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Duffy EA, Hooke MC, Landier W. Reflections on the Past Decade in Evidence-Based Practice Within the Children's Oncology Group. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:129-139. [PMID: 38437793 PMCID: PMC11145516 DOI: 10.1177/27527530231222827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Background: The Children's Oncology Group (COG) is the only National Cancer Institute-supported clinical trials organization focused exclusively on childhood and adolescent cancer research. The COG Nursing Discipline Committee has embedded the tenets of evidence-based practice (EBP) into clinical trials nursing in order to standardize the nursing care delivered to children enrolled on these trials. The COG nursing EBP initiative is aimed at developing evidence-based clinical resources and tools to provide guidance to clinicians regarding topics relevant to the provision of cancer treatment for patients enrolled on COG clinical trials from diagnosis through survivorship. A rigorous, evidence-based process designed to guide development of the evidence-based clinical tools and resources within the COG nursing discipline was developed and was implemented with the first nurse expert team beginning in 2012. Method: The standardized process included (a) selecting EBP projects and nursing expert teams (NETs), (b) providing leadership, mentoring, and championship for NETs; (c) approving clinical content developed through the NETs; and (d) providing guidance and oversight over planned dissemination of the COG EBP projects. Results: The COG Nursing EBP Subcommittee has developed 15 publications to date that include 90 authors. Eleven of these authors contributed to multiple publications. Discussion: On this 10th anniversary of the development of the EBP within the COG nursing discipline, we recognize its contributions to the professional growth of many of the discipline's members and to advances in nursing care for children enrolled in pediatric cancer clinical trials.
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Affiliation(s)
- Elizabeth A. Duffy
- Health Behavior and Biological Sciences, The University of Michigan School of Nursing
| | - Mary C. Hooke
- School of Nursing, University of Minnesota, Eden Prairie, Minnesota, USA
| | - Wendy Landier
- Pediatric Hematology/Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Tan CE, Admodisastro N, Lau SCD, Tan KA, Teh KH, Lee CC, Mohd Sidik S. Development and user evaluation of an online caregiver education resource for Malaysian parents of children with leukemia or lymphoma. Asia Pac J Oncol Nurs 2024; 11:100363. [PMID: 38304227 PMCID: PMC10831254 DOI: 10.1016/j.apjon.2023.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/15/2023] [Indexed: 02/03/2024] Open
Abstract
Objective Malaysian parents of children diagnosed with leukemia or lymphoma stand to benefit from a comprehensive Malay-language online resource, complementing existing caregiver education practices. This study aimed to develop and assess the efficacy of e-Hematological Oncology Parents Education (e-HOPE), an online caregiver education resource in Malay, designed to enhance the knowledge of parents with children diagnosed with leukemia or lymphoma in Malaysia. Methods A user profile and topic list were established based on previous needs analysis studies. Content was developed for each identified topic. An expert panel assessed the content validity of both informational content and activity sections. Subsequently, the contents were presented via a learning management system to parents of children newly diagnosed with leukemia or lymphoma. Parents evaluated the quality of e-HOPE using the Website Evaluation Questionnaire (WEQ) after an 8-week period. Results The scale content validity index (S-CVI/Ave) achieved 0.996 for informational content and 0.991 for the activity section. Sixteen parents provided evaluations of e-HOPE after an 8-week usage period. Mean WEQ scores for various dimensions ranged from 4.23 for completeness to 4.88 for relevance. Conclusions E-HOPE was meticulously designed and developed to offer Malaysian parents a Malay-language resource complementing current caregiver education practices. It exhibited strong content validity and received positive user ratings for quality. Further assessment is warranted to evaluate its effectiveness in supporting parents of children with leukemia or lymphoma. The resource is anticipated to enhance information accessibility and support for Malaysian parents facing hematological cancers in their children. Trial registration Clinicaltrials.govNCT05455268.
