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O'Donnell N, Phillips B, Morgan JE, Howell D. 'It's not meant to be for life, but it carries on': a qualitative investigation into the psychosocial needs of young retinoblastoma survivors. BMJ Open 2024; 14:e082779. [PMID: 38688668 PMCID: PMC11086577 DOI: 10.1136/bmjopen-2023-082779] [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] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE AND DESIGN Retinoblastoma (Rb) is a rare childhood eye cancer, with 45% of individuals impacted by heritable disease and the remainder impacted non-heritably. The condition can leave survivors with life-long psychological and social challenges. This qualitative study examined the psychosocial needs of teenagers and young adults living beyond Rb. SETTING A qualitative, exploratory study was conducted using focus groups with teenagers and interviews with young adults. Participants were recruited via the Childhood Eye Cancer Trust and the two national Rb treatment centres in the UK. Reflexive thematic analysis was used to analyse data using exploratory and inductive methods. PARTICIPANTS 32 young survivors of Rb (10 heritable, 21 non-heritable, 1 unknown; 23 unilateral, 9 bilateral) aged between 13 and 29 years (12 male, 20 female). RESULTS Data were rich and spanned the life course: three key themes were generated, containing eight subthemes. Theme 1 describes participants' experiences of childhood and trauma, including survivor guilt, memories from treatment and impact on personality. Theme 2 focuses on the challenges of adolescence, including the psychological impact of Rb, the impact on identity, and the sense of normality and adaptation to late effects. The third theme considered adulthood and the development of acceptance, a state of being widely considered unachievable during childhood, as well as the 'work' needed to feel supported, including seeking out information, peer support and therapeutic strategies. CONCLUSIONS This study provides in-depth insight into the experiences of life beyond Rb. Findings highlight the need for specific psychosocial interventions informed by codesign.
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Affiliation(s)
| | - Bob Phillips
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Debra Howell
- Department of Health Sciences, University of York, York, UK
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Arpaci T, Altay N. Qualitative Analysis of School Re-Entry Experiences of Turkish Survivors of Childhood and Adolescent Cancer: Parental Perspective. Semin Oncol Nurs 2024:151613. [PMID: 38413308 DOI: 10.1016/j.soncn.2024.151613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE This study aimed to explore the school re-entry experiences of Turkish survivors of childhood and adolescent cancer. DATA SOURCES In this qualitative study, semistructured in-depth interviews were undertaken with parents of childhood cancer survivors who had completed treatment for at least 2 years (n = 20). Interviews were conducted via telephone or video conferencing. The study was conducted and reported according to the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. The components of qualitative rigor were considered to ensure confidence in the methods and data. CONCLUSIONS The average age of parents was 43.20 ± 4.66 years (range 37-55) (n = 20). The mean age of survivors was 8.45 ± 2.03 years at diagnosis and 15.05 ± 2.08 years during the study. The diagnosis of most of the survivors was lymphoma (35%). Four main themes were developed: worry; challenging situations; negative effects of the disease process; and facilitating situations. Parents stated that both children and parents need support during the school re-entry process. IMPLICATION FOR NURSING PRACTICE This study revealed that survivors may experience problems that make school re-entry difficult. With cooperation between the health team and the school, arrangements should be made to ensure survivors have a positive experience on school re-entry. Pediatric oncology nurses should know survivors' requirements and take action to deliver school re-entry adjustment programs.
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Affiliation(s)
- Tuba Arpaci
- Department of Nursing, Faculty of Health Sciences, Karamanoglu Mehmetbey University, Karaman, Türkiye.
