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Williams AH, Welcome B, Rivas S, Fuentes L, Cáceres-Serrano A, Ferrara G, Reeves T, Antillon-Klussmann F, Rodriguez-Galindo C, Mack JW, Graetz DE. Parent-provider communication dynamics during the pediatric oncology diagnostic process in Guatemala: A qualitative study. Pediatr Blood Cancer 2024; 71:e31227. [PMID: 39054688 DOI: 10.1002/pbc.31227] [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: 04/01/2024] [Revised: 06/25/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Effective communication is founded on bidirectional participation from families and healthcare providers. In adult medicine, bidirectional communication promotes treatment adherence and builds the family-provider relationship. However, the relationship between communication styles in pediatrics remains poorly understood, particularly in culturally diverse settings. This study aims to investigate parent-provider communication dynamics and parental involvement during diagnostic cancer communication in Guatemala. PROCEDURE This qualitative study included 20 families of children with cancer and 10 providers at Unidad Nacional de Oncología Pediátrica in Guatemala. Psychoeducation and diagnostic conversations between parents, psychologists, and oncologists were recorded and thematically analyzed using a priori and novel codes exploring communication behaviors, parental engagement, and interpersonal dynamics. RESULTS Participating parents had children with various diagnoses. Only 15% of fathers and 5% of mothers reported education beyond primary school. Providers spoke 68% of words during psychoeducation and 85% of words during diagnosis conversations. Providers used supportive communication behaviors providing explanations, demonstrating verbal attentiveness, and soliciting questions and non-supportive behaviors including paternalistic talk. Parental participation was considered active when they asked questions, expressed hopes or concerns, or asserted their opinions, and non-active when participation was limited to brief responses to closed-ended questions. Supportive provider communication often encouraged active participation; non-supportive communication did not. Furthermore, active parental participation prompted supportive communication from providers, while non-active participation did not. CONCLUSIONS Our findings highlight the bidirectional nature of effective communication, establishing that provider communication styles both influence and are influenced by parental participation, and emphasizing the importance of supportive provider communication for patient-centered care.
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Affiliation(s)
| | - Bria Welcome
- Howard University, Washington, District of Columbia, USA
| | - Silvia Rivas
- Unidad Nacional de Oncología Pediátrica, Guatemala, Guatemala
| | - Lucia Fuentes
- Unidad Nacional de Oncología Pediátrica, Guatemala, Guatemala
| | | | - Gia Ferrara
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Tegan Reeves
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Federico Antillon-Klussmann
- Unidad Nacional de Oncología Pediátrica, Guatemala, Guatemala
- Francisco Marroquin University School of Medicine, Guatemala, Guatemala
| | | | - Jennifer W Mack
- Dana Farber Cancer Institute/Boston Children's Hospital, Boston, Massachusetts, USA
| | - Dylan E Graetz
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Ochoa-Dominguez CY, Banegas MP, Miller KA, Orellana Garcia C, Sabater-Minarim D, Chan RY. Healthcare Communication Experiences of Hispanic Caregivers of Childhood Cancer Survivors. Healthcare (Basel) 2024; 12:1307. [PMID: 38998842 PMCID: PMC11241517 DOI: 10.3390/healthcare12131307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/28/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Interpersonal communication is a crucial component of the cancer experience that can contribute to managing cancer care and improving cancer survivors' and caregivers' quality of life. Cultural and contextual factors may impact Hispanic childhood cancer survivor (CCS) and parent caregiver relationships and communication. This study sought to describe the healthcare communication experiences of Hispanic parents with CCS, families, and medical providers. METHODS We conducted 15 semi-structured interviews with Hispanic caregivers from a safety-net hospital in Los Angeles County. Interviews were conducted in English and Spanish, audio-recorded and professionally transcribed, and analyzed using a thematic approach. RESULTS Caregivers shared the importance and impact of medical communication when exploring the "first big talk" of the diagnosis, uncertainty about treatment, navigating multiple providers, therapeutic communication (i.e., providing emotional reassurance), and current and lingering effects of cancer. All caregivers shared "good communication" experiences, while others shared various barriers to communication, including a lack of understanding of the cancer diagnosis and caregiver experience, psychological challenges impacting communication, cultural and language differences, physical factors that limit communication, and young age of child impacting communication with caregivers. CONCLUSIONS Our findings suggest that a strong interpersonal communication skill set for clinicians can contribute to managing cancer care and improving caregivers' psychological adjustment.
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Affiliation(s)
- Carol Y. Ochoa-Dominguez
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA 92093, USA
- Center for Health Equity Education and Research, University of California San Diego, La Jolla, CA 92093, USA
| | - Matthew P. Banegas
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA 92093, USA
- Center for Health Equity Education and Research, University of California San Diego, La Jolla, CA 92093, USA
| | - Kimberly A. Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Carlos Orellana Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Daniel Sabater-Minarim
- Center for Health Equity Education and Research, University of California San Diego, La Jolla, CA 92093, USA
- Department of Biological Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Randall Y. Chan
- Department of Pediatrics, Los Angeles General Medical Center, Los Angeles, CA 90033, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
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Du Y, Huang X, Xie R, Gu Y, Zhu D, Wang H. Parents' Experiences of Communicating With Children About Their Diagnosis of Nonterminal Cancer and Its Related Issues: A Systematic Review of Qualitative Studies. Cancer Nurs 2024:00002820-990000000-00263. [PMID: 38865604 DOI: 10.1097/ncc.0000000000001362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
BACKGROUND Many children experience serious symptoms when they are diagnosed with and treated for cancer. Through appropriate parent-child communication, parents were able to identify children's physical and psychological problems, adjust their behavior, and help them cope with the disease. OBJECTIVE This study aimed to systematically search for and integrate evidence from qualitative studies on communication between parents and children with nonterminal cancer from parents' perspectives. METHODS A thorough systematic review and metasynthesis of qualitative studies were conducted. Articles were searched from PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, and PsycArticles from the database inception to November 6, 2022. After screening and quality appraisal, 14 articles were finally included in the metasynthesis. RESULTS Three themes and 11 subthemes were identified: (1) communication content, including diagnosis, treatment, health management, health risk, and emotion; (2) factors influencing communication, including ages of children, parents' experience of communication, parents' awareness of protection, and culture; and (3) children's responses, including acceptance and resistance. CONCLUSIONS This systematic review found that parents were influenced by various factors during the decision-making process of parent-child communication about childhood cancer and its related issues. Parents tended to adjust their communication content and style to protect their children. IMPLICATIONS FOR PRACTICE Future research should be conducted to explore children's experiences of communicating with their parents and analyze the similarities and differences between the communication needs of parents and children. Healthcare professionals should provide professional communication guidance to facilitate the parent-child relationship and improve the mental health of both children and their parents.
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Affiliation(s)
- Yiran Du
- Author Affiliations: School of Nursing, Fudan University (Mss Du and Xie and Dr Huang); and Children's Hospital of Fudan University (Drs Gu, Zhu, and Wang), Shanghai, China
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Huang HM, Yeh TC, Lee TY. Taiwanese fathers' experiences of caring for their children during childhood cancer treatment. Eur J Oncol Nurs 2024; 69:102543. [PMID: 38457933 DOI: 10.1016/j.ejon.2024.102543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE Parents must manage their own stress and help their child with cancer during the treatment process, both physically and emotionally. With the increased involvement of fathers in caring for the family, how fathers adjust to the stress and play a role in care responsibilities is unknown. This study aimed to explore the fathers' experiences of caring for their ill child during the cancer diagnosis and treatment process. METHOD This study adopted a qualitative descriptive design and conducted in-depth interviews with 21 fathers with a diagnosed child recruited from a northern Taiwan medical center. Data were managed and analysed using content analysis. RESULTS Two main categories in the Taiwanese fathers' experiences of caring for their ill child during the cancer diagnosis and treatment process emerged: 1) the maintainer of family stability, and 2) thoughts and value adjustment. Each main category consists of 3-4 generic categories. They make the necessary adjustments between work and family, actively participate in caring for the entire family, and redefine family values. They convey information about the illness to their children, pay attention to the physical and psychological development of the child with cancer, and cherish the time spent together as a family. CONCLUSIONS During the cancer treatment process, fathers play the roles of the protector and maintainer of family stability and adjust their attitudes and thoughts toward the family members and family life. Healthcare professionals can offer the fathers comprehensive support and improve the family's overall well-being during this demanding period.
