani VDC, Lima RAGD, Silva-Rodrigues FM, Pfeifer LI, Nascimento LC. Puppets as a strategy for communication with Brazilian children with cancer. Nurs Health Sci 2016; 18:30-7. [DOI: 10.1111/nhs.12222] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | - Luzia Iara Pfeifer
- Ribeirao Preto Medical School; University of Sao Paulo; Ribeirao Preto Brazil
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Svedberg P, Einberg EL, Wärnestål P, Stigmar J, Castor A, Enskär K, Nygren JM. Support from healthcare services during transition to adulthood - Experiences of young adult survivors of pediatric cancer. Eur J Oncol Nurs 2016; 21:105-12. [PMID: 26952685 DOI: 10.1016/j.ejon.2016.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 02/02/2016] [Accepted: 02/06/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE Improved survival rates of pediatric cancer have drawn attention on how to best facilitate long-term follow up and transition from pediatric to adult care. The transition process is multifactorial and necessitates the joint involvement of the patient, the family and the healthcare providers. The purpose of this study was to explore the experiences of support from healthcare services during the transition from adolescence to adulthood described by young adult survivors of pediatric cancer. METHODS A mixed method with a convergent parallel design was used to evaluate the experiences of receiving support from healthcare services (eg pediatric oncology and pediatric clinic) during transition from adolescence to adulthood described by young adult survivors of pediatric cancer (n = 213) in a nation wide cross-sectional survey. RESULTS A quantitative assessment of the experienced extent and satisfaction of support from healthcare services to handle physical, mental and social changes to continue life after the disease showed that a majority of the participants had received insufficient support. The qualitative analysis indicated a need for equal roles in healthcare to promote participation, a need to manage and process consequences of the disease, and a need for continuous support. CONCLUSIONS During transition to adulthood, there's a need for a personalized care plan that takes a holistic approach towards supporting the young cancer survivor in managing life in the best way. Identifying and handling the individual needs of pediatric cancer survivors is important for providing the resources and support required to increase the likelihood of successful transition to adulthood.
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Affiliation(s)
- Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Eva-Lena Einberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden; School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Pontus Wärnestål
- School of Information Technology, Halmstad University, Halmstad, Sweden
| | - Jennie Stigmar
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - Anders Castor
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - Karin Enskär
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.
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Darcy L, Björk M, Knutsson S, Granlund M, Enskär K. Following Young Children’s Health and Functioning in Everyday Life Through Their Cancer Trajectory. J Pediatr Oncol Nurs 2015; 33:173-89. [DOI: 10.1177/1043454215610489] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Knowledge of living with childhood cancer, through the trajectory, is sparse. Aim: The aim of this study was to follow young children’s health and functioning in everyday life through their cancer trajectory. Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis. Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children’s trajectories in relation to diagnosis but individual patterns were seen for each child. Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.
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Affiliation(s)
- Laura Darcy
- Jönköping University, Jönköping, Sweden
- University of Borås, Borås, Sweden
| | - Maria Björk
- Jönköping University, Jönköping, Sweden
- University of Skövde, Skövde, Sweden
| | - Susanne Knutsson
- Jönköping University, Jönköping, Sweden
- University of Borås, Borås, Sweden
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Gårdling J, Edwinson Månsson M, Törnqvist E, Hallström I. Caring for children undergoing radiotherapy treatment: Swedish radiotherapy nurses' perceptions. Eur J Oncol Nurs 2015; 19:660-6. [DOI: 10.1016/j.ejon.2015.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 04/10/2015] [Accepted: 04/19/2015] [Indexed: 11/26/2022]
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Biru M, Lundqvist P, Molla M, Jerene D, Hallström I. Surviving Overwhelming Challenges: Family Caregivers' Lived Experience of Caring for a Child Diagnosed with HIV and Enrolled in Antiretroviral Treatment in Ethiopia. ACTA ACUST UNITED AC 2015; 38:282-99. [PMID: 26375615 DOI: 10.3109/01460862.2015.1079278] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Family caregivers play a critical role in caring for children living with HIV, however, there is little knowledge about their experiences. The aim of this study was to illuminate the family caregivers' lived experiences of caring for a child when he or she has been diagnosed with HIV and enrolled to antiretroviral treatment. Qualitative interviews with 21 family caregivers of 21 children diagnosed with HIV were analyzed using an inductive design with a hermeneutic phenomenological approach. The caregivers' experience were articulated in 5 subthemes under the main theme of "Surviving overwhelming challenges": "Committed care-giving," "Breaking the family life," "Caring burdens," "Confronting conflicts," and "Living with worry." Despite the difficult situation the family caregivers experienced with extensive worry, caring burdens, and disrupted family and social networks, they were committed caregivers. They were empowered by their belief in God but also by their strong belief in the child's treatment and support from healthcare workers. The healthcare system needs to consider possible ways to support the family caregivers during child's HIV diagnosis and treatment initiation as part of a continuum of care.