| | - Naime Altay
- Department of Pediatric Nursing, Faculty of Nursing, Gazi University, Ankara, Türkiye
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Tamboli M, Means B, Jurbergs N, Conklin HM, Gajjar A, Willard VW. Social participation of school-aged survivors of pediatric brain tumors: A daily diary report. Pediatr Blood Cancer 2024; 71:e30764. [PMID: 37950459 DOI: 10.1002/pbc.30764] [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: 06/21/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Difficulties with social functioning are common among survivors of pediatric brain tumors. Social participation is an understudied measure of social functioning that is associated with emotional health across the lifespan. This paper uses a diary method to assess the social participation of survivors of pediatric brain tumors in middle childhood. PROCEDURE Survivors of pediatric brain tumors (N = 47; age 10.6 ± 1.4 years; 51.1% male, 89.4% White) who were 5.3 (SD = 2.4, range: 2-9.9) years post therapy completed a daily diary assessment of social interaction (5-7 days) and an objective measure of facial affect recognition. The participant's caregiver completed the NIH Toolbox Emotion Measures and a background information questionnaire. RESULTS Overall, frequency and quality of reported social interactions were low for survivors, with a large subset of survivors (n = 16, 34%) endorsing fewer than 10 social interactions over the course of a typical school week, and almost half of parents (48.9%) reporting that their child participates in zero social activities outside of school during a typical week. Participants engaged in more positive social participation exhibited stronger social skills (facial affect recognition (F(2,44) = 4.85, p < .05). CONCLUSIONS School-aged survivors of pediatric brain tumors seemed to be infrequently engaged in social participation and quality interaction with peers. More specifically, the interactions most commonly reported on the diary assessment are not indicative of friendship development and maintenance. Survivors of pediatric brain tumors would likely benefit from interventions designed to increase quality time spent with peers.
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Affiliation(s)
- Mollie Tamboli
- Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Bethany Means
- Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Niki Jurbergs
- Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Heather M Conklin
- Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Amar Gajjar
- Departments of Oncology and Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Victoria W Willard
- Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Larsen MH, Larsen EH, Ålykkja A, Underhaug KA, Ruud E, Lie HC. "The post-it note just said leukemia" - Information exchange challenges of teachers and local stakeholders supporting young childhood cancer survivors at school - A qualitative study from the Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) group. Eur J Oncol Nurs 2024; 68:102464. [PMID: 38029601 DOI: 10.1016/j.ejon.2023.102464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/26/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Explore teachers', school nurses', cancer coordinators' and other local stakeholders' experiences providing education and support for young childhood cancer survivors in the years after treatment. METHODS We conducted four focus groups and three individual telephone interviews with 15 teachers, nine nurses and three other stakeholders, using inductive thematic analysis inspired by Braun & Clark. Nvivo v12 was used for data-management. RESULTS Three main themes were developed; "Perceived parent attitudes and facilitation", "The missing link - lack of communication and collaboration", and "Enabling mastery, inclusion and thriving". Parents were perceived to be the sole managers of providing cancer information and school-related follow-up needs. Teachers and other stakeholders experienced the nonexistence of information from specialist healthcare services and poor communication within the municipality. Teachers went to great lengths to meet survivors' pedagogical needs and facilitate peer interactions. Teachers voiced a need for more cancer and late effect knowledge, not being dependent solely on parents' for information. CONCLUSIONS Teachers and other stakeholders have essential roles in the continuing school experience for survivors. A more regulated teamwork between the stakeholders in the municipalities and the specialist healthcare system could ensure tailored late effect information at school. Implementing formal support could enable a co-creation of a personalized follow up that could relieve the burden on survivors, parents and teachers.
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Affiliation(s)
- Marie H Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway; Lovisenberg Diaconal University College, Lovisenberggt 15, 0458, Oslo, Norway.
| | - Elna H Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway; Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, P. O. Box 4950 NydalenN-0424, Oslo, Norway.
| | - Anette Ålykkja
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway; Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, P. O. Box 4950 NydalenN-0424, Oslo, Norway.
| | - Katrine Aass Underhaug
- Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, P. O. Box 4950 NydalenN-0424, Oslo, Norway.
| | - Ellen Ruud
- Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, P. O. Box 4950 NydalenN-0424, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, Univerity of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway.
| | - Hanne C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway.
