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Hernádfői MV, Koch DK, Kói T, Imrei M, Nagy R, Máté V, Garai R, Donnet J, Balogh J, Kovács GT, Párniczky A, Hegyi P, Garami M. Burden of Childhood Cancer and the Social and Economic Challenges in Adulthood: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024; 178:548-566. [PMID: 38619829 PMCID: PMC11019450 DOI: 10.1001/jamapediatrics.2024.0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/31/2024] [Indexed: 04/16/2024]
Abstract
Importance Significant advancements in pediatric oncology have led to a continuously growing population of survivors. Although extensive research is being conducted on the short-, medium-, and long-term somatic effects, reports on psychosocial reintegration are often conflicting; therefore, there is an urgent need to synthesize the evidence to obtain the clearest understanding and the most comprehensive answer. Objective To provide a comprehensive review and analysis of the socioeconomic attainment of childhood cancer survivors (CCSs) compared with their unaffected peers. Data Sources A systematic review and meta-analysis was conducted using data obtained from a comprehensive search of MEDLINE (via PubMed), Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases on October 23, 2021; the search was updated until July 31, 2023. Study Selection Eligible articles reported on educational attainment, employment, family formation, quality of life (QoL), or health-risk behavior-related outcomes of CCSs, and compared them with their unaffected peers. Study selection was performed in duplicate by 4 blinded independent coauthors. Data Extraction and Synthesis Data extraction was performed in duplicate by 4 independent authors following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcome measures were odds ratios (ORs) and mean differences with 95% CIs; data were pooled using a random-effects model. Results The search identified 43 913 articles, 280 of which were eligible for analysis, reporting data on a total of 389 502 survivors. CCSs were less likely to complete higher levels of education (OR, 0.69; 95% CI, 0.40-1.18), had higher odds of health-related unemployment (OR, 2.94; 95% CI, 1.90-4.57), and showed lower rates of marriage (OR, 0.72; 95% CI, 0.63-0.84) and parenthood (OR, 0.60; 95% CI, 0.49-0.74) compared with population-based controls. Conclusion and Relevance Study findings suggest that CCSs face several socioeconomic difficulties; as a result, the next goal of pediatric oncology should be to minimize adverse effects, as well as to provide lifelong survivorship support aimed at maximizing social reintegration.
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Affiliation(s)
- Márk Viktor Hernádfői
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Bethesda Children’s Hospital, Budapest, Hungary
| | - Dóra Kornélia Koch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Mathematics, Department of Stochastics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Marcell Imrei
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Rita Nagy
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Vanda Máté
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Réka Garai
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Jessica Donnet
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - József Balogh
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | | | - Andrea Párniczky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Miklós Garami
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
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Arpaci T, Altay N. Qualitative Analysis of School Re-Entry Experiences of Turkish Survivors of Childhood and Adolescent Cancer: Parental Perspective. Semin Oncol Nurs 2024:151613. [PMID: 38413308 DOI: 10.1016/j.soncn.2024.151613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE This study aimed to explore the school re-entry experiences of Turkish survivors of childhood and adolescent cancer. DATA SOURCES In this qualitative study, semistructured in-depth interviews were undertaken with parents of childhood cancer survivors who had completed treatment for at least 2 years (n = 20). Interviews were conducted via telephone or video conferencing. The study was conducted and reported according to the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. The components of qualitative rigor were considered to ensure confidence in the methods and data. CONCLUSIONS The average age of parents was 43.20 ± 4.66 years (range 37-55) (n = 20). The mean age of survivors was 8.45 ± 2.03 years at diagnosis and 15.05 ± 2.08 years during the study. The diagnosis of most of the survivors was lymphoma (35%). Four main themes were developed: worry; challenging situations; negative effects of the disease process; and facilitating situations. Parents stated that both children and parents need support during the school re-entry process. IMPLICATION FOR NURSING PRACTICE This study revealed that survivors may experience problems that make school re-entry difficult. With cooperation between the health team and the school, arrangements should be made to ensure survivors have a positive experience on school re-entry. Pediatric oncology nurses should know survivors' requirements and take action to deliver school re-entry adjustment programs.