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Affiliation(s)
- Chai-Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Novia Admodisastro
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sie Chong Doris Lau
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kit Aun Tan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kok Hoi Teh
- Department of Pediatrics, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Chee Chan Lee
- Department of Pediatrics, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Sherina Mohd Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Withycombe JS, Kubaney HR, Okada M, Yun CS, Gupta S, Bloom C, Parker V, Rau RE, Zupanec S. Delivery of Care for Pediatric Patients Receiving Blinatumomab: A Children's Oncology Group Study. Cancer Nurs 2023:00002820-990000000-00192. [PMID: 38016041 PMCID: PMC11128477 DOI: 10.1097/ncc.0000000000001309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Blinatumomab is an immunotherapy agent used in pediatric oncology for the treatment of B-lineage acute lymphoblastic leukemia. Administration of blinatumomab, via continuous 28-day infusion cycles, can present multiple decision points and challenges related to patient care. Nurses are at the forefront of coordinating and delivering care for patients receiving blinatumomab. OBJECTIVE To describe the current state of practice across Children's Oncology Group (COG) member institutions regarding blinatumomab administration in both inpatient and home/outpatient settings. METHODS Between August and December 2021, a cross-sectional survey was used to determine current institutional practices related to blinatumomab administration. A single targeted respondent who was actively engaged in coordinating blinatumomab administration completed the survey on behalf of each COG institution. RESULTS Survey participation rate was 78% (150/192). During the first 28-day blinatumomab cycle, 71 institutions (53%) reported patient hospital stays between 73 hours and 7 days; 42 (31%) reported hospital stays ≤72 hours, and only 12 (9%) reported hospitalization for the full 28-day infusion. Small- to medium-size institutions were more likely to report longer hospitalizations (P = .03). Most blinatumomab administration occurred in the outpatient setting, with low rates of unplanned clinic/emergency room visits. CONCLUSIONS The majority of COG institutions have navigated the complex coordination of care required for children to receive blinatumomab at home. Wide variations in practice were noted across institutions. IMPLICATIONS FOR PRACTICE This study describes current institutional practices surrounding administration of 28-day blinatumomab infusions in children with leukemia and offers a starting point for institutional benchmarking and standardization of practice.
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Affiliation(s)
- Janice S Withycombe
- Author Affiliations: Clemson University, Clemson (Dr Withycombe, Ms Bloom, and Dr Parker); and Prisma Health Children's Hospital, Greenville (Dr Withycombe), South Carolina; Dell Children's Blood and Cancer Center, Austin, Texas (Mrs Kubaney); Miller Children's & Women's Hospital, Long Beach, California (Mrs Okada); and Children's Hospital of Orange County, Orange (Mrs Yun), California; Texas Children's Hospital, Houston (Dr Rau), and SickKids, Toronto, Ontario, Canada (Dr Gupta and Mrs Zupanec)
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Zupanec S, Herriage T, Landier W. Children's Oncology Group 2023 blueprint: Nursing discipline. Pediatr Blood Cancer 2023; 70 Suppl 6:e30575. [PMID: 37470719 PMCID: PMC10655901 DOI: 10.1002/pbc.30575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
In contrast to other Children's Oncology Group (COG) committees, the COG nursing discipline is unique in that it provides the infrastructure necessary for nurses to support COG clinical trials and implements a research agenda aimed at scientific discovery. This hybrid focus of the discipline reflects the varied roles and expertise within pediatric oncology clinical trials nursing that encompass clinical care, leadership, and research. Nurses are broadly represented across COG disease, domain, and administrative committees, and are assigned to all clinically focused protocols. Equally important is the provision of clinical trials-specific education and training for nurses caring for patients on COG trials. Nurses involved in the discipline's evidence-based practice initiative have published a wide array of systematic reviews on topics of clinical importance to the discipline. Nurses also develop and lead research studies within COG, including stand-alone studies and aims embedded in disease/ treatment trials. Additionally, the nursing discipline is charged with responsibility for developing patient/family educational resources within COG. Looking to the future, the nursing discipline will continue to support COG clinical trials through a multifaceted approach, with a particular focus on patient-reported outcomes and health equity/disparities, and development of interventions to better understand and address illness-related distress in children with cancer.