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Affiliation(s)
- Hsiu-Mei Huang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Ting-Chi Yeh
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Mackay Children's Hospital and Mackay Medical College, Taipei, Taiwan
| | - Tzu-Ying Lee
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan.
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McClintock S, MacDonald D, MacDonald T. Medicine education in a pediatric oncology setting: What can we do better? EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100373. [PMID: 38146317 PMCID: PMC10749275 DOI: 10.1016/j.rcsop.2023.100373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 12/27/2023] Open
Abstract
Background When patients feel more involved in their care, there tends to be a higher rate of adherence and improved health outcomes. This can be more difficult to achieve in pediatric care since children have varying levels of medicine comprehension and parents are an integral component of the child's learning. Objectives This study aimed to determine the satisfaction of children and families being treated for cancer with their medicine education and determine areas for improvement. Methods Semi-structured interviews were conducted over six months (2016/2017) with families and children with cancer, ages 7 to 19 years, (n = 6) and healthcare providers (n = 9) to assess the current method of medicine education delivery. Results Families reported increased stress and anxiety levels at the time of diagnosis, negatively impacting their information retention. Patients, families, and healthcare providers reported inconsistent education delivery, including varying amounts of information throughout the treatment and inconsistencies between providers, such as medication names. Parents mentioned a desire for a more consistent and standardized delivery of medicine education, which was found to be helped by a pharmacist-led approach. Receiving supplemental written materials to support verbal education helped with learners' understanding and information retention. Ensuring that the parents are comfortable and familiar with the medicines is a significant component of medicine teaching in pediatric care because they are often responsible for the child's medications and their children see them as a trusted source of information. Ensuring parents' needs are met translates to improved medicine adherence for children with cancer. Conclusion Medicine education should occur sometime post-diagnosis once the patient/family has had time to adjust and the anxiety lessens. Medicine education should be given as consistently as possible by a recurring member of the care team, ideally the pharmacist. The learners' ability to understand and retain information should be individually assessed to determine the delivery of medicine education. Motivating and empowering learners, including children, through frequent medicine encounters could help improve adherence, patient health outcomes, and quality of life and make them more self-managing throughout life.
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Affiliation(s)
- Sean McClintock
- College of Pharmacy, Faculty of Health, Dalhousie University, 5968 College Street, Halifax, Nova Scotia B3H 1X7, Canada
| | - Derek MacDonald
- Independent researcher, King's View Academy, 9 Strath Lane, Dartmouth, Nova Scotia B2X 1Y8, Canada
| | - Tamara MacDonald
- College of Pharmacy, Faculty of Health, Dalhousie University, 5968 College Street, Halifax, Nova Scotia B3H 1X7, Canada
- Department of Pharmacy, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada
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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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Ringnér A, Björk M, Olsson C. Effects of Person-Centered Information for Parents of Children With Cancer (the PIFBO Study): A Randomized Controlled Trial. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:400-410. [PMID: 36731493 DOI: 10.1177/27527530221115860] [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: 02/04/2023]
Abstract
Background: Conveying information to parents is a core part of pediatric oncology nursing; however, most published interventions do not tailor information to individual parental needs. Objective: To evaluate the effect on parental illness-related stress of person-centered information provided to parents of children with cancer. Methods: A multicenter, unblinded randomized controlled trial with two parallel arms recruiting parents of children diagnosed within the past two months from two tertiary children's cancer centers in Sweden. Parents were randomized using sealed envelopes prepared and opened by an independent person. Parents in the intervention arm met four times with experienced nurses trained in the intervention, whereas controls received standard care. The effect of the intervention was measured five times regarding parents' illness-related stress. Secondary outcomes were psychosocial states, experiences with healthcare providers, and received information. Further, we collected process data on the intervention's content and fidelity. Results: Of the 32 parents included and analyzed in the study, 16 were randomized to the intervention, which addressed a broad variety of topics. The intervention increased parents' knowledge about the biophysiological and functional aspects of their child's illness, but it had no measurable effect on their distress. Discussion: Although fidelity to the intervention protocol was sufficient, the study was flawed by recruitment difficulties, primarily due to organizational factors, which may have prevented us from observing any possible effects on psychosocial distress. Having a person-centered perspective could be promising for future studies aimed at parents of children with cancer. (Registered at Clinicaltrials.gov, number NCT02332226.).
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Affiliation(s)
- Anders Ringnér
- Department of Nursing, Umeå University, Umeå, Sweden
- Clinical Department of Pediatrics, Umeå University Hospital, Umeå, Sweden
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Maria Björk
- CHILD Research Group, Department of Nursing, School of Health and Welfare, Jönköping, Sweden
| | - Cecilia Olsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Department of Bachelor Education, Lovisenberg Diaconal University College, Oslo, Norway
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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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Hashimoto H, Takahashi K, Imai Y. Nursing practice to fulfill the information needs of parents of hospitalized children with cancer and related factors. J Pediatr Nurs 2023; 72:e98-e104. [PMID: 37414625 DOI: 10.1016/j.pedn.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE This study aimed to clarify the current status of nursing practice to fulfill the information needs of parents of hospitalized children with cancer and to determine the associated factors. DESIGN AND METHODS A cross-sectional survey using a questionnaire was administered to nurses working on wards admitting children with cancer in Japan. Data were analyzed using logistic regression analysis, after exploratory factor analysis. RESULTS Three factors were extracted as nursing practice: "provision of information that supports the child's future and other family members' daily lives" (factor 1), "provision of information regarding care for the child in the treatment process" (factor 2), "provision of information regarding the child's disease and treatment" (factor 3). Among these three factors, factor 1 achieved the lowest score for the level of practice. Logistic regression analysis indicated that interprofessional information sharing increased the scores of factors 1 and 3 (Odds ratio: 6.150, and 4.932, respectively); assessment of parental information needs increased the scores of factors 1, 2, and 3 (Odds ratio: 3.993, 3.654, and 3.671, respectively); and participation in training increased the score of factor 2 (Odds ratio: 3.078). CONCLUSIONS Nursing practice to fulfill the parents' information needs consisted of three factors. The degree of practice varied according to the information content and was primarily influenced by assessment of parental information needs, interprofessional information sharing, and participation in training. PRACTICE IMPLICATIONS It is necessary for nurses to accurately assess parents' needs, and interprofessional sharing of information is important to fulfill the information needs of parents.
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Affiliation(s)
- Hiroko Hashimoto
- Department of Child Health and Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan.
| | - Kumi Takahashi
- Department of Child Health and Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Yoshie Imai
- Department of Oncology Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
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Hilario R, Cosme M, Barzola I, Bejarano G, Benavente A, Sabrera G, Celis E, Mirabal F, Huerta MDP, Carpio Z, Quispe Y, Elera E, Ascue K, Jesús M, Grados I, Allauca N, Escobedo M, Muñoz S, Ruda L, Velandres MDC, Olarte-Sierra MF, Maradiegue E, Pascual C, Vasquez L. Development and Implementation of Educational Material by Nurses for Parents/Caregivers of Children With Cancer: A Peruvian National Study. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:356-363. [PMID: 37908104 DOI: 10.1177/27527530231198202] [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: 11/02/2023]
Abstract
Background: Education for parents and caregivers of children with cancer is one of the fundamental roles of nurses to avoid complications, provide quality care, promote adherence to treatment and maintain basic standards of care. This study aimed to design educational material for parents and caregivers of children with cancer in Peru on general information about childhood cancer and its care. Method: Within the framework of the WHO Global Initiative for Childhood Cancer in Peru, a multicenter working group was convened by the Peruvian Ministry of Health. A comprehensive needs assessment of parents and caregivers of children with cancer was performed through a survey in June and July 2020. The survey was conducted online (via Google Forms) and in person at nine hospitals to examine the preferred method of delivery and content of information. Results: Based on the findings from the parent needs assessment, a national nursing working group developed Spanish-language audiovisual materials (i.e., diagnosis and treatment videos for nurses to educate parents and caregivers). A total of 365 parents and caregivers were included. Most respondents (56.9%) were parents of children receiving treatment. Main topics were childhood cancer overview and side effects (85%), food and nutrition (75%), and palliative care (67%); most (70.9%) preferred information through talks and videos (64.7%). Twenty-three videos were developed with support by the Pan American Health Organization and the Ministry of Health. Discussion: Assessing the educational needs of parents and caregivers of children with cancer provides a starting point in the design of targeted strategies.