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Affiliation(s)
- Tuba Arpaci
- Department of Nursing, Faculty of Health Sciences, Karamanoglu Mehmetbey University, Karaman, Türkiye.
| | - Naime Altay
- Department of Pediatric Nursing, Faculty of Nursing, Gazi University, Ankara, Türkiye
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Erdoğan B, Yıldız S, Bayram D, Kılıçarslan Törüner E, Altay N. Back to school readiness scale for children with oncological problems: 7-18 years of age. J Pediatr Nurs 2023; 73:e594-e601. [PMID: 37945458 DOI: 10.1016/j.pedn.2023.10.039] [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: 07/06/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Childhood cancers are one of the important health problems in both developed and underdeveloped countries. The cancer treatment process is a difficult period that can last for months or years, interrupt school activities for a while, or even cause them to leave completely, and require long-term hospitalization. PURPOSE This study was carried out to develop the Back to School Readiness Scale for Children with Oncological Problems: 7-18 years of age, and to establish its validity and reliability. METHOD The research is a methodological study and the validity and reliability study of a developed scale was conducted. RESULTS Kaiser-Meyer-Olkin (KMO) value was determined as 0.951. As a result of Bartlett's test analysis, Chi-Square value is 6261.566, degree of freedom is 703 and the value found is significant (p = 0.00, p < 0.05). While the loadings of the items on the first factor vary between 0.79 and 0.46, the loads on the second factor vary between 0.76 and.47. The item-total-test correlation value is 0.63. Total Croncabh alpha (α) value of the scale is 0.97. CONCLUSION Back to School Readiness Scale for Children with Oncological Problems: 7-18 years of age is a valid and reliable measurement tool. PRACTICE IMPLICATIONS Returning to school is a difficult process for children living with cancer due to long-term hospitalization. This scale can be used by both pediatric nurses and school nurses to evaluate children's return to school. Additionally, children and families can get an idea about preparing for returning to school by applying this scale.
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Affiliation(s)
- Birgül Erdoğan
- Kocaeli University, Faculty of Health Sciences, Department of Pediatric Nursing, Türkiye.
| | - Sümeyye Yıldız
- Gazi University, Faculty of Nursing, Department of Pediatric Nursing, Türkiye.
| | - Dilek Bayram
- Zonguldak Bulent Ecevit University, Department of Pediatric Oncology, Türkiye.
| | | | - Naime Altay
- Gazi University, Faculty of Nursing, Department of Pediatric Nursing, Türkiye.
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Devine KA, Christen S, Mulder RL, Brown MC, Ingerski LM, Mader L, Potter EJ, Sleurs C, Viola AS, Waern S, Constine LS, Hudson MM, Kremer LCM, Skinner R, Michel G, Gilleland Marchak J, Schulte FSM. Recommendations for the surveillance of education and employment outcomes in survivors of childhood, adolescent, and young adult cancer: A report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Cancer 2022; 128:2405-2419. [PMID: 35435238 PMCID: PMC9321726 DOI: 10.1002/cncr.34215] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 07/30/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022]
Abstract
Educational achievement and employment outcomes are critical indicators of quality of life in survivors of childhood, adolescent, and young adult (CAYA) cancer. This review is aimed at providing an evidence-based clinical practice guideline (CPG) with internationally harmonized recommendations for the surveillance of education and employment outcomes in survivors of CAYA cancer diagnosed before the age of 30 years. The CPG was developed by a multidisciplinary panel under the umbrella of the International Late Effects of Childhood Cancer Guideline Harmonization Group. After evaluating concordances and discordances of 4 existing CPGs, the authors performed a systematic literature search through February 2021. They screened articles for eligibility, assessed quality, and extracted and summarized the data from included articles. The authors formulated recommendations based on the evidence and clinical judgment. There were 3930 articles identified, and 83 of them, originating from 17 countries, were included. On a group level, survivors were more likely to have lower educational achievement and more likely to be unemployed than comparisons. Key risk factors for poor outcomes included receiving a primary diagnosis of a central nervous system tumor and experiencing late effects. The authors recommend that health care providers be aware of the risk of educational and employment problems, implement regular surveillance, and refer survivors to specialists if problems are identified. In conclusion, this review presents a harmonized CPG that aims to facilitate evidence-based care, positively influence education and employment outcomes, and ultimately minimize the burden of disease and treatment-related late adverse effects for survivors of CAYA cancers. LAY SUMMARY: A multidisciplinary panel has developed guidelines for the surveillance of education and employment outcomes among survivors of childhood, adolescent, and young adult cancer. On the basis of evidence showing that survivors are at risk for lower educational achievement and unemployment, it is recommended that all survivors receive regular screening for educational and employment outcomes.