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Neenan A, Byrd M, Hoodin F, Staples AD. Activism, Coping, and Hopefulness Among Parents of Children With Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:56-66. [PMID: 37885240 DOI: 10.1177/27527530231194566] [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: 10/28/2023]
Abstract
Background: Coping styles employed by parents of children with cancer have significant implications for parents' and children's well-being. To supplement the minimal literature in this area, activism (participation in activities that serve to benefit children with cancer as a group) was investigated as a potential coping strategy. Method: Parents (N = 67) of children with cancer completed an online survey that included measures of COPE inventory (COPE), hopefulness (Adult Hope Scale), and depression (Patient Health Questionnaire-9-item). Participants retrospectively reported their engagement in activism to benefit children with cancer and to benefit other causes, including actions that were taken before and after their child's cancer diagnosis. Relations between activism, overall styles of coping, hopefulness, and depression were assessed. Results: Activism was positively correlated with hope and active coping, but not associated with depression. Participants reported a significant increase in childhood-cancer-related activism following their own child's diagnosis, with 100% of parents endorsing engagement in such activism. Postdiagnosis childhood-cancer-related activism uniquely explained 17% of the variance in hopefulness after other forms of activism had been accounted for. Discussion: Childhood-cancer-related activism is a common activity among parents of children with cancer that has significant implications for parental hopefulness. Parents who endorse an active, solution-focused approach to coping with the childhood cancer experience may be more likely than others to engage in activism. Further research is needed to clarify the role of activism in the lives of families of children with cancer.
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Affiliation(s)
- Alexandra Neenan
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Michelle Byrd
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Flora Hoodin
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Angela D Staples
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
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Fridh MK, Schmidt-Andersen P, Andrés-Jensen L, Thorsteinsson T, Wehner PS, Hasle H, Schmiegelow K, Larsen HB. Children with cancer and their cardiorespiratory fitness and physical function-the long-term effects of a physical activity program during treatment: a multicenter non-randomized controlled trial. J Cancer Surviv 2023:10.1007/s11764-023-01499-7. [PMID: 38057671 DOI: 10.1007/s11764-023-01499-7] [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: 08/04/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE We aimed to determine the effects of a classmate-supported, supervised, in-hospital physical activity program during treatment primarily on cardiorespiratory fitness and secondarily on physical function. METHODS A multicenter non-randomized controlled intervention study including children diagnosed with cancer, 6-18 years at diagnosis treated with chemo-/radiotherapy. The intervention comprised (i) an educational session on cancer in the child's school class; (ii) selection of two "ambassadors"-classmates who were co-admitted, supporting the child's everyday hospital life; and (iii) supervised in-hospital physical activity from diagnosis and throughout intensive treatment. One-year post-treatment, physical testing included cardiorespiratory fitness (primary outcome), Sit-to-Stand test, Timed-Up-and-Go, and Handgrip Strength. RESULTS The intervention group included 75 of 120 children (61% boys, 13.4 ± 3.1 years); the control groups included 33 of 58 children with cancer (58% boys, 13.5 ± 2.5 years), and 94 age- and sex-matched children without a cancer history. One-year post-treatment, cardiorespiratory fitness tended to be higher in the intervention group (37.0 ± 6.0 mL/kg/min) than in the patient control group with cancer (32.3 ± 9.7 mL/kg/min) (mean difference 4.7 [0.4 to 9.1], p = 0.034). The intervention group performed better in the secondary outcomes. Compared with community controls, both patient groups had lower cardiorespiratory fitness. The patient control group had lower Sit-to-Stand, Timed Up and Go, and Handgrip Strength, while the intervention group had strength comparable to that of the community controls. CONCLUSIONS Peer-supported, supervised, in-hospital physical activity during treatment may improve cardiorespiratory fitness and muscle strength 1-year post-treatment in children with cancer; however, survivors continue to have lower cardiorespiratory fitness than community controls. IMPLICATIONS FOR CANCER SURVIVORS Children with cancer may benefit from in-hospital physical activity in improving long-term cardiorespiratory fitness and muscle strength.
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Affiliation(s)
- Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
| | - Peter Schmidt-Andersen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- The University of Copenhagen, Faculty of Health Science, Institute for Clinical Medicine, Copenhagen, Denmark
- Department of Occupational Therapy and Physiotherapy, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Liv Andrés-Jensen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Troels Thorsteinsson
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Peder Skov Wehner
- Department of Pediatric Hematology and Oncology, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
- The University of Copenhagen, Faculty of Health Science, Institute for Clinical Medicine, Copenhagen, Denmark.