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Affiliation(s)
- Rosmery Hilario
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Melitta Cosme
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Isela Barzola
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Giovanna Bejarano
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Annaly Benavente
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
- Deceased
| | - Gina Sabrera
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Edinho Celis
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Flor Mirabal
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | | | - Zulma Carpio
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Yuly Quispe
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Elizabeth Elera
- Pediatric Oncology Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Kathy Ascue
- Pediatric Oncology Nursing, Instituto Nacional del Niño-San Borja, Lima, Peru
| | - Maritza Jesús
- Pediatric Oncology Nursing, Hospital Nacional Guillermo Almenara Yrigoyen, Lima, Peru
| | - Ivonne Grados
- Pediatric Oncology Nursing, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Nora Allauca
- Pediatric Oncology Nursing, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Milagros Escobedo
- Pediatric Nutrition, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Sara Muñoz
- Pediatric Oncology Nursing, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Lourdes Ruda
- Psychooncology, Asociación Nacional de Psicooncología del Perú (ANPPE), Lima, Peru
| | | | - María Fernanda Olarte-Sierra
- Medical Anthropology & Global Health Institute for Cultural and Social Anthropology Universität Wien, University of Vienna, Vienna, Austria
| | - Essy Maradiegue
- Division of Prevention and Control of Cancer, Ministry of Health, Lima, Peru
| | - Claudia Pascual
- Department of Non-communicable Disease, PAHO/WHO, Lima, Peru
| | - Liliana Vasquez
- Department of Non-communicable Disease, PAHO/WHO, Washington, DC, USA
- Faculty of Medicine, University of San Martin de Porres, Research, Center of Precision Medicine, Lima, Peru
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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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12
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Ilic A, Sievers Y, Roser K, Scheinemann K, Michel G. The information needs of relatives of childhood cancer patients and survivors: A systematic review of qualitative evidence. PATIENT EDUCATION AND COUNSELING 2023; 114:107840. [PMID: 37321115 DOI: 10.1016/j.pec.2023.107840] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To synthesize qualitative research on the information needs of relatives of childhood cancer patients and survivors. METHODS Systematic searches of PubMed, PsycINFO, CINAHL, and Scopus identified relevant literature. Extracted data were combined using thematic synthesis. Methodological quality was assessed using the JBI critical appraisal tool for qualitative research. RESULTS The review included 27 publications, with most research focusing on parents or primary caregivers. Five areas of information needs were identified: treatment, medication, and care; general information about cancer; coping and support; follow-up, late effects, and rehabilitation; and parenting and everyday life. Appropriateness of information depended on health care professionals' aptitude, message characteristics, communication setting, and relatives' personal factors. Preferences for form, sources, and timing for information provision varied. CONCLUSION The review identified information needs, communication barriers, and preferences among caregivers and siblings of childhood cancer patients and survivors, highlighting areas requiring further research and clinical consideration in addressing the identified challenges. PRACTICE IMPLICATIONS Caregivers and siblings have unique but similar information needs regarding childhood cancer. To ensure that these needs are met, health care professionals could use eHealth and mHealth technologies, assess each family member's knowledge, and create a safe and supportive environment for questions and feedback.
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Affiliation(s)
- Anica Ilic
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Yara Sievers
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Center for Pediatric Hematology/Oncology, East Swiss Children's Hospital, St. Gallen, Switzerland; Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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13
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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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14
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Six KA, Wadhwa A, York JM, Adams K, Henneberg H, Bhatia S, Landier W. The New Oncologic Diagnosis Discussion: Perspectives of Pediatric Oncologists. JCO Oncol Pract 2023; 19:e492-e503. [PMID: 36623244 DOI: 10.1200/op.22.00558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/10/2022] [Accepted: 11/15/2022] [Indexed: 01/11/2023] Open
Abstract
PURPOSE We aimed to understand how new diagnosis discussions are conducted in pediatric oncology, and the training provided for their conduct. METHODS This mixed-methods study used a sequential exploratory design. Qualitative interviews (n = 20) were conducted with pediatric oncologists (n = 15) and fellows (n = 5) at a single institution, focusing on the process used to convey the diagnosis and treatment plan to the family. Accreditation Council for Graduate Medical Education-accredited pediatric oncology fellowship program directors (n = 38) and fellows (n = 70) were subsequently surveyed to confirm qualitative results and elucidate the training that fellows receive in conducting new diagnosis discussions. RESULTS Our findings suggest that new diagnosis discussions in pediatric oncology are typically conducted in three stages: (1) concern for cancer; (2) confirmation of diagnosis; and (3) treatment plan/consent, and are fundamentally similar across settings; however, pediatric oncologists skillfully tailor their approach on the basis of clinical circumstances and parental needs. Decisions regarding inclusion of the child are primarily determined by parental preference, whereas inclusion of health care team members is driven by physician role (ie, trainee v program director) and health care organization-related factors. Physician preparation for discussions involves logistical, intellectual, and emotional components. Disclosure of prognosis is nuanced. There is variability across pediatric oncology fellowship programs in the provision of training for these discussions. CONCLUSION We identified common practices of pediatric oncologists as they prepare for and lead new diagnosis discussions in pediatric oncology. We found variability in the training that pediatric oncology fellows receive regarding how to conduct these discussions, highlighting a need for standardized training curricula.
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Affiliation(s)
- Kathryn A Six
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
- Atrium Health Levine Children's Cancer and Blood Disorders, Wake Forest University School of Medicine, Charlotte, NC
| | - Aman Wadhwa
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Jocelyn M York
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Kandice Adams
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Harrison Henneberg
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Wendy Landier
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
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15
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Greenzang KA, Scavotto ML, Revette AC, Schlegel SF, Silverman LB, Mack JW. "There's no playbook for when your kid has cancer": Desired elements of an electronic resource to support pediatric cancer communication. Pediatr Blood Cancer 2023; 70:e30198. [PMID: 36602023 PMCID: PMC10375908 DOI: 10.1002/pbc.30198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Acute lymphoblastic leukemia (ALL), the most common childhood malignancy, has a relatively favorable long-term prognosis. Yet the complexity of treatment and the emotionality of the diagnosis leave families feeling unprepared for many aspects of therapy. This qualitative study aimed to identify desired elements and format of a communication resource to support patients and families facing a diagnosis of ALL. METHODS Semi-structured interviews of 12 parents of children receiving ALL treatment, 10 parents of survivors of ALL, and eight adolescent and young adult (AYA) survivors of ALL were conducted between February and June 2021. The interviews focused on communication experiences throughout treatment and identified domains to be addressed in a resource in development. RESULTS All participants supported the development of an interactive, electronic health (eHealth) resource to help navigate ALL treatment. They felt a website would be helpful in addressing information gaps and mitigating pervasive feelings of overwhelm. Participants specifically sought: (a) information resources to address feelings of cognitive overload; (b) practical tips to help navigate logistical challenges; (c) clear depictions of treatment choices and trajectories to facilitate decision-making; and (d) additional psychosocial resources and support. Two overarching themes that families felt should be interwoven throughout the eHealth resource were connections with other patients/families and extra support at transitions between phases of treatment. CONCLUSIONS A new diagnosis of ALL and its treatment are extremely overwhelming. Patients and families unanimously supported an eHealth resource to provide additional information and connect them with emotional support, starting at diagnosis and extending throughout treatment.