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Affiliation(s)
- Katie A Devine
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Salome Christen
- Health Science and Health Policy, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Renée L Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Morven C Brown
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.,Newcastle University Centre for Cancer, Newcastle Upon Tyne, United Kingdom
| | - Lisa M Ingerski
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Luzius Mader
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | | | - Adrienne S Viola
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | | | - Louis S Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York.,Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Melissa M Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle Upon Tyne, United Kingdom.,Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Gisela Michel
- Health Science and Health Policy, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jordan Gilleland Marchak
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Powell T, Cohen J, Patterson P. Keeping Connected With School: Implementing Telepresence Robots to Improve the Wellbeing of Adolescent Cancer Patients. Front Psychol 2021; 12:749957. [PMID: 34867634 PMCID: PMC8636051 DOI: 10.3389/fpsyg.2021.749957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Adolescent cancer patients experience considerable absence from their education, contributing to poorer academic attainment and isolation from peers, and impacting wellbeing. Telepresence robots have been used to support the educational and social needs of young people with chronic illness. This article presents the results of the development and pilot-testing of a telepresence robot service in schools for adolescent cancer patients – the TRECA (Telepresence Robots to Engage CAncer patients in education) service. Methods: Phase I used semi-structured interviews (n = 25) to assess the views of patients, parents, schools and clinicians on the benefits, acceptability, barriers, and enablers of utilizing robots in schools for adolescent cancer patients. Results from Phase I informed the development of the TRECA service. Phase II used semi-structured interviews (n = 22) to assess the implementation experiences of adolescent cancer patients, and their families, schools, and keyworkers who pilot-tested the TRECA service. Results: Phase I demonstrated the need for telepresence technology in connecting adolescent cancer patients to school. Given the variable support during treatment, a telepresence robot service was considered an acceptable method of facilitating a school-patient connection. The recommendations provided in Phase I, such as the need for provision of ongoing education, training, and support to the patient and school, informed the development of the TRECA service. In Phase II, the themes of The necessity of stakeholder buy-in, A facilitator of meaningful connection, and One size does not fit all were generated. The TRECA service’s flexibility in meeting the needs of its users helped facilitate meaningful connections. Participants reported that these connections provided patients an enhanced sense of agency and wellbeing. The importance of stakeholder buy-in and taking an individualized approach to service delivery were also highlighted. Stakeholder miscommunication and lack of knowledge were key aspects of implementation needing improvement as the service is rolled out on a larger scale. Conclusion: Using telepresence robots to connect adolescents to school during cancer treatment was regarded as highly acceptable, facilitating peer and academic connection. By making stakeholder-recommended improvements to the TRECA service’s existing processes, the service will continue to grow in effectiveness and capacity.
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Affiliation(s)
| | - Jennifer Cohen
- Canteen Australia, Sydney, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Pandora Patterson
- Canteen Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Bryan G, Kelly P, Chesters H, Franklin J, Griffiths H, Langton L, Langton L, Wakefield CE, Gibson F. Access to and experience of education for children and adolescents with cancer: a scoping review protocol. Syst Rev 2021; 10:167. [PMID: 34099059 PMCID: PMC8182947 DOI: 10.1186/s13643-021-01723-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer diagnosis in childhood or adolescence impacts significantly on school attendance, experience and educational outcomes. While there is longstanding recognition in clinical practice that these effects span the whole illness trajectory and continue beyond treatment completion, further clarity is required on the specific barriers and facilitators to education during cancer treatment and beyond, as well as on the experiences of children and adolescents across the full range of education settings (hospital, home, virtual, original school of enrolment), in order to determine which interventions are successful in improving access and experience from their perspective. The aim of this review is to identify what is known from the existing literature about access to and experience of education for children and adolescents with cancer during and post treatment. METHODS We have planned a scoping literature review searching the following databases from inception onwards: MEDLINE (Ovid), Embase and Embase Classic, Web of Science Core Collection, Education Resources Index, Sociological Abstracts, APA PsycINFO, SCOPUS, CINAHL Plus, Emcare and The Cochrane Library. In addition, DARE, conference abstracts, key journals, and institutional websites will be searched. Arksey and O'Malley's six-step process will be followed, including a consultation exercise. Studies, reports and policies from any country providing care and treatment for children and adolescents with cancer published in English will be considered eligible for inclusion. Two reviewers will independently screen all citations, full-text articles and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. DISCUSSION This is a timely examination given the increased incidence of childhood cancer, more intensive treatment regimens and improved survival rates for childhood cancer. The inclusion of a substantive consultation exercise with families and professionals will provide an important opportunity to examine the scoping review outputs. Findings will assist the childhood cancer community in developing a comprehensive evidence-based understanding of a significant associated bio-psychosocial impact of cancer diagnosis and treatment and will form the first step towards developing effective interventions and policies to mitigate identified detrimental effects. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (osf/io/yc4wt).