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Affiliation(s)
- Sue Zupanec
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Wendy Landier
- University of Alabama at Birmingham, Birmingham, Alabama
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Keith KE, Wadhwa A, York J, Fazeli PL, Bhatia S, Landier W. Health Literacy in Parents of Children Newly Diagnosed With Cancer and Comprehension of Key Concepts Related to Their Child's Care. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:235-244. [PMID: 37063061 DOI: 10.1177/27527530221140076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background: There is a paucity of literature regarding health literacy in pediatric oncology. We sought to understand the relationship between health literacy and comprehension of key new diagnosis education concepts in parents of children newly diagnosed with cancer. Methods: Using data from a study evaluating a structured new diagnosis discharge teaching intervention, we performed a secondary analysis to understand the relationship between parental health literacy (Brief Health Literacy Screener: BHLS) and comprehension of six key concepts (child's diagnosis, primary oncologist, and treatment plan; seeking emergent care; fever definition; re-dosing medication). We also evaluated the association between parents self-reported sociodemographic characteristics, preferred learning style (one-item ordinal assessment) and health literacy. We tested relationships using Fisher's exact tests, independent samples t-tests, and Pearson correlations. Results: Fifty parents participated (age 35.4 ± 8.2 years [M ± SD]; 86% female; 60% non-Hispanic white; 24% with ≤high school education); nine parents (18%) scored in the BHLS low literacy range; 80% correctly responded to all six items on the key concepts questionnaire (100% comprehension). Health literacy was not significantly related to 100% comprehension or to individual key concept responses, with the exception of "child's treatment plan" (correct responses: 55.6% in low vs. 100% in adequate literacy groups; p < .001). Parental sociodemographic characteristics and preferred learning styles were not significantly related to health literacy. Discussion:Despite variability in health literacy levels, 80% of the parents comprehended all key concepts, suggesting that the intervention was effective for most parents, regardless of health literacy level.
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Affiliation(s)
- K Elizabeth Keith
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Aman Wadhwa
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jocelyn York
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wendy Landier
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Landier W, Gonzalez PDC, Henneberg H, York JM, Wadhwa A, Adams K, Madan-Swain A, Wolfson JA, Benton B, Seidel C, Slater V, Snuggs K, Folsom A, Miller J, Tomlinson K, Zupanec S, Bhatia S. Children's Oncology Group KidsCare smartphone application for parents of children with cancer. Pediatr Blood Cancer 2023; 70:e30288. [PMID: 36945123 PMCID: PMC10631815 DOI: 10.1002/pbc.30288] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Parents of children with cancer must learn and retain crucial information necessary to provide safe care for their child. Smartphone applications (apps) provide a significant opportunity to meet the informational needs of these parents. We aimed to develop, refine, and evaluate a smartphone app, informed by the Children's Oncology Group (COG) expert consensus recommendations, to support the informational needs of parents of children with cancer. PROCEDURE We employed a user-centered iterative mixed-methods approach in two phases (prototype development/refinement and pilot testing). We engaged parents and clinicians in evaluating the app via qualitative interviews and standardized tools that measured app quality (Mobile Application Rating Scale [MARS]), usability (System Usability Scale [SUS]), and acceptability (System Acceptability Scale [SAS]). We evaluated early usage patterns after public release. RESULTS Thirty-two parents and 17 clinicians participated. Mean (± standard deviation [SD]) scores for app quality, usability, and acceptability were: MARS: 4.5 ± 0.7 on a 5-point scale; SUS: 86.7 ± 23.8 on a 100-point scale; and SAS: superior (61%); similar (28%); inferior (11%) to written materials. Qualitative findings largely confirmed the quantitative data. Downloads of the app during the first year following public release have exceeded 5000. CONCLUSIONS The COG KidsCare app prototype was found to be of high quality and received high usability and acceptability ratings. Further testing is needed to determine app effectiveness in improving parental knowledge regarding care of children with cancer.