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Affiliation(s)
- Katie A Greenzang
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Pediatric Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Madison L Scavotto
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Anna C Revette
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Sarah F Schlegel
- Division of Pediatric Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lewis B Silverman
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Pediatric Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jennifer W Mack
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Pediatric Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA
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16
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Ringnér A, Björk M, Olsson C. What Was on the Parents' Minds? Changes Over Time in Topics of Person-Centred Information for Mothers and Fathers of Children with Cancer. Compr Child Adolesc Nurs 2023; 46:114-125. [PMID: 36811905 DOI: 10.1080/24694193.2023.2168790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Acquiring information about one's child's cancer diagnosis is a complex and ever-changing process, and parents' needs change over time. As yet, we know little about what information parents require at different stages of their child's illness. This paper is part of a larger randomized control trial studying the parent-centered information given to mothers and fathers. The aim of this paper was to describe the topics addressed in person-centered meetings between nurses and parents of children with cancer and how those changed over time. Using qualitative content analysis, we analyzed nurses' written summaries of 56 meetings with 16 parents and then computed for each topic the percentage of parents who brought it up at any time during the intervention. The main categories were Child's disease and treatment (addressed by 100% of parents), Consequences of treatment (88%), Emotional management for the child (75%), Emotional management for the parent (100%), Social life of the child (63%), and Social life of the parent (100%). Different topics were addressed at different points in time, and fathers raised more concerns about the child's emotional management and the consequences of treatment than mothers. This paper suggests that parental information demands change over time and differ between fathers and mothers, implying that information should be person-centered. Registered at Clinicaltrials.gov (NCT02332226).
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Affiliation(s)
- Anders Ringnér
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Maria Björk
- CHILD Research Group, Department of Nursing, School of Health and Welfare, Jönköping, Sweden
| | - Cecilia Olsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Department of Bachelor in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
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17
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Akkawi El Edelbi R, Eksborg S, Kreicbergs U, Lövgren M, Wallén K, Ekman J, Lindemalm S. Parents' experiences of handling oral anticancer drugs at home: 'It all falls on me …'. J Eval Clin Pract 2023; 29:94-100. [PMID: 35927976 PMCID: PMC10086976 DOI: 10.1111/jep.13737] [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: 02/04/2022] [Revised: 06/15/2022] [Accepted: 07/01/2022] [Indexed: 01/18/2023]
Abstract
AIM The aim of this study was to describe the experiences of parents handling oral anticancer drugs in a home setting. METHODS Parents of children with cancer were recruited from a paediatric oncology ward in Sweden to participate in an interview. The interviews were transcribed verbatim and subjected to qualitative content analysis. RESULTS We found the following categories and subcategories: parents' views on the provided information-lack of, too little or contradictory information, and parents' preferences for information delivery; safety over time; correct drug dose; and drug administration. As time passed, most parents adapted to their child's illness, felt safer and found it easier to take in and process any given information. Parents preferred information in different formats (written, movie clips and orally) and in their mother tongue. Many parents were aware of the importance of giving an accurate dose to their child and described the process of drug administration as overwhelming. CONCLUSION Parents need to be provided with accurate, timely, nonconflicting and repeated information-in different forms and in their mother tongue-on how to handle oral anticancer drugs at home.
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Affiliation(s)
- Ranaa Akkawi El Edelbi
- Department of Women's and Children's Health, Childhood Cancer Research UnitKarolinska InstitutetStockholmSweden
- Division of Pediatrics, Karolinska University HospitalAstrid Lindgren Children's HospitalStockholmSweden
| | - Staffan Eksborg
- Department of Women's and Children's Health, Childhood Cancer Research UnitKarolinska InstitutetStockholmSweden
- Division of Pediatrics, Karolinska University HospitalAstrid Lindgren Children's HospitalStockholmSweden
| | - Ulrika Kreicbergs
- Department of Women's and Children's Health, Childhood Cancer Research UnitKarolinska InstitutetStockholmSweden
- Department of Health Care Sciences, Palliative Research CentreErsta Sköndal Bräcke University CollegeStockholmSweden
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research CentreErsta Sköndal Bräcke University CollegeStockholmSweden
- Advanced Pediatric Home CareKarolinska University HospitalStockholmSweden
| | - Klara Wallén
- Division of Pediatrics, Karolinska University HospitalAstrid Lindgren Children's HospitalStockholmSweden
| | - Jennie Ekman
- Division of Pediatrics, Karolinska University HospitalAstrid Lindgren Children's HospitalStockholmSweden
| | - Synnöve Lindemalm
- Division of Pediatrics, Karolinska University HospitalAstrid Lindgren Children's HospitalStockholmSweden
- Department of Clinical Sciences, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
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18
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Landier W, York JM, Wadhwa A, Adams K, Henneberg HM, Madan-Swain A, Benton B, Slater V, Zupanec S, Miller J, Tomlinson K, Richman JS, Bhatia S. A Structured Discharge Education Intervention for Parents of Newly Diagnosed Pediatric Oncology Patients. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:145-157. [PMID: 36654478 DOI: 10.1177/27527530221140058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background: Parents of children newly diagnosed with cancer require specialized knowledge and skills in order to safely care for their children at home. The Children's Oncology Group (COG) developed expert consensus recommendations to guide new diagnosis education; however, these recommendations have not been empirically tested. Methods: We used a sequential two-cohort study design to test a nurse-led Structured Discharge Teaching Intervention (SDTI) that operationalizes the COG expert recommendations in the setting of a tertiary children's hospital. Outcomes included parent Readiness for Hospital Discharge Scale (RHDS); Quality of Discharge Teaching Scale (QDTS); Post-Discharge Coping Difficulty (PDCD); Nurse Satisfaction; and post-discharge unplanned healthcare utilization. Results: The process for discharge education changed significantly before and after implementation of the SDTI, with significantly fewer instances of one-day discharge teaching, and higher involvement of staff nurses in teaching. Overall, parental RHDS, QDTS, and PDCD scores were similar in the unintervened and intervened cohorts. Almost 60% of patients had unplanned healthcare encounters during the first 30 days following their initial hospital discharge. Overall nurse satisfaction with the quality and process of discharge education significantly increased post-intervention. Discussion: Although the structure for and process of delivering discharge education changed significantly with implementation of the SDTI, parent RHDS and QDTS scores remained uniformly high and PDCD scores and non-preventable unplanned healthcare utilization remained similar, while nurse satisfaction with the quality and process of discharge education significantly improved, suggesting that further testing of the SDTI across diverse pediatric oncology settings is warranted.
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Affiliation(s)
- Wendy Landier
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jocelyn M York
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Aman Wadhwa
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kandice Adams
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Avi Madan-Swain
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Sue Zupanec
- 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jeneane Miller
- 6567Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | - Smita Bhatia
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
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19
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Falzon S, Galea N, Calvagna V, Pham JT, Grech L, Azzopardi LM. Development and use of an innovative Gap Finding Tool to create a Pharmaceutical Care Model within a paediatric oncology setting. J Oncol Pharm Pract 2023; 29:74-82. [PMID: 34775858 DOI: 10.1177/10781552211053249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION A paediatric cancer ward is a setting where pharmacists participate in direct patient care, acting as coordinators between the patient, caregivers and healthcare professionals. The aim of the study was to develop a Gap Finding Tool to support the setting up of a pharmaceutical care model at a Paediatric-Adolescent Cancer Ward. METHODS The Standards of Practice for Clinical Pharmacy Services by the Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Clinical Pharmacy (2013), the American College of Clinical Pharmacy (2014) and the European Association of Hospital Pharmacists (2014) were used to compile the Gap Finding Tool. The developed Tool was tested for content validity by a panel of experts and subsequently implemented over 2 months. RESULTS The Gap Finding Tool comprised of nine sections with an average of eight statements each about pharmacy services that should be provided at ward level. For each statement, the rater indicates whether these contributions are provided. When the Tool was implemented at the Paediatric-Adolescent Cancer Ward, four major gaps were identified, namely, absence of a clinical pharmacist, lack of medicines information, vetting of chemotherapy prescriptions by pharmacist with limited access to patient data and lack of pharmacist-input on medicines availability. Processes requiring optimisation included discharge medication advice and documentation processes. CONCLUSION The developed Gap Finding Tool is an innovative tool which is versatile and can be used in ward or ambulatory clinical settings to identify gaps in pharmaceutical processes and services and compare national or regional practices to international standards.