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Affiliation(s)
- Gemma Bryan
- School of Health Sciences, University of Surrey, Stag Hill, Guildford, GU2 7XH, Surrey, UK.,Louis Dundas Centre for Children's Palliative Care, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Paula Kelly
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, 37 Queen Square, London, UK.
| | - Heather Chesters
- Great Ormond Street Institute of Child Health Library, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Jayne Franklin
- The Children's Hospital School at Great Ormond Street Hospital & UCH, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK
| | - Helen Griffiths
- Clinical Health Psychology Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, Children's Psychological Medicine, John Radcliffe Hospital, Oxford, UK
| | | | | | - Claire E Wakefield
- School of Women's and Children's Health, UNSW MEDICINE, UNSW, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Faith Gibson
- School of Health Sciences, University of Surrey, Stag Hill, Guildford, GU2 7XH, Surrey, UK.,Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, 37 Queen Square, London, UK
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Nilsson S, Eriksson A, Sörman A, Kreicbergs U, Lövgren M, Nolbris MJ. Children's and adolescents' experiences of living with cancer. Nurs Child Young People 2021; 33:10-16. [PMID: 33225673 DOI: 10.7748/ncyp.2020.e1304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Background All healthcare professionals working with children should have a child-centred perspective, and should be responsive to children and adolescents who want to talk about their thoughts and feelings. The child's or adolescent's story is the starting point for mutual understanding between them and the healthcare professional, and is the basis for shared decision-making between patients and healthcare professionals in child-centred care. Aim To advance understanding of how Swedish children and adolescents with cancer perceived the effects of the disease and its treatment on their everyday life. Method Ten girls and five boys, aged between five and 18 years, with cancer were interviewed individually using four communication tools. The interviews lasted between 20 and 65 minutes and took place without their parents present. The data were analysed using content analysis. Findings Transition to an unpredictable everyday life was identified as a main theme, with five subthemes: struggling with side effects of the cancer and its treatment; treatment as an 'emotional rollercoaster'; changed self and being vulnerable; changed social life; and concerns about academic achievement. Conclusion To provide effective support and care for children and adolescents with cancer, healthcare professionals should strive to listen to them and focus on their perspectives.
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Affiliation(s)
- Stefan Nilsson
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Annie Eriksson
- The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Anna Sörman
- Barn- och ungdomsmedicinsk mottagning, Gothenburg, Sweden
| | - Ulrika Kreicbergs
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke, University College, Stockholm, Sweden
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke, University College, Stockholm, Sweden
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Braga TRL, Mattos CXD, Cabral IE. Participatory health education on school (re)inclusion of the adolescent cancer survivor. Rev Bras Enferm 2021; 74:e20200006. [PMID: 33787779 DOI: 10.1590/0034-7167-2020-0006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 09/07/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze school (re)inclusion of an adolescent cancer survivor before/after participatory health education with adolescents. METHODS qualitative and participatory research that included data from the medical record of an adolescent rhabdomyosarcoma survivor and Talking Map dynamics (to diagnose the demand for learning and assess changes). The body-knowledge dynamics were applied in the educational intervention. In a public school in Rio de Janeiro, the adolescent (reference case) and nine people (four teachers and five teenagers) generated empirical materials, which became the content analysis objects. RESULTS strangeness to changes in an adolescent cancer survivor's body image, bullying, and acceptance were problematized in educational body-knowledge dynamics through relationships between changes and barriers to welcoming. The participatory educational process was essential in raising awareness by promoting re-inclusive actions. CONCLUSIONS participatory-problematizing education contributed to constructing a new collective identity and improvement in school interaction among peers.