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Affiliation(s)
- Mulatu Biru
- a Department of Health Sciences, Faculty of Medicine , Lund University , Sweden
| | - Pia Lundqvist
- a Department of Health Sciences, Faculty of Medicine , Lund University , Sweden
| | - Mitikie Molla
- b School of Public Health, Addis Ababa University , Ethiopia , and
| | - Degu Jerene
- c HEAL TB project, Management Sciences for Health , Ethiopia
| | - Inger Hallström
- a Department of Health Sciences, Faculty of Medicine , Lund University , Sweden
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Enskär K, Huus K, Björk M, Granlund M, Darcy L, Knutsson S. An Analytic Review of Clinical Implications From Nursing and Psychosocial Research Within Swedish Pediatric Oncology. J Pediatr Nurs 2015; 30:550-9. [PMID: 25448474 DOI: 10.1016/j.pedn.2014.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 09/29/2014] [Accepted: 11/01/2014] [Indexed: 11/26/2022]
Abstract
The purpose of this manuscript is to analyze researchers' suggestions for clinical implications of their findings as stated in recent published articles on nursing and psychosocial research within the setting of Swedish pediatric oncology. Identified categories included staff awareness of the effects of child illness on families; systems for care improvement; provision of quality of care, education and support; and empowerment of children and families. In order to be able to realize these clinical suggestions, expanded research is needed as well as continued education and support for staff.
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Affiliation(s)
- Karin Enskär
- School of Health Sciences, Jönköping University, Jönköping, Sweden; CHILD Research Group, Jönköping University, Jönköping, Sweden.
| | - Karina Huus
- School of Health Sciences, Jönköping University, Jönköping, Sweden; CHILD Research Group, Jönköping University, Jönköping, Sweden
| | - Maria Björk
- CHILD Research Group, Jönköping University, Jönköping, Sweden; School of Life Science, University of Skövde, Skövde, Sweden
| | - Mats Granlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden; CHILD Research Group, Jönköping University, Jönköping, Sweden
| | - Laura Darcy
- CHILD Research Group, Jönköping University, Jönköping, Sweden; Institution of Health Science, University College of Borås, Borås, Sweden
| | - Susanne Knutsson
- School of Health Sciences, Jönköping University, Jönköping, Sweden; Institution of Health Science, University College of Borås, Borås, Sweden
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Darcy L, Enskär K, Granlund M, Simeonsson RJ, Peterson C, Björk M. Health and functioning in the everyday lives of young children with cancer: documenting with the International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY). Child Care Health Dev 2015; 41:475-82. [PMID: 25219405 DOI: 10.1111/cch.12191] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Health care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY). AIMS The aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment. METHOD Interviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures. RESULTS A comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence. CONCLUSIONS The ICF-CY can be used to document the nature and range of characteristics and consequences of cancer experienced by children. The identified comprehensive code set could be helpful to health care professionals, parents and teachers in assessing and supporting young children's health and everyday life through the cancer trajectory. The comprehensive code set could be developed as a clinical assessment tool for those caring for young children with cancer. The universal language of the ICF-CY means that the utility of a clinical assessment tool based on identified codes can have wide reaching effects for the care of young children with cancer.
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Affiliation(s)
- L Darcy
- CHILD Research Group, School of Health Sciences, Jönköping University, Jönköping, Sweden; School of Health Sciences, University College Borås, Borås, Sweden
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Filová A, Sikorová L. Evaluating the needs of children with cancer. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2015. [DOI: 10.15452/cejnm.2015.06.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Darcy L, Björk M, Enskär K, Knutsson S. The process of striving for an ordinary, everyday life, in young children living with cancer, at six months and one year post diagnosis. Eur J Oncol Nurs 2014; 18:605-12. [DOI: 10.1016/j.ejon.2014.06.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 06/04/2014] [Accepted: 06/06/2014] [Indexed: 10/25/2022]
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The Everyday Life of the Young Child Shortly After Receiving a Cancer Diagnosis, From Both Children’s and Parent’s Perspectives. Cancer Nurs 2014; 37:445-56. [DOI: 10.1097/ncc.0000000000000114] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ångström-Brännström C, Norberg A. Children undergoing cancer treatment describe their experiences of comfort in interviews and drawings. J Pediatr Oncol Nurs 2014; 31:135-46. [PMID: 24651546 DOI: 10.1177/1043454214521693] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Children with cancer often undergo a long course of treatment, described as painful, and associated with feelings of discomfort and need of comfort. The aim of this descriptive interview study was to investigate how children, aged 3 to 9 years, undergoing cancer treatment describe their experience of comfort. The children were interviewed and asked to make drawings. Data were content analyzed and four themes were constructed--enduring discomfort, expressing discomfort, finding comfort, and comforting others. The findings show that the children endured discomfort during treatment, and were sometimes able to express it. They found comfort especially from their family and from hospital staff. The children also described that they comforted family members. The findings are in accordance with previous research about children's and adults' accounts of comfort. An incidental finding is that parents were surprised when they listened to the children's accounts of their experience of discomfort and comfort and achieved a better understanding of their children.