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Affiliation(s)
- Sephorah Falzon
- Department of Pharmacy, 37563University of Malta, Msida, Malta
| | - Nathalie Galea
- Department of Paediatrics, 223089Mater Dei Hospital, Msida, Malta
| | - Victor Calvagna
- Department of Paediatrics, 223089Mater Dei Hospital, Msida, Malta
| | - Jennifer T Pham
- Department of Pharmacy Practice, 14681University of Illinois at Chicago, College of Pharmacy, Chicago, IL, USA
| | - Louise Grech
- Department of Pharmacy, 37563University of Malta, Msida, Malta
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20
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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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21
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MONIZ A, SANTOS MAD, NASCIMENTO LC, OLIVEIRA-CARDOSO ÉAD. Bone Marrow Transplantation: bereavement due to the impact of bodily and psychosocial changes from the perspective of adolescent recipients and their parents. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2022. [DOI: 10.1590/1982-0275202239e200027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract The diagnosis and treatment of a life-threatening disease have adverse consequences on child development and impact the family. This study aimed to investigate bereavement due to the impact of bodily and psychosocial changes resulting from Bone Marrow Transplantation from the perspective of adolescent patients and their parents. This is a qualitative, descriptive, exploratory, cross-sectional study. Nine dyads (patients and mothers / fathers) were included. Data collection took place through semi-structured audio-recorded interviews. The thematic analysis made it possible to elaborate three categories: losses due to illness; new losses experienced with treatment; learning to appreciate the gains of adverse experience. The results show that transplantation has repercussions that transcend the physical dimension and include social harm, changes in body image, and loss of friends. However, once the radical journey of transplantation is over, the participants positively connoted their experience, identifying benefits that go beyond health recovery, such as emotional maturation, improvement of self-esteem, and the ability to socialize.
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22
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Creating Video-Based Education Modules for Parents of Newly Diagnosed Pediatric Patients With Cancer. Cancer Nurs 2021; 45:E428-E435. [PMID: 34554941 DOI: 10.1097/ncc.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Parents of children newly diagnosed with cancer are required to understand a significant amount of new information during a time of distress. Parents of children with cancer have expressed that concise information with visual cues, which can be repeated, positively influences their ability to understand. OBJECTIVES The primary objective was to develop 2 concise, video-based education modules that are understandable to parents of children with cancer. A secondary objective was to determine feasibility of a future trial evaluating efficacy of video-based education. METHODS The study was conducted in phases: script development, video creation, and feasibility testing. Topics were "managing fever at home" and "giving medications at home." Content was developed by pediatric oncology experts and turned into video scripts. Scripts were refined through cognitive interviews with parents of children with cancer. Feasibility testing included recruitment of 20 parents of a child given a diagnosis of cancer within 4 weeks. Parents watched both videos and answered questions that assessed their understanding and perceived confidence. RESULTS Final scripts were reviewed by 25 participants. Feasibility was achieved with 20 parents recruited within 7 weeks, with 100% watching both videos and answering knowledge and confidence questions. CONCLUSIONS We successfully developed 2 educational videos for parents of children newly diagnosed with cancer. A future trial to test the efficacy of video-based education modules is feasible. IMPLICATIONS TO PRACTICE Delivering quality education to parents of children newly diagnosed with cancer can decrease parental distress and improve safe care during a high-risk time for treatment-related morbidity and mortality.
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23
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Linder LA. Contributions of Pediatric Oncology Nursing to Advance Care and Reduce Disparities Among Children and Adolescents with Cancer: Introduction. Semin Oncol Nurs 2021; 37:151165. [PMID: 34140191 DOI: 10.1016/j.soncn.2021.151165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Highlight examples of pediatric oncology nursing's accomplishments during the past 2 decades with attention to specialized practice, patient/family education, research/evidence-based practice, and advocacy and how these efforts can be leveraged to reduce disparities in the cure and care of children and adolescents with cancer. DATA SOURCES Review of currently published literature, guidelines, and websites documenting pediatric oncology nursing's contributions. CONCLUSION Over the past 20 years, the collective work of pediatric oncology nurses across the world has improved the care of children with cancer and their families and brought attention to areas of disparities. IMPLICATIONS FOR NURSING PRACTICE Although work remains to reduce disparities, current evidence from nursing science and practice is available to address disparities and guide advocacy efforts for children and their families as well as the nurses who care for them.
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Affiliation(s)
- Lauri A Linder
- College of Nursing, University of Utah, Salt Lake City; Primary Children's Hospital, Salt Lake City, UT.
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24
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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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Bailie K, Jacques L, Phillips A, Mahon P. Exploring Perceptions of Education for Central Venous Catheter Care at Home. J Pediatr Oncol Nurs 2021; 38:157-165. [PMID: 33616461 PMCID: PMC8114452 DOI: 10.1177/1043454221992293] [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] [Indexed: 12/04/2022] Open
Abstract
Pediatric oncology patients with an external central venous catheter (CVC) in situ can be discharged from the hospital. Caregivers are expected to learn how to care for the CVC prior to discharge while also dealing with their child's new cancer diagnosis. This study aimed to evaluate the perceptions of a CVC education program received by caregivers to identify opportunities for improvement. A qualitative study was conducted in 3 stages, using an evidence-based co-design approach, involving caregivers and one adolescent patient discharged from the British Columbia Children's Hospital Oncology/Hematology/BMT inpatient unit. Stage I involved semi-structured interviews to gain feedback on the existing CVC education program. In Stage II, educational resources were updated or developed and implemented. For Stage III, the revised CVC education program was evaluated through a focus group and semi-structured interviews. Interview transcripts were analyzed using QSR NVivo®. The original CVC education program was overall well received. Repeated instruction and support provided by nurses was reported to have increased confidence with performing CVC skills. Participants appreciated the multimodal approach to meet learning needs and expressed interest in additional visual aids. Inconsistencies in nurses’ practice and offers of “tips and tricks” were identified to be challenging for caregivers while learning a new skill. Videos depicting CVC care were developed to provide an additional visual tool, decreased inconsistencies in care, and support to caregivers at home. Caring for a CVC at home is challenging and overwhelming for caregivers. A standardized multimodal education program is required to support caregivers at home.
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Affiliation(s)
- Kiera Bailie
- Division of Hematology, Oncology and Bone Marrow Transplant, 37210British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Lisa Jacques
- Division of Hematology, Oncology and Bone Marrow Transplant, 37210British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Angele Phillips
- Division of Hematology, Oncology and Bone Marrow Transplant, 37210British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Paula Mahon
- Division of Hematology, Oncology and Bone Marrow Transplant, 37210British Columbia Children's Hospital, Vancouver, BC, Canada.,School of Nursing, 8166The University of British Columbia, Vancouver, BC, Canada
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Ringnér A, Olsson C, Eriksson E, From I, Björk M. A moment just for me - parents' experiences of an intervention for person-centred information in paediatric oncology. Eur J Oncol Nurs 2021; 51:101923. [PMID: 33618229 DOI: 10.1016/j.ejon.2021.101923] [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: 07/26/2020] [Revised: 01/02/2021] [Accepted: 02/07/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Information can help parents of children with cancer by reducing uncertainty and giving them a sense of control in a chaotic situation. Although providing information to parents is a core activity of paediatric oncology nursing, few studies focus on interventions for informing parents. Thus, the aim of this study is to evaluate parents' experiences after participating in a person-centred information intervention for parents of children with cancer. METHOD This study is part of a process evaluation of a person-centred informational intervention in paediatric oncology for patients' parents. Qualitative semi-structured interviews with 13 parents who had taken part in the intervention were analysed using qualitative content analysis. RESULTS An opening for healing emerged as the overarching theme, consisting of three categories. Gaining a deeper understanding of the entire situation describes how parents benefitted from processing current topics and moving forward by learning. Caring reflections in a safe space describes how parents appreciated having a moment just for themselves and feeling better by venting their feelings. Meeting a competent and compassionate nurse describes how parents experienced trust and being listened to. CONCLUSION Having individual information meetings integrated as a primary nursing responsibility, mediated by competent and compassionate nurses also responsible for the care of the child, could enhance person-centred care and individualise parental education.