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9
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Martinez-Santos AE, Fernandez-De-La-Iglesia JDC, Sheaf G, Coyne I. A systematic review of the educational experiences and needs of children with cancer returning to school. J Adv Nurs 2021; 77:2971-2994. [PMID: 33598984 DOI: 10.1111/jan.14784] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/11/2020] [Accepted: 01/25/2021] [Indexed: 11/28/2022]
Abstract
AIMS To critically review and synthesize empirical studies on childhood cancer survivors' experiences and needs on returning to school after treatment. DESIGN A mixed-method systematic review. DATA SOURCES A search of CINAHL, PsycINFO, EMBASE, MEDLINE, ERIC and Web of Science was conducted for studies published in English, Spanish and Portuguese languages between January 2010 and May 2020. REVIEW METHODS Twenty-one studies were eligible for inclusion (13 qualitative studies, 6 quantitative and 2 mixed-method studies). The quality of the studies was assessed using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Findings were synthesized using data-based convergent synthesis design. RESULTS Findings were synthesized under four themes: academic continuity and school re-entry; physical and psychological well-being; school life and participation and stakeholders' responses to childhood cancer. Findings indicated that prolonged/recurring absences, physical and mental changes, personal/health factors impacted children's social participation, peer relationships and school re-integration. Factors which contributed to a more positive experience included maintaining contact with peers and teachers throughout treatment, peer relationships, understanding and support from school community. Sharing information about cancer was an ongoing challenging issue for children, that needed to be handled sensitively. CONCLUSION It is evident that re-entry to school was very challenging for most children due to treatment side effects, prolonged absences, disrupted peer relationships, lack of preparation and lack of communication between schools, families and healthcare professionals. IMPACT Despite the growing number of childhood cancer survivors worldwide, there is a deficit of studies about children's re-entry experiences and educational needs. This review illustrates the considerable challenges that children face on school re-entry and the critical importance of better care, support and collaboration from healthcare professionals, parents and school personnel. Nurses could help by raising awareness and leading on preparation for school re-entry.
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Affiliation(s)
- Alba-Elena Martinez-Santos
- Faculty of Education Sciences, University of Santiago de Compostela, Santiago de Compostela, Spain.,Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Greg Sheaf
- The Library of Trinity College Dublin, Trinity College Dublin, Dublin, Ireland
| | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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10
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Social isolation and connection in adolescents with cancer and survivors of childhood cancer: A systematic review. J Adolesc 2021; 87:15-27. [DOI: 10.1016/j.adolescence.2020.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/20/2020] [Accepted: 12/21/2020] [Indexed: 12/25/2022]
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Vanclooster S, Bilsen J, Peremans L, Van Der Werff Ten Bosch J, Laureys G, Paquier P, Jansen A. Reintegration Into School After Treatment for a Brain Tumor: The Child's Perspective. Glob Pediatr Health 2019; 6:2333794X19860659. [PMID: 31321257 PMCID: PMC6610440 DOI: 10.1177/2333794x19860659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 05/02/2019] [Accepted: 06/05/2019] [Indexed: 01/18/2023] Open
Abstract
This multiple case study investigated perspectives of childhood brain tumor
survivors on reintegration into school over a 2-year period. Semistructured
interviews were conducted with 5 children at 3 times to obtain an extensive view
of their overall school experience. Thematic analysis of data resulted in 4
themes: “school life and participation,” “peer relations and friendships,”
“performance and difficulties,” and “support and follow-up.” Childhood brain
tumor survivors consider school attendance as part of a normal disease-free
life. Social contact and friendships represent their main motivating factors for
returning to school. Attitudes and feelings regarding performance, difficulties,
and support vary among survivors and change over time. In conclusion, continuity
in learning and social contact established before the return facilitate the
reintegration process. A comprehensive assessment of their academic and
psychosocial functioning should be organized on reentry. Systematic follow-up by
parents, school staff, and health professionals throughout the child’s school
career is required.