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Affiliation(s)
| | | | | | | | - Aman Wadhwa
- University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | | | | | | | | | | | | | | | - Susan Zupanec
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Smita Bhatia
- University of Alabama at Birmingham, Birmingham, AL
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Collazo CK, Tena N, Duffy EA. Facilitating and Implementing a Process for the Delivery of Pediatric Oncology New Diagnosis Education Among Nursing Staff Through the Electronic Medical Record. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 40:133-138. [PMID: 36288198 DOI: 10.1177/27527530211073873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: An estimated 11,060 children between the ages of 1 and 14 years and 4,900 adolescents between the ages of 15 and 19 years are diagnosed with cancer in the United States. Parents with children newly diagnosed with cancer must acquire new knowledge related to the diagnosis, treatment plan, psychosocial care, and home management therapies to safely provide care following discharge. Expert consensus and review of current evidence demonstrate that utilizing a new diagnosis education checklist allows the delivery of essential information to patients and caregivers. The checklist divides educational topics into three sections: primary, secondary, and tertiary topics. This project followed the completion of an evidence-based fellowship through Children's Oncology Group focusing upon the feasibility and efficacy of implementing a standardized new diagnosis education checklist. The fellowship identified secondary topic documentation and an electronic medical record (EMR) checklist as areas of future work. Methods: This quality improvement project focused upon nursing staffs’ documentation of secondary topics and the development/utilization of an EMR checklist. A pre–post survey design evaluated the outcomes of secondary topic documentation and EMR checklist implementation. Results: This nurse-led initiative created templates for primary and secondary topic checklists using Epic's SmartPhrase feature “.PHOPTED1” and “.PHOPTED2.” Secondary topic completion and documentation increased 26% following implementation, and over 40% of the nursing staff indicated that they were very likely to continue to use the new templates. Discussion: Project templates are readily applicable to institutions that utilize Epic. Template examples and strategies to facilitate inpatient/outpatient checklist completion are discussed.
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Affiliation(s)
| | - Nancy Tena
- C.S. Mott Children’s Hospital, Coach Carr Cancer Unit, Ann Arbor, MI, USA
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Duffy EA, Herriage T, Ranney L, Tena N. Implementing and Evaluating a Standardized New Diagnosis Education Checklist: A Report From the Children's Oncology Group. J Pediatr Oncol Nurs 2021; 38:322-330. [PMID: 34029147 DOI: 10.1177/10434542211011059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
When a child is newly diagnosed with cancer, parents report feeling overwhelmed with the amount of information that they must process in order to safely care for their child at home. The Children's Oncology Group (COG) Nursing Discipline has focused on examining current practices for educating families of children newly diagnosed with cancer, and developing tools to enhance the process of patient/family education at the time of diagnosis, including development of a COG Standardized Education Checklist, which classifies education into primary, secondary, and tertiary topics. The COG Nursing Discipline awarded nursing fellowships to two doctorally prepared nurses practicing at two distinct COG institutions to evaluate the checklist implementation. This project addressed the primary topics on the checklist essential to safely care for the child at home following the first hospital discharge. Checklist feasibility was determined by the proportion of checklists completed. Checklist fidelity was determined by review of documentation on the checklist regarding educational topics covered, learner preferences, and methods used. Checklist acceptability was assessed through parent/caregiver and nurse feedback. Project implementation occurred over a 5-month period and involved 69 newly diagnosed families. Implementation of the checklist was feasible (81%), with moderate fidelity to checklist topics taught across the two sites. Verbal instruction and written documentation were the most prevalent form of education. The return rate for the parent/caregiver and nurse acceptability questionnaires was moderate to low (68% and 12%, respectively), parent/caregiver feedback was positive and acceptability among responding nurses was high, with 92% of nurses identifying the primary checklist as useful.
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Affiliation(s)
- Elizabeth A Duffy
- Health Behavior and Biological Sciences, 21614The University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | | | | | - Nancy Tena
- C.S. Mott Children's Hospital, Coach Carr Cancer Unit, Ann Arbor, Michigan, USA
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Kuntz SR, Gerhardt LM, Ferreira AM, Santos MTD, Ludwig MCF, Wegner W. Primeira transição do cuidado hospitalar para domiciliar da criança com câncer: orientações da equipe multiprofissional. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Descrever as orientações para a primeira transição do cuidado hospitalar para o domiciliar da criança com câncer sob a ótica da equipe multiprofissional. Método Estudo de abordagem qualitativa do tipo exploratório-descritivo realizado em um Hospital Universitário do Sul do Brasil, com nove profissionais da equipe multiprofissional de uma unidade de internação de oncologia pediátrica entre julho e setembro de 2018. Foram realizadas entrevistas semiestruturadas submetidas a análise de conteúdo temática. Resultados Foram identificadas três categorias temáticas: planejamento multiprofissional para a alta hospitalar da criança com câncer e sua família; a equipe multiprofissional frente ao processo de alta hospitalar; orientações para a primeira alta hospitalar a famílias de crianças com câncer recém diagnosticado. Conclusão/implicações para prática o planejamento e sistematização multiprofissional para as orientações da primeira alta hospitalar são fundamentais para contemplar as necessidades do paciente e suas famílias, tendo o enfermeiro papel central. Mostram-se necessárias melhorias nesse processo.