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Affiliation(s)
- Anders Ringnér
- Umeå University, Department of Nursing, Umeå, Sweden; Umeå University Hospital, Clinical Department of Paediatrics, Umeå, Sweden.
| | - Cecilia Olsson
- Karlstad University, Department of Health Sciences, Karlstad, Sweden
| | - Emma Eriksson
- Umeå University, Department of Nursing, Umeå, Sweden; Umeå University Hospital, Clinical Department of Paediatrics, Umeå, Sweden
| | - Ida From
- Umeå University, Department of Nursing, Umeå, Sweden; Umeå University Hospital, Clinical Department of Paediatrics, Umeå, Sweden
| | - Maria Björk
- Jönköping University, CHILD Research Group, Department of Nursing, School of Health and Welfare, Jönköping, Sweden
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27
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Withycombe JS, Carlson A, Coleman C, Leslie SL, Skeens M, Tseitlin H, Duffy EA. Commonly Reported Adverse Events Associated With Pediatric Immunotherapy: A Systematic Review From the Children's Oncology Group. J Pediatr Oncol Nurs 2020; 38:16-25. [PMID: 33111626 PMCID: PMC8822201 DOI: 10.1177/1043454220966590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Immunotherapy is a new and promising approach to treating pediatric cancers. These types of therapies have unique mechanisms of action for identifying and fighting cancer, as compared with traditional chemotherapy, and therefore are associated with different therapy-related adverse events (AEs). The purpose of this systematic review was to review available evidence to: (a) identify commonly reported AEs associated with immunotherapy agents frequently used in pediatric oncology and (b) generate recommendations for nursing practice. METHOD A clinical question was developed and used to guide the systematic literature review. Five immunotherapy agents (dinutuximab, blinatumomab, rituximab, inotuzumab ozogamicin, brentuximab vedotin) were selected for inclusion secondary to their high relevance to pediatric oncology. A literature search was conducted to locate articles published between January 1, 2003 and October 31, 2018. RESULTS Seventeen articles met eligibility criteria for inclusion and were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation criteria. The most commonly reported AEs for the selected immunotherapy agents were identified and summarized. Strong recommendations are made for nurses to become familiar with the unique AE profiles associated with individual immunotherapy agents. Agent-specific recommendations for nursing practice regarding AEs associated with dinutuximab and rituximab were generated. CONCLUSIONS Immunotherapy is rapidly emerging as an effective therapy for pediatric cancers. Nurses need to be aware of the breadth of agent-specific, immunotherapy-related AEs to appropriately monitor and manage patients receiving these therapies. Additional work is needed to confidently profile immunotherapy-related AEs in pediatric oncology and to develop agent-specific educational materials for patients/families.
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Affiliation(s)
- Janice S. Withycombe
- Clemson University, Clemson, SC,
USA
- Bi-Lo Charities Children’s Cancer
Center, Greenville, SC, USA
| | - Aimee Carlson
- Cleveland Clinic Children’s
Hospital, Cleveland, OH, USA
| | - Carly Coleman
- Cohen Children’s Medical Center,
New Hyde Park, NY, USA
| | | | - Micah Skeens
- Nationwide Children’s Hospital,
Columbus, OH, USA
| | - Hanna Tseitlin
- McMaster Children’s Hospital at
Hamilton Health Sciences, Hamilton, Ontario, Canada
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28
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De la Maza V, Manriquez M, Castro M, Viveros P, Fernandez M, Vogel E, Peña E, Santolaya ME, Villarroel M, Torres JP. Impact of a structured educational programme for caregivers of children with cancer on parental knowledge of the disease and paediatric clinical outcomes during the first year of treatment. Eur J Cancer Care (Engl) 2020; 29:e13294. [PMID: 32706521 DOI: 10.1111/ecc.13294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the impact of a structured educational programme for caregivers of children with cancer on their level of knowledge about the disease and patient's clinical outcome. METHODS This prospective, non-randomised, experimental study included caregivers of recently diagnosed children at two hospitals in Chile. Caregivers whose children were treated at the first centre were the structured education programme group (EPG), while the second hospital provided the standard care (SCG). We evaluated caregivers' level of knowledge on days 1, 10 and 90 as well as the children's clinical outcomes over 1 year of treatment. RESULTS A total of 102 caregivers were enrolled between 2014 and 2015. Only the EPG showed a significant increase in knowledge between days 1 and 90. The rate of central venous catheter infections was significantly lower in the EPG versus SCG (7% versus 26%; p = .01). The risk ratio was 0.35 (95% CI = 0.13-0.94), and a log-rank test showed a statistically significant difference between the two groups (p = .018). There were also fewer Emergency Department visits in the EPG for fever episodes. CONCLUSION Providing a structured education to caregivers increased their level of knowledge and improved the clinical outcome of their children during the first year of treatment.
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Affiliation(s)
- Verónica De la Maza
- Research Unit, Department of Pediatrics, Faculty of Medicine, Hospital Dr. Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Macarena Manriquez
- Research and Teaching Unit, Arturo López Pérez Foundation Oncology Institute, Santiago, Chile
| | | | - Paola Viveros
- Department of Pediatrics, Oncology Unit, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
| | - María Fernandez
- Department of Pediatrics, Oncology Unit, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
| | - Evelyn Vogel
- Department of Pediatrics, Oncology Unit, Hospital Exequiel González Cortés, Santiago, Chile
| | - Erica Peña
- Department of Pediatrics, Oncology Unit, Hospital Exequiel González Cortés, Santiago, Chile
| | - María Elena Santolaya
- Research Unit, Department of Pediatrics, Faculty of Medicine, Hospital Dr. Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile.,Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine, Hospital Dr. Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Milena Villarroel
- Department of Pediatrics, Oncology Unit, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
| | - Juan Pablo Torres
- Research Unit, Department of Pediatrics, Faculty of Medicine, Hospital Dr. Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile.,Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine, Hospital Dr. Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
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Di Giuseppe G, Pole JD, Abla O, Punnett A. Impact of Videotaped Information on the Experience of Parents of Children with Acute Lymphoblastic Leukemia. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:479-484. [PMID: 30739269 DOI: 10.1007/s13187-019-1485-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Videotaped information has been shown to be effective in reducing parental anxiety and facilitating knowledge transfer in various clinical settings. There is lack of literature on the use of videotaped information during the pediatric oncology initial family disclosure meeting. The purpose of this study was to deliver an informative DVD, highlighting information on childhood acute lymphoblastic leukemia (ALL), to parents of children with newly diagnosed ALL and to assess if the DVD provided increased levels of satisfaction and decreased levels of anxiety in parents around the time of diagnosis. We surveyed 24 parents of children on active treatment for ALL, diagnosed between the ages of 1 and 18 years from 2008 to 2016 at The Hospital for Sick Children, Toronto, Canada. Parents were provided a survey questionnaire assessing levels of satisfaction with information communicated by the healthcare team and anxiety following verbal disclosure and were asked to report satisfaction and anxiety levels immediately following viewing the DVD intervention. Twenty-three/24 (95.8%) parents surveyed reported seeking information from additional resources after disclosure. Of the 24 parents who watched the DVD, 12 (50.0%) watched it once, while 12 (50.0%) watched it twice or more. All parents were satisfied with DVD information, and there was a significant decrease in anxiety after viewing (P = 0.03). All 24 parents felt that the DVD was a useful educational tool. Videotaped information after verbal disclosure is an effective educational resource and is associated with reduced anxiety among parents of children with ALL.
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Affiliation(s)
- Giancarlo Di Giuseppe
- Division of Haematology/Oncology, Department of Paediatrics, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Pediatric Oncology Group of Ontario, Toronto, Canada
| | - Jason D Pole
- Pediatric Oncology Group of Ontario, Toronto, Canada
| | - Oussama Abla
- Division of Haematology/Oncology, Department of Paediatrics, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Angela Punnett
- Division of Haematology/Oncology, Department of Paediatrics, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
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30
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31
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McCann E, Fuentes-Alabí S, Antillón F, Vega-Vega L, Sanchez MS, Albanti I. Identifying and Prioritizing Family Education Needs at Pediatric Oncology Centers in Central America and Mexico. J Glob Oncol 2019; 5:1-10. [PMID: 31834833 PMCID: PMC6939744 DOI: 10.1200/jgo.19.00272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The educational needs of parents at the time of their child’s cancer diagnosis are often unclear, and research on this topic in low- and middle-income countries is limited. This study evaluated the educational needs of families at major pediatric oncology centers in Central America and Mexico.