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Nordén C, Hult K, Engström Å. Ambulance nurses' experiences of nursing critically ill and injured children: A difficult aspect of ambulance nursing care. Int Emerg Nurs 2013; 22:75-80. [PMID: 23711561 DOI: 10.1016/j.ienj.2013.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/15/2013] [Accepted: 04/16/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND Ambulance nurses work daily in both emergency and non-emergency situations that can be demanding. One emotionally demanding situation for ambulance nurses is to nurse children who are ill. AIM The aim of this study was to describe ambulance nurses' experiences of nursing critically ill or injured children. METHOD Eight specialist ambulance nurses were interviewed and the interviews were analyzed using qualitative content analysis. FINDINGS The analysis resulted in one theme, a difficult aspect of ambulance nursing care, with five categories. The security of both child and parents was considered to be paramount. Ambulance nurses felt relieved when they handed over the responsibility and the child to the receiving unit. The ambulance nurses felt that more training, education and follow-up was desirable in order to increase their security when nursing children. CONCLUSION Ambulance nurses are subject to stressful feelings while nursing children. As providing reassurance to the child and its parents is a cornerstone of the treatment, it is important for the ambulance nurses to take the time to build up a trusting relationship in such an encounter. Skill development in the area might lead to increased security and reduce the mental burden resulting from negative stress.
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Affiliation(s)
| | | | - Åsa Engström
- Division of Nursing, Department of Health Care Science, Luleå University of Technology, Luleå, Sweden.
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Bergh I, Björk M. Sense of coherence over time for parents with a child diagnosed with cancer. BMC Pediatr 2012; 12:79. [PMID: 22721396 PMCID: PMC3441899 DOI: 10.1186/1471-2431-12-79] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 06/06/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND When a child is diagnosed with childhood cancer this creates severe stress in the parents. The aim of the study was to describe the sense of coherence and its change over time in a sample of parents of children diagnosed with cancer. METHODS The Swedish version of SOC (29 items) was used to measure the parents' (n = 29) sense of coherence. Data were collected at four time-points: Time-point 1 at the time of diagnosis; time-point 2 during the treatment; time-point 3 after the child had completed their treatment and time-point 4 when the child had been off treatment for some years or had died. RESULTS The results showed that SOC in the investigated population is not stable over time. The parents decreased in total SOC between time-points 1, 2 and 3. Mothers had significantly weaker total SOC score including the components Manageability and Meaningfulness at time-points 1 as well time-point 2 compared to the fathers. However, for the component Comprehensibility no significant differences were shown between mothers and fathers. This study indicates that mothers' and fathers' SOC scores change over time during the child's cancer trajectory. However, the pattern in these changes varies between mothers and fathers. CONCLUSIONS This study indicates that mothers and fathers may have different support needs during their child's cancer trajectory.
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Affiliation(s)
- Ingrid Bergh
- School of Life Sciences, University of Skövde, Box 408, 541 28, Skövde, Sweden
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Roberts CA, Messmer PR. Unaccompanied hospitalized children: nurses' search for understanding. J Holist Nurs 2011; 30:117-26. [PMID: 22024952 DOI: 10.1177/0898010111423422] [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]
Abstract
PURPOSE To explore the experiences and feelings of pediatric nurses who care for hospitalized children that are unaccompanied by their parents. DESIGN AND METHODS This phenomenological study consisted of interviews with 12 pediatric nurses. Verbatim transcriptions were reviewed with participants and analyzed. FINDINGS Pediatric nurses viewed the circumstances of unaccompanied hospitalized children through the perspective of their own life-worlds. They used both cognitive and emotional constructs to describe the phenomenon. Nurses' perceptions were affected by day-to-day contingencies of their life worlds which come through the four dimensions of space, mind/body, time, and relationships. These perceptions affected their assessment of parents' situated contexts. Nurses' assessments could lead to negative judgments of parents because they worried about ill effects on the unaccompanied children. Meanwhile,nurses often perceived that parents demonstrated trust when they relegated their child's care to them. CONCLUSIONS Pediatric nurses dealt with increased emotional work while remaining compassionate with their patients. Nurses indicated that they needed to understand their own life-worlds and that parents' day-to-day contingencies may affect parents' ability to remain with their hospitalized children. Participants were aware of judgmental attitudes which could interfere with the development of therapeutic relationships with parents, and therefore, with hospitalized children.