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Affiliation(s)
| | | | | | | | | | - Wiliam Wegner
- Hospital de Clínicas de Porto Alegre, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
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Ruble KJ, Paré-Blagoev EJ, Cooper SL, Jacobson LA. Assessment of Online Resources for Returning to School During and After Treatment of Childhood Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:876-884. [PMID: 31049872 DOI: 10.1007/s13187-019-01537-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To evaluate current online parent education resources for children returning to school after a cancer diagnosis. Online search was conducted using 3 search engines and terms recommended by affected families. Sites were evaluated by 3 reviewers for understandability and actionability (scored 0-100%) using the Patient Education Materials Assessment Tool (PEMAT). Readability was assessed using Flesch-Kincaid (grade K-12) and content comprehensiveness by a clinical expert review for 5 late effect domains (scored 0-100%). A total of 56 unique online resources were evaluated. Mean understandability and actionability scores were 54% (range 17-83) and 36% (range 0-83) respectively. The mean Flesch-Kincaid grade level was 10th grade (mode 12th). Comprehensiveness of domain coverage was 34% (mode 20%). Some high-quality materials for this topic are available, but generally low scores on the PEMAT scales and high reading level estimates on Flesch-Kincaid indicate parents may have difficulty understanding and using the information. The low scores for comprehensiveness of information indicate parents will likely need to access multiple sources for complete information. A table provides the names, website (URL), and scoring for the 24 top-rated sites and can be used to make recommendations to parents with improved confidence in quality.
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Affiliation(s)
- Kathy Jeanne Ruble
- Bloomberg Children's Center, Johns Hopkins School of Medicine, Johns Hopkins Hospital, 1800 Orleans St., Baltimore, MD, 21234, USA.
| | | | - Stacy Lorine Cooper
- Bloomberg Children's Center, Johns Hopkins School of Medicine, Johns Hopkins Hospital, 1800 Orleans St., Baltimore, MD, 21234, USA
| | - Lisa Anne Jacobson
- Bloomberg Children's Center, Johns Hopkins School of Medicine, Johns Hopkins Hospital, 1800 Orleans St., Baltimore, MD, 21234, USA
- Kennedy Krieger Institute, 1750 E Fairmount Ave, Baltimore, MD, 21231, USA
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Haugen M, Skeens M, Hancock D, Ureda T, Arthur M, Hockenberry M. Implementing a pediatric oncology nursing multisite trial. J SPEC PEDIATR NURS 2020; 25:e12293. [PMID: 32419299 DOI: 10.1111/jspn.12293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/08/2020] [Accepted: 05/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE/BACKGROUND The Parent Educational Discharge Support Strategies (PEDSS) nursing study includes 16 magnet pediatric oncology institutions across the United States and one in Saudi Arabia, evaluating a nurse-led parent educational discharge support strategy for families experiencing a child newly diagnosed with cancer. METHODS During the first 3 months of the study, a research implementation survey was administered electronically to each site principal investigator to evaluate facilitators and barriers in the research process for this multisite nurse-led pediatric oncology study. RESULTS Facilitators included nursing leadership support and commitment from the nursing staff. Common barriers reported were the Institutional Review Board process, the consent process, the timing of the intervention, data collection, as well as nursing time for the study. Results from the survey suggest nurse-led research teams were motivated and felt the intervention was easy to deliver. PRACTICE IMPLICATIONS Nursing practice is enhanced when nurses participate in research and generate evidence regarding best practices within pediatric oncology nursing care. CONCLUSION Nursing research endeavors focusing on collaborative approaches for implementation can lead to successful nursing studies with careful planning, training and administrative support.