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Affiliation(s)
- Erin McCann
- Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Federico Antillón
- Unidad Nacional de Oncología Pediátrica and School of Medicine Francisco Marroquin University, Guatemala City, Guatemala
| | | | | | - Irini Albanti
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA
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Lemos HJMD, Mendes-Castillo AMC. Social support of families with tracheostomized children. Rev Bras Enferm 2019; 72:282-289. [DOI: 10.1590/0034-7167-2018-0708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/02/2019] [Indexed: 02/17/2023] Open
Abstract
ABSTRACT Objective: To understand the social support of families with tracheostomized children. Method: Qualitative study using the Model of Dimensions of Social Support together with the Family System-Illness model as theoretical frameworks, based on the hybrid model of thematic analysis. Nine families with tracheostomized children were interviewed in an outpatient pediatric otorhinolaryngology department of a public hospital in the inner state of São Paulo. Results: The experience of social support to each phase of the family experience was presented in three themes: “Knowing the need for a tracheostomy”, “Performing a tracheostomy” and “Living with a tracheostomy”. Final considerations: Understanding how the experience of social support occurs can support assessment and intervention strategies, aiming to meet the demands of the family at each phase of its trajectory, collaborating for a continuous and integral nursing care.
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CE: Hematologic Childhood Cancers: An Evidence-Based Review. Am J Nurs 2019; 119:34-44. [PMID: 31764050 DOI: 10.1097/01.naj.0000615784.09785.ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Every year in the United States, thousands of children and adolescents are diagnosed with a hematologic cancer. That diagnosis and the prescribed course of treatment profoundly affect both the child and the family. This article provides a brief overview of the therapies used to treat such cancers, describes the presentations and diagnoses of the various hematologic cancers, and explains the treatments specific to each. Nursing care of the child and family is discussed, with an emphasis on education and supportive care.
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34
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Robertson EG, Wakefield CE, Cohn RJ, Battisti RA, Donoghoe MW, Ziegler DS, Fardell JE, Mitchell R, O'Brien TA. Piloting a parent and patient decision aid to support clinical trial decision making in childhood cancer. Psychooncology 2019; 28:1520-1529. [DOI: 10.1002/pon.5109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/02/2019] [Accepted: 05/08/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Eden G. Robertson
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
| | - Claire E. Wakefield
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
| | - Richard J. Cohn
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
- Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
| | - Robert A. Battisti
- Cancer Centre for ChildrenChildren's Hospital at Westmead Westmead New South Wales Australia
| | | | - David S. Ziegler
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
- Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
| | - Joanna E. Fardell
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
| | - Richard Mitchell
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
- Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
| | - Tracey A. O'Brien
- School of Women's and Children's HealthUNSW Sydney Kensington New South Wales Australia
- Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
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35
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Silva-Rodrigues FM, Bernardo CSG, Alvarenga WDA, Janzen DC, Nascimento LC. Transitional care to home in the perspective of parents of children with leukemia. ACTA ACUST UNITED AC 2019; 40:e20180238. [PMID: 31188974 DOI: 10.1590/1983-1447.2019.20180238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/21/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe the experiences of parents of children and adolescents with leukemia in regards to the transition from hospital care to home. METHOD A qualitative, descriptive study conducted with nine mothers and two fathers, in a pediatric public hospital. The data were collected through semi-structured interviews, from May 2017 to January 2017, organized in the software Atlas.ti 7® and submitted to inductive content analysis. The Change Theory was used as theoretical framework. RESULTS The central category was "Returning home: the birth of a new reality", which originated three subcategories: apprehension with the new reality of care; immediate impact of changes; and implementing the guidance plan. CONCLUSION The transition to the home setting made parents adapt to a new and complex reality of care. Improvements in the planning and systematization of the first hospital discharge are necessary.
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Affiliation(s)
- Fernanda Machado Silva-Rodrigues
- Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP). São Paulo, São Paulo, Brasil.,Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, São Paulo, Brasil
| | | | | | - Danielle Castro Janzen
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem. São Paulo, São Paulo, Brasil
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Hentea C, Downs SM, Tucker Edmonds B, Vik T, Wiehe SE, Cheng ER. Impact of socioeconomic markers on parents' retention of pediatric oncology home care education: A pilot study. Pediatr Blood Cancer 2019; 66:e27624. [PMID: 30693652 DOI: 10.1002/pbc.27624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/27/2018] [Accepted: 12/26/2018] [Indexed: 11/12/2022]
Abstract
Little is known about the extent to which parents retain the education on how to manage home medical emergencies. We sought to describe retention of pediatric oncology home care education (POHCE) in a cohort of 24 parents of newly diagnosed children with cancer and investigate sociodemographic disparities in this retention. We measured retention using a vignette-based survey instrument. The mean score was 4 (range 0-6, SD = 1.6) and parents with high school only education and those with limited cancer health literacy scored lowest (2.5 and 2.8, respectively). Future POHCE interventions can focus on parents' literacy and education levels as predictors to tailor alternative education strategies.
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Affiliation(s)
- Cristiana Hentea
- Children's Health Services Research, Indiana University, Indianapolis, Indiana
- Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana
| | - Stephen M Downs
- Children's Health Services Research, Indiana University, Indianapolis, Indiana
| | - Brownsyne Tucker Edmonds
- Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University, Indianapolis, Indiana
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
| | - Terry Vik
- Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana
| | - Sarah E Wiehe
- Children's Health Services Research, Indiana University, Indianapolis, Indiana
| | - Erika R Cheng
- Children's Health Services Research, Indiana University, Indianapolis, Indiana
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37
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Gunter MD, Duke G. Social Support to Reduce Uncertainty in Childhood Cancer in South Texas: A Case Study. J Pediatr Oncol Nurs 2019; 36:207-218. [PMID: 30929543 DOI: 10.1177/1043454219835450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To determine if supportive measures are found to be most helpful and feasible for families of children with cancer by obtaining in-depth perspectives of uncertainty and adaptation. HYPOTHESES Traditional methods of psychosocial support do not meet the needs of parents and families dealing with cancer. Participants prefer more informal meetings and gatherings that are more social in nature. METHOD A descriptive single embedded case study was used to study uncertainty and social support for families with children treated at a pediatric hematology/oncology department in south Texas. The sample included members of the health care team in a pediatric cancer/bone marrow transplant unit and parents of children diagnosed with cancer. Data were gathered through audio-recorded interviews. DATA ANALYSIS Data were transcribed and analyzed through thematic content and pattern matching using computer software. RESULTS Four themes were identified: meaning of uncertainty in parents and members of the health care team, facilitators of parental adaptation, education and psychosocial support, and patient/family obstacles hindering successful adaptation. These demonstrated aspects of care interventions, clarifying what uncertainty means and how it affects the ability of parents to adapt to life with pediatric cancer, perceptions regarding the helpfulness of education and support interventions or lack thereof, and what internal and external obstacles hinder the family's adaptation. IMPLICATIONS FOR PRACTICE Improving patient education through individualization and delivery time frame as well as providing opportunities for informal sharing and community building are key to reducing uncertainty and improving family adaptation to life with childhood cancer.