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Affiliation(s)
- Cristine A Roberts
- University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO 64108, USA.
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Oberholzer AE, Nel E, Myburgh CP, Poggenpoel M. Exploring the needs and resources of children in a haematology-oncology unit. Health SA 2011. [DOI: 10.4102/hsag.v16i1.565] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Too often a child’s body is restored to health in the hospital, but the child is sent home with emotional wounds. This study explored the needs of children in a haematology-oncology unit as well as the resources that could be mobilised in order to address these needs by firstly carrying out a literature review. A field study was then conducted in order to prioritise the resources according to their importance for children in a haematology-oncology unit. A definite trend could be found in the way that the children responded to the request to prioritise the resources. The first three resources, as chosen by the children, all concerned the external social environment of the child. It could therefore be concluded that support from parents and other people of significance are most important to the child and should be taken into account when facilitating support for children in a haematology-oncology unit. It could also be concluded that these children do not experience sufficient control in their situation and it could therefore be suggested that children in a haematology-oncology unit should experience more control and power in their situation.OpsommingSo dikwels word ‘n kind se liggaam genees in die hospitaal, maar hierdie selfde kind gaan huis toe met emosionele wonde. Die behoeftes van kinders in ‘n hematologie-onkologie eenheid is ondersoek asook die hulpbronne wat gemobiliseer kan word om hierdie behoeftes aan te spreek deur gebruik te maak van ‘n literatuurstudie. Daarna is ‘n veldstudie gedoen om hierdie hulpbronne te prioritiseer volgens die belangrikheid daarvan vir kinders in ‘n hematologieonkologie eenheid. Die manier waarop die kinders die hulpbronne geprioritiseer het, het ‘n definitiewe tendens getoon. Die eerste drie hulpbronne wat deur die kinders gekies is, is al drie hulpbronne wat die eksterne sosiale omgewing van die kind behels. Die gevolgtrekking kan dus gemaak word dat die ondersteuning van ouers en ander persone wat belangrik is vir die kind, van uiterste belang is en in aanmerking geneem behoort te word in die fasilitering van ondersteuning van kinders in ‘n hematologie-onkologie eenheid. Die gevolgtrekking wat gemaak kan word is dat hierdie kinders nie genoeg beheer ervaar in hulle situasie nie en daarom word voorgestel dat kinders in ‘n hematologie-onkologie eenheid meer bemagtig behoort te word gegewe hulle omstandighede.
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Activité physique adaptée et qualité de vie liée à la santé lors d’un séjour hospitalier chez des enfants atteints d’un cancer : APOP, un essai randomisé en cross-over. Sci Sports 2011. [DOI: 10.1016/j.scispo.2011.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Salmela M, Aronen ET, Salanterä S. The experience of hospital-related fears of 4- to 6-year-old children. Child Care Health Dev 2011; 37:719-26. [PMID: 21143264 DOI: 10.1111/j.1365-2214.2010.01171.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is little information available on a 4- to 6-year-old child's subjective experience of hospital-related fears, even though the data collected from parents and hospital staff indicate that hospitalization is an anxiety-producing experience for young children. METHODS A qualitative method was chosen using a purposive sample of 90 children. The data were gathered via semi-structured interview from 2004 to 2006. The data were analysed using the structure of Colaizzi's Method of Phenomenological Analysis. RESULTS The essential fears were fears related to nursing interventions and pain, to the separation from parents and being left alone, to the lack of information, and to instruments and equipment. Children expressed their fears verbally or through their actions. The meaning of hospital-related fear formed four main clusters: insecurity, injury, helplessness, and rejection. CONCLUSIONS For young children, an experience of hospital-related might be so traumatic that it influences the well-being of the child. The fear may damage the sense of security felt by the children, and weaken the child's willingness to trust health-care professionals. The children often expressed their fear in a contradictory manner or denied it. Children need the help of adults to express their hospital-related fears, including the objects of these fears.
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Affiliation(s)
- M Salmela
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
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Hansson H, Kjaergaard H, Schmiegelow K, Hallström I. Hospital-based home care for children with cancer: a qualitative exploration of family members' experiences in Denmark. Eur J Cancer Care (Engl) 2011; 21:59-66. [PMID: 21848580 DOI: 10.1111/j.1365-2354.2011.01280.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment, as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory. Our study highlights the importance of providing hospital-based home care with consideration for the family members' need for the sense of security achieved by home care by experienced paediatric oncology nurses and regular contact with the doctor. In future studies, interviews with children and siblings could be an important source of information for planning and delivering care suited to the families' perceived needs.
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Affiliation(s)
- H Hansson
- The Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark.
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