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Affiliation(s)
- Maureen Haugen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | | | | | - Tonya Ureda
- St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Megan Arthur
- Duke University School of Nursing, Durham, North Carolina
| | - Marilyn Hockenberry
- School of Nursing, Duke Institutional Review Board, Duke University School of Nursing, Durham, North Carolina
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Shinnick S. Assessment of the Role of the Pediatric Nurse in Patient Education and Follow-up of Patients Receiving Oral Anticancer Treatment. J Pediatr Oncol Nurs 2019; 37:46-54. [PMID: 31475636 DOI: 10.1177/1043454219871081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To assess the role of the pediatric nurse/advanced practice provider in patient education and follow-up of patients receiving oral anticancer therapy. Methods: Association of Pediatric Hematology/Oncology Nurses members were invited to participate in a survey that focused on the nurses' roles in patient education of patients taking oral oncolytic agents. Data were collected via a 16-item questionnaire. Respondents included 197 nurses and advanced practice providers. Content analysis techniques were used to describe the qualitative data while Fisher's exact test and chi-square test were used in the quantitative statistical analysis. Results: Seventy-one percent of respondents reported some type of involvement in patient education. Knowledge as well as comfort level improved as years of oncology nursing experience increased. Generally, policies and procedures are in place; however, nurses noted there is a need for improved oral oncolytic guidelines. Nurses also reported a need for improved and updated educational resources. Conclusion: While the development of oral oncolytic agents continues to rise, findings show a need to develop evidence-based guidelines for nurses, which include management of oral oncolytic dosing, adverse events, and safety issues.
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Tang S, Landery D, Covington G, Ward J. The Use of a Video for Discharge Education for Parents After Pediatric Stem Cell Transplantation. J Pediatr Oncol Nurs 2019. [DOI: 10.1177/1043454218818059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: Caring for a child at home after hematopoietic stem cell transplant (HSCT) is challenging for parents, and discharge education is critical to ensure parents are prepared. The purpose of this study is to evaluate the feasibility and effectiveness of a discharge video intervention (DVI) as an adjunct to standard discharge teaching (SDT). Method: A two-phase study was conducted at an urban children’s hospital in the western United States. Phase 1 involved SDT alone followed by nurse-administered proficiency testing of parent knowledge in caring for their children at home using a 4-point Likert-type scale of parents of children post-allogeneic HSCT. These results informed the DVI, created in English and Spanish in Phase 2. The DVI content included topics on home cleaning, notifying the medical team, graft-versus-host disease (GVHD), diet and visitor restrictions, and outpatient visits. In Phase 2, the DVI was viewable by parents who also received SDT. Parents’ proficiency was evaluated using the same procedure as in Phase 1. Results: Thirty-four parents participated: 17 in Phase 1 (SDT), 17 in Phase 2 (SDT + DVI). The DVI was viewed by parents in Phase 2 approximately twice prior to discharge. Parents in Phase 2 had higher proficiency scores on home cleaning, signs/symptoms of GVHD, and diet restriction. Parents in Phase 1 had higher proficiency regarding notifying the team. Conclusions: The DVI was feasible and demonstrated incremental increases in parent’s proficiency related to some discharge topics.