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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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39
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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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Kelly KP, Withycombe J, Stegenga K, Rodgers C. The Why Behind the Questions: Question-asking in Parents of Children Newly Diagnosed With Cancer - A Report From the Children's Oncology Group. J Pediatr Nurs 2018; 43:23-28. [PMID: 30473153 PMCID: PMC6613215 DOI: 10.1016/j.pedn.2018.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE For parents of children newly diagnosed with cancer, the exchange of information during initial educational processes is critical. This focused analysis was completed to describe parent question-asking during the new childhood cancer diagnosis timeframe. DESIGN & METHODS In previous research of new diagnosis education experiences, parents spoke extensively about asking questions. These data, captured in first level coding, were incorporated across higher level codes to describe how parents processed information after their child's cancer diagnosis. Using constant comparative analysis, we returned to our data to complete a focused analysis of our first level code, Asking Questions. Team members independently coded Asking Questions data from 20 parent interviews, followed by team discussions and consensus agreement for code assignment. RESULTS Parents asked questions to learn, fill an unmet need, or clarify information. Clinicians asked questions to assess parent learning. CONCLUSION Question-asking is a technique used by parents and clinicians to communicate new information, assess understanding of provided content, and/or to confirm previously provided information. PRACTICE IMPLICATIONS Clinicians can benefit from carefully listening to patients/parents and reflecting on the type of questions asked in an effort to understand the reason behind the question. This can be used to guide further education.
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Affiliation(s)
- Katherine Patterson Kelly
- Children's National Health System, Department of Nursing Research, Professional Practice, and Quality, Washington, DC USA; George Washington University School of Medicine and Health Sciences, Washington, DC USA.
| | - Janice Withycombe
- Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA USA.
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Madrigal VN, Kelly KP. Supporting Family Decision-making for a Child Who Is Seriously Ill: Creating Synchrony and Connection. Pediatrics 2018; 142:S170-S177. [PMID: 30385624 PMCID: PMC6220653 DOI: 10.1542/peds.2018-0516h] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2018] [Indexed: 11/24/2022] Open
Abstract
The families of children with chronic or serious illness are sometimes faced with difficult decisions never previously imagined. We offer a stepwise approach in building a human connection with these families to support them through the decision-making process. We encourage the clinician to stop talking and to actively listen and find common ground. We suggest that offering open and honest information begins with an invitation. We encourage clinicians to explore concepts with the family, including their fears and hopes. We discuss nurturing an emotional connection between the child and family and describe ways to discover a family's preference for involvement in the decision-making process. Central to supporting a family is to place infinite value on the life of their child. We argue that attention to these matters will help the clinician remain in sync with the family to ensure meaningful and high-quality decision-making during highly vulnerable times for families.
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Affiliation(s)
- Vanessa N Madrigal
- Division of Critical Care Medicine, Departments of Pediatrics and
- Associate Professor of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Katherine Patterson Kelly
- Nursing Science, Professional Practice, and Quality, Children's National Health System, Washington, District of Columbia; and
- Director of Pediatric Ethics Program, Assistant Professor and
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Stock NM, Costa B, Williams J, Martindale A, At The Centre For Appearance Research TVFRT. Parental views of antenatal testing and termination following a diagnosis of cleft lip. PSYCHOL HEALTH MED 2018; 24:456-469. [PMID: 30280914 DOI: 10.1080/13548506.2018.1529328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Fetal anomaly screening at 18-21 weeks now routinely includes cleft lip. If detected, the manner in which the diagnosis is communicated can considerably influence prospective parents' decision-making in regard to further testing and termination of pregnancy (TOP). Given the known psychological impact of an antenatal diagnosis of cleft lip on prospective parents, this study aimed to explore the decision-making process from the parents' perspective, in order to evaluate how well current practice is meeting guidelines. Data from 217 parents of children born with cleft lip (with or without cleft palate) were collected using a mixed-methods online survey. Respondents reported feeling upset, offended and/or anxious following the diagnosis, due to unsatisfactory information and a perceived lack of empathy from health professionals. Some respondents had felt under pressure to make a decision quickly, with a minority having regretted undergoing amniocentesis, and/or experiencing significant distress at having come close to TOP unnecessarily. A number of suggestions are made as to how the discussion between parents and health professionals could be improved, to ensure that the information and support needs of families affected by cleft lip are fully addressed.
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Affiliation(s)
- Nicola Marie Stock
- a Centre for Appearance Research , University of the West of England , Bristol , UK
| | - Bruna Costa
- a Centre for Appearance Research , University of the West of England , Bristol , UK
| | - Jenny Williams
- b South Thames Cleft Service, St Thomas' Hospital , London , UK
| | - Anna Martindale
- c Communications and Information , Cleft Lip and Palate Association , London , UK
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Hentea C, Cheng ER, Bauer NS, Mueller EL. Parent-centered communication at time of pediatric cancer diagnosis: A systematic review. Pediatr Blood Cancer 2018; 65:e27070. [PMID: 29667725 DOI: 10.1002/pbc.27070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 11/11/2022]
Abstract
There are limited data focused on parental communication needs surrounding the time when a child is diagnosed with cancer. In this systematic review, we synthesized current literature on communication preferences of parents at the time of their child's diagnosis of cancer. We identified 16 studies that yielded 4 major themes parents recognized as important: communication style, content, logistics, and healthcare team. We further identified several concepts that inform parent-centered communication practice. The ensuing pediatric oncology parent-centered communication concept map is meant as a tool to expand providers' communication experience at the time of a new cancer diagnosis.
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Affiliation(s)
- Cristiana Hentea
- Children's Health Services Research, Indiana University, Indianapolis, Indiana, USA.,Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Erika R Cheng
- Children's Health Services Research, Indiana University, Indianapolis, Indiana, USA
| | - Nerissa S Bauer
- Children's Health Services Research, Indiana University, Indianapolis, Indiana, USA
| | - Emily L Mueller
- Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA.,Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University, Indianapolis, Indiana, USA
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Wilson Smith MG, Sachse K, Perry MT. Road to Home Program: A Performance Improvement Initiative to Increase Family and Nurse Satisfaction With the Discharge Education Process for Newly Diagnosed Pediatric Oncology Patients. J Pediatr Oncol Nurs 2018; 35:368-374. [DOI: 10.1177/1043454218767872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Families of children, adolescents, and young adults with a new oncology diagnosis must absorb knowledge and skills needed to care for their child at home during a period of emergent hospitalizations and intense medical interventions. Effective nurse-led teaching and discharge planning begun at diagnosis can prepare families to safely care for their child following discharge, and be a source of satisfaction. The objective of this performance improvement initiative was to increase family and nurse satisfaction with new diagnosis education and discharge. Using standard performance improvement techniques, family and nursing stakeholder satisfaction with current processes was assessed. Working from established best practice and literature review; The Road to Home was designed and implemented. This novel, comprehensive program includes a visual, interactive display of required education based on the Children’s Oncology Group Family Handbook© and hospital specific discharge materials; standardized teaching, tools and documentation for nursing; and caregiver discharge tool kits. Stakeholder input guided improvement strategies throughout the phases of implementation. Sustained increases in family and nurse satisfaction resulted from each phase. The Road to Home program is established for all families of newly diagnosed oncology patients and is meeting goals of increased family and nurse satisfaction with discharge education.
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Coad J, Smith J, Pontin D, Gibson F. Consult, Negotiate, and Involve: Evaluation of an Advanced Communication Skills Program for Health Care Professionals. J Pediatr Oncol Nurs 2018; 35:296-307. [DOI: 10.1177/1043454218765136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Effective communication is central to children, young people, and their families’ experiences of health care. Most patient complaints in developed health care systems result from ineffective communication, including inadequate information provision, not feeling listened to, failure to value patients concerns, and patients not feeling involved in care decisions. Advanced communication skills training is now embedded within cancer care policy in the United Kingdom and now features prominently within cancer education in many countries. Here, we share findings from a research evaluation of an advanced communication skills training program dedicated to health professionals caring for children and young people with cancer. We evaluated participants’ (n = 59) perceptions of the program, impact on their skills, knowledge, competence, and confidence. An appreciative inquiry design was adopted; data included interviews, precourse-postcourse evaluations, e-mail blog survey, and 360-degree reflective work records. The framework approach underpinned data analysis and triangulation of data sets. Key findings highlighted good and poor practice in health professionals’ engagement with children, young people, and their families; the purpose of communicating effectively was not always consistent with collaborative working. Attending a program helped participants expand their knowledge of communication theories and strategies. Participants valued using simulated scenarios to develop their skills and were keen to use their new skills to enhance care delivery. Our emphasis within this evaluation, however, remained on what was communicated, when and how, rather than to what effect. The impact of programs such as these must now be evaluated in terms of patient benefit.
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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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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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