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Affiliation(s)
| | | | - Lieve Peremans
- Vrije Universiteit Brussel, Brussels, Belgium.,University of Antwerp, Antwerp, Belgium
| | | | | | - Philippe Paquier
- Vrije Universiteit Brussel, Brussels, Belgium.,Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Anna Jansen
- Vrije Universiteit Brussel, Brussels, Belgium.,UZ Brussel, Brussels, Belgium
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Collins DE, Ellis SJ, Janin MM, Wakefield CE, Bussey K, Cohn RJ, Lah S, Fardell JE. A Systematic Review Summarizing the State of Evidence on Bullying in Childhood Cancer Patients/Survivors [Formula: see text]. J Pediatr Oncol Nurs 2018; 36:55-68. [PMID: 30406714 DOI: 10.1177/1043454218810136] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND One in four school-aged children is bullied. However, the risk may be greater for childhood cancer patients/survivors (diagnosed <18 years), because of symptoms of the disease and treatment that may prejudice peers. While the serious consequences of bullying are well documented in the general population, bullying may have even greater impact in children with cancer due to the myriad of challenges associated with treatment and prolonged school absence. OBJECTIVE To summarize the state of evidence on bullying in childhood cancer patients/survivors; specifically, the rate and types of bullying experienced and the associated factors. METHOD We searched five electronic databases from inception to February 2018 for original research articles reporting on bullying in childhood cancer patients/survivors. RESULTS We identified 29 eligible articles, representing 1,078 patients/survivors ( M = 14.35 years). Self-reports from patients/survivors revealed a considerably higher rate of bullying (32.2%) compared with the general population (25%). Our review identified little information on the factors associated with bullying in patients/survivors. However, the bullying described tended to be verbal and was often related to the physical side effects of treatment, indicating that differences in appearance may prejudice peers. It was further suggested that educating the child's classmates about cancer may prevent bullying. CONCLUSIONS Our findings confirm that bullying is a significant challenge for many childhood cancer patients/survivors. Additional studies are needed to identify factors that may influence the risk of bullying, which will inform the development of evidence-based interventions and guidelines to prevent bullying in childhood cancer patients/survivors.
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Affiliation(s)
- Daisy E Collins
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Sarah J Ellis
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Madeleine M Janin
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Kay Bussey
- 3 Macquarie University, Sydney, New South Wales, Australia
| | - Richard J Cohn
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Suncica Lah
- 4 University of Sydney, Sydney, New South Wales, Australia.,5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - Joanna E Fardell
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
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13
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Park M, Park HJ, Lee JM, Ju HY, Park BK, Yu ES, Yang HK, Kim JY, Park SK, Lee YH, Shim YJ, Kim HS, Lee JA, Lim YJ, Cheuh HW, Park JK, Lee MJ, Kim SK, Choi HS, Hah JO, Park KD, Kang HJ, Shin HY. School performance of childhood cancer survivors in Korea: A multi-institutional study on behalf of the Korean Society of Pediatric Hematology and Oncology. Psychooncology 2018; 27:2257-2264. [DOI: 10.1002/pon.4819] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/05/2018] [Accepted: 06/11/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Meerim Park
- Center for Pediatric Cancer, National Cancer Center; Goyang South Korea
| | - Hyeon Jin Park
- Center for Pediatric Cancer, National Cancer Center; Goyang South Korea
| | - Jae Min Lee
- Department of Pediatrics; Yeungnam University College of Medicine; Daegu South Korea
| | - Hee Young Ju
- Center for Pediatric Cancer, National Cancer Center; Goyang South Korea
| | - Byung Kiu Park
- Center for Pediatric Cancer, National Cancer Center; Goyang South Korea
| | - Eun-Seung Yu
- Mental Health Clinic, National Cancer Center; Goyang South Korea
| | - Hyung-Kook Yang
- Cancer Survivorship Branch, National Cancer Center; Goyang South Korea
| | - Ji Yoon Kim
- Department of Pediatrics; Kyungpook National University School of Medicine; Daegu South Korea
| | - Sang Kyu Park
- Department of Pediatrics, Ulsan University Hospital; University of Ulsan College of Medicine; Ulsan South Korea
| | - Young Ho Lee
- Department of Pediatrics; Hanyang University College of Medicine; Seoul South Korea
| | - Ye Jee Shim
- Department of Pediatrics; Keimyung University Dongsan Medical Center; Daegu South Korea
| | - Heung Sik Kim
- Department of Pediatrics; Keimyung University Dongsan Medical Center; Daegu South Korea
| | - Jun Ah Lee
- Department of Pediatrics; Korea Cancer Center Hospital; Seoul South Korea
| | - Yeon-Jung Lim
- Department of Pediatrics; Chungnam National University College of Medicine; Daejon South Korea