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Affiliation(s)
- Shinyi Tang
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Dawn Landery
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Jessica Ward
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
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Dobrozsi S, Tomlinson K, Chan S, Belongia M, Herda C, Maloney K, Long C, Vertz L, Bingen K. Education Milestones for Newly Diagnosed Pediatric, Adolescent, and Young Adult Cancer Patients: A Quality Improvement Initiative. J Pediatr Oncol Nurs 2019; 36:103-118. [PMID: 30600752 DOI: 10.1177/1043454218820906] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The diagnosis of cancer in a child, adolescent, or young adult is an emotionally overwhelming time. To improve the quality of education and support provided to patients and caregivers with a new cancer diagnosis, we executed a quality improvement initiative to (a) define key education milestones for the delivery of essential education during the first 2 months following diagnosis and (b) to define role accountability within the multidisciplinary team for delivery of content and execution of tasks. To develop education milestones, we (a) identified educational content from review of the literature, (b) determined the sequence of content delivery through qualitative interviews with patients and caregivers, and (c) developed education milestones by evaluation of existing workflows. To develop task lists, we (a) determined which multidisciplinary team member was best suited to deliver specific content and (b) defined discrete tasks required to execute education milestones. Key content topics and preferred sequence are as follows: Emotional Adjustment to Diagnosis, When and How to Call the Doctor, Medication Management, Practical Needs, Line Care, and Access to Nontherapeutic Clinical Trials. Eight education milestones were defined across the initial 2 months following cancer diagnosis. The education milestones are paired with task lists. The education milestones and task lists guide the execution of complex education across a multidisciplinary service line in an emotionally challenging time. Early information focuses on essential content, role responsibility is clearly defined, and psychosocial support services are purposefully and iteratively integrated into care during the initial weeks following a cancer diagnosis.
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Affiliation(s)
| | | | | | | | - Carolyn Herda
- 2 Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | | | - Catherine Long
- 3 Prevea Health/St. Vincent's Hospital, Green Bay, WI, USA
| | - Lori Vertz
- 3 Prevea Health/St. Vincent's Hospital, Green Bay, WI, USA
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16
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Withycombe JS, Alonzo TA, Wilkins-Sanchez MA, Hetherington M, Adamson PC, Landier W. The Children's Oncology Group: Organizational Structure, Membership, and Institutional Characteristics. J Pediatr Oncol Nurs 2018; 36:24-34. [PMID: 30426816 PMCID: PMC6389409 DOI: 10.1177/1043454218810141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The Children's Oncology Group (COG) is the only organization within the National Cancer Institute's National Clinical Trials Network dedicated exclusively to pediatric cancer research. The purpose of this article is to provide an overview of COG's organizational structure, to characterize its institutional and individual membership, and to summarize enrollments onto COG clinical trials. METHOD Data from 2013 to 2015 were compiled from sources internal (Network Operations, Statistics and Data Center, Chair's Office) and external (American Hospital Association, American Nurses Credentialing Center) to COG, to present a comprehensive overview of COG's structure, individual and institutional membership, and group operations. RESULTS In 2016, COG comprised 8,785 individuals from 223 member institutions, across seven countries. An average of 9,661 new patients were registered with COG per year over the most recent (2013-2015) 3-year period. Over the same 3-year time frame, there were an average of 16,836 enrollments onto therapeutic (i.e., treatment) and nontherapeutic (e.g., epidemiology, survivorship, biology) trials per year. CONCLUSIONS COG institutions have diverse characteristics related to size, geographical location, and infrastructure. Individual membership also reflects diversity with representation from over 28 disciplines and groups. The diversity of COG institutions and individual members allows for unique perspectives and contributions to science unified under a common goal to enroll children/adolescents onto clinical trials. COG's collaborative, multidisciplinary approach to science functions to support the development of research that seeks to continually improve outcomes for children and adolescents with cancer.
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Affiliation(s)
- Janice S. Withycombe
- Emory University, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Todd A. Alonzo
- University of Southern California, Los Angeles, CA, USA
- Children’s Oncology Group, Monrovia, CA, USA
| | | | | | | | - Wendy Landier
- The University of Alabama at Birmingham, Birmingham, AL, USA
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17
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Rodgers C, Bertini V, Conway MA, Crosty A, Filice A, Herring RA, Isbell J, Lown DrPH EA, Miller K, Perry M, Sanborn P, Spreen N, Tena N, Winkle C, Darling J, Slaven A, Sullivan J, Tomlinson KM, Windt K, Hockenberry M, Landier W. A Standardized Education Checklist for Parents of Children Newly Diagnosed With Cancer: A Report From the Children's Oncology Group. J Pediatr Oncol Nurs 2018; 35:235-246. [PMID: 29589818 DOI: 10.1177/1043454218764889] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Parents of children newly diagnosed with cancer must acquire new knowledge and skills in order to safely care for their child at home. Institutional variation exists in the methods and content used by nurses in providing the initial education. The goal of this project was to develop a checklist, standardized across institutions, to guide nursing education provided to parents of children newly diagnosed with cancer. A team of 21 members (19 nurses and 2 parent advocates) used current hospital educational checklists, expert consensus recommendations, and a series of iterative activities and discussions to develop one standardized checklist. The final checklist specifies primary topics that are essential to teach prior to the initial hospital discharge, secondary topics that should be discussed within the first month after the cancer diagnosis, and tertiary topics that should be discussed prior to completion of therapy. This checklist is designed to guide education and will set the stage for future studies to identify effective teaching strategies that optimize the educational process for parents of children newly diagnosed with cancer.
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Affiliation(s)
| | - Vanessa Bertini
- 2 Children's Hospital of the King's Daughters, Norfolk, VA, USA
| | | | - Ashley Crosty
- 4 Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Angela Filice
- 5 McMaster Children's Hospital, Hamilton, Ontario, Canada
| | | | - Julie Isbell
- 7 The Children's Hospital at TriStar Centennial, Nashville, TN, USA
| | | | | | - Margaret Perry
- 10 Children's National Medical Center, Washington, DC, USA
| | - Paula Sanborn
- 11 Nationwide Children's Hospital, Columbus, OH, USA
| | - Nicole Spreen
- 4 Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Nancy Tena
- 12 C.S. Mott Children's Hospital, Ann Arbor, MI, USA
| | | | | | - Abigail Slaven
- 14 Cohen Children's Medical Center Northwell Health, New Hyde Park, NY, USA
| | | | | | - Kate Windt
- 17 Rady Children's Hospital, San Diego, CA, USA
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18
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Landier W, Ahern J, Barakat LP, Bhatia S, Bingen KM, Bondurant PG, Cohn SL, Dobrozsi SK, Haugen M, Herring RA, Hooke MC, Martin M, Murphy K, Newman AR, Rodgers CC, Ruccione KS, Sullivan J, Weiss M, Withycombe J, Yasui L, Hockenberry M. Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients. J Pediatr Oncol Nurs 2016; 33:422-431. [PMID: 27385664 DOI: 10.1177/1043454216655983] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.
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Affiliation(s)
| | - JoAnn Ahern
- 2 Western Connecticut Health Network, Danbury, CT, USA
| | - Lamia P Barakat
- 3 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | - Susan L Cohn
- 6 University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | | | - Maureen Haugen
- 7 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Mary C Hooke
- 9 University of Minnesota School of Nursing, Minneapolis, MN, USA
| | | | | | - Amy R Newman
- 4 Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | | | - Marianne Weiss
- 14 Marquette University College of Nursing, Milwaukee, WI, USA
| | | | - Lise Yasui
- 16 Children's Oncology Group, Monrovia, CA, USA
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19
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Haugen MS, Landier W, Mandrell BN, Sullivan J, Schwartz C, Skeens MA, Hockenberry M. Educating Families of Children Newly Diagnosed With Cancer. J Pediatr Oncol Nurs 2016; 33:405-413. [PMID: 27268501 DOI: 10.1177/1043454216652856] [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] [Indexed: 11/16/2022] Open
Abstract
Parents/caregivers require specialized education in order to care for their child with a newly diagnosed cancer. Currently, no evidence-based guidelines exist to identify content essential for inclusion in patient/family education prior to a child's initial discharge home; this study used Delphi methodology to obtain multidisciplinary consensus regarding essential content amongst pediatric oncology experts from the Children's Oncology Group. Three questionnaire rounds were employed to identify essential content, evaluate the importance of the educational topics identified, and gain expert consensus regarding the final ranking of topics identified and whether or not each topic was considered mandatory for inclusion in education for newly diagnosed patients. Disease-specific topics were also identified for patients with leukemia, solid tumors, and central nervous system tumors. The results of this study provide, for the first time, multidisciplinary expert consensus regarding key content essential for inclusion in discharge education for newly diagnosed pediatric oncology patients.
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Affiliation(s)
- Maureen S Haugen
- 1 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Wendy Landier
- 2 University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | | | - Courtney Schwartz
- 1 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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