| | - Hee Won Cheuh
- Department of Pediatrics; Dong-A University College of Medicine; Busan South Korea
| | - Ji Kyoung Park
- Department of Pediatrics; Inje University Busan Paik Hospital; Busan South Korea
| | - Mee Jeong Lee
- Department of Pediatrics; Dankook University College of Medicine; Cheonan South Korea
| | - Soon Ki Kim
- Department of Pediatrics; Inha University College of Medicine; Incheon South Korea
| | - Hyoung Soo Choi
- Department of Pediatrics; Seoul National University Bundang Hospital; Seongnam South Korea
| | - Jeong Ok Hah
- Department of Pediatrics; Yeungnam University College of Medicine; Daegu South Korea
- Department of Pediatrics; Daegu Fatima Hospital; Daegu South Korea
| | - Kyung Duk Park
- Department of Pediatrics; Chonbuk National University Medical School; Jeonju South Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Cancer Research Institute; Seoul National University College of Medicine; Seoul South Korea
| | - Hee Young Shin
- Department of Pediatrics, Cancer Research Institute; Seoul National University College of Medicine; Seoul South Korea
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14
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15
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Andersen KK, Duun-Henriksen AK, Frederiksen MH, Winther JF. Ninth grade school performance in Danish childhood cancer survivors. Br J Cancer 2017; 116:398-404. [PMID: 28081550 PMCID: PMC5294489 DOI: 10.1038/bjc.2016.438] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 12/05/2016] [Accepted: 12/08/2016] [Indexed: 11/18/2022] Open
Abstract
Background: Childhood cancer survivors can experience learning problems resulting in lower-than-expected attained education as adults. It is unclear whether learning problems manifest already during adolescence. Methods: We analysed nationwide Danish registries on school grades for Danish children during 2001–2014. Applying a matched design we compared grades of childhood cancer survivors to children without cancer at ninth grade. We estimated grade differences by subject and its correlation to cancer site and age at diagnosis. The available statistical precision allowed for an analysis of more rare cancer sites. Results: The total study population was 793 332 children (mean age 15.24 years and 49.7% girls), of whom 1320 were childhood cancer survivors. Lower rank grades were seen in children with cancer in all school subjects but differed substantially according to cancer site. Most affected were survivors of central nervous system (CNS) tumours, neuroblastoma, lymphoma, leukaemia, other malignant neoplasm and germ-cell tumours. Survivors from other cancer types did not obtain lower grades. Lower rank grades were associated with young age at diagnosis. Conclusions: The effect of childhood cancer differed substantially between cancer sites. The largest effect was among survivors of CNS tumours and leukaemia diagnosed at a young age, suggesting an association with radiation therapy. However, the majority of cancer survivors fare well. Increasing awareness on children affected by cancer and special accommodations may help maximise the learning potential of those most affected.
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Affiliation(s)
- Klaus Kaae Andersen
- Unit of Statistics, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | | | - Marie Hoffmann Frederiksen
- Unit of Statistics, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - Jeanette Falck Winther
- Unit of Cancer Survivorship, Childhood Cancer Survivorship Research Group, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
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16
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Lown EA, Phillips F, Schwartz LA, Rosenberg AR, Jones B. Psychosocial Follow-Up in Survivorship as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S514-84. [PMID: 26700918 PMCID: PMC5242467 DOI: 10.1002/pbc.25783] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 01/08/2023]
Abstract
Childhood cancer survivors (CCS) have a high risk of medical late effects following cancer therapy. Psychosocial late effects are less often recognized. Many CCS do not receive long-term follow-up (LTFU) care, and those who do are rarely screened for psychosocial late effects. An interdisciplinary team conducted a systematic review of qualitative and quantitative studies to assess social, educational, vocational, psychological, and behavioral outcomes along with factors related to receipt of LTFU care. We propose that psychosocial screening be considered a standard of care in long-term follow-up care and that education be provided to promote the use LTFU care starting early in the treatment trajectory.
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Affiliation(s)
- E. Anne Lown
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
| | - Farya Phillips
- School of Social Work, The University of Texas at Austin, Austin, Texas
| | - Lisa A. Schwartz
- The Children’s Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abby R. Rosenberg
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Barbara Jones
- School of Social Work, The University of Texas at Austin, Austin, Texas
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