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Wawrzynski SE, Alderfer MA, Waters AR, Linder L, Reblin M, Guo JW, Litchman M, Cloyes KG. Technology-Mediated Support Among Siblings of Children with Cancer. J Adolesc Young Adult Oncol 2023; 12:685-691. [PMID: 36787472 PMCID: PMC10611953 DOI: 10.1089/jayao.2022.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Purpose: A diagnosis of pediatric cancer can leave healthy siblings with limited access to support. Technology-mediated interpersonal interactions have been noted among adolescent and young adults with cancer and may be an effective source of support for adolescent siblings of children with cancer. In this study, we understand how adolescent siblings use technology to connect with their support network and how their technology use changes after their sibling's cancer diagnosis. Methods: Participants included a national sample (N = 24) of adolescents aged 12-17 who had a sibling diagnosed with cancer in the last 2 years (up to 3 years if still receiving curative-focused treatment). Ecomaps were cocreated with participants to identify sources of social support and modality of interactions. Interviews were transcribed, coded, content analyzed, and descriptively summarized. Results: Adolescent siblings (mean = 14.2 years) perceived technology as a tool to maintain support from their established personal network, rather than a way to expand sources of social support. Most did not seek support or information about cancer outside their known network, preferring information to come from parents or trusted network members. Siblings identified video calls as an important resource for connecting with parents, their sick brother or sister, and others to receive emotional support and companionship. Conclusions: Findings suggest that adolescent siblings of children use technology to connect with their established network for support, an important finding for designing assessments and interventions for this population. Future inquiry should explore these differences, identify unmet needs, and inform acceptable, effective interventions to augment support.
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Affiliation(s)
- Sarah E. Wawrzynski
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Melissa A. Alderfer
- Center for Healthcare Delivery Science, Nemours Children's Hospital, Delaware, Wilmington, Delaware, USA
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Austin R. Waters
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute-University of Utah, Salt Lake City, Utah, USA
| | - Lauri Linder
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute-University of Utah, Salt Lake City, Utah, USA
| | - Maija Reblin
- College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Jia-Wen Guo
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | - Kristin G. Cloyes
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA
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Madi D, Abi Abdallah Doumit M, Hallal M, Moubarak MM. Outlooks on using a mobile health intervention for supportive pain management for children and adolescents with cancer: a qualitative study. BMC Nurs 2023; 22:301. [PMID: 37667338 PMCID: PMC10476416 DOI: 10.1186/s12912-023-01461-z] [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: 04/25/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Considerable improvements in the prognosis of pediatric cancer patients have been achieved over recent decades due to advances in treatment. Nevertheless, as the most common and distressing health issue for pediatrics with cancer, cancer-related pain is still a significant hurdle that impedes patients' journey to recovery, compromises their quality of life, and delays the positive outcome and effectiveness of their treatments. PURPOSE Taking into consideration that acceptability studies are imperative for the design, evaluation, and implementation of healthcare interventions, this study aims to explore pediatric oncology patients' readiness to use a mobile health application that emphasizes social assistance and peer support in addition to conventional pain management methods. DESIGN AND METHODS This study followed the Qualitative description approach. Twelve participants were chosen based on purposive sampling and maximum variation sampling. Interviews were analyzed using the conventional content analysis. RESULTS Analysis of the interviews revealed four major categories: (A) The need for connectedness; (B) An innovative way to connect yet fearful; (C) A 3D approach; (D) Fears of the unfamiliar. CONCLUSIONS This study is the first in Lebanon and the region to undertake an initiative towards introducing technology for pain assessment and management of children with cancer through a dedicated digital platform. The study results attested to the acceptability and potential utilization of this platform by children with cancer. PRACTICE IMPLICATIONS Nurses need to be trained to play an essential role in teaching children with cancer about the significance of social support and assisting them to establish their social support network. Children with cancer are encouraged to voice out their need for help. Our proposed application can create an enabling environment to harness the power of social support and provide children with cancer the opportunity to connect on a deeper level in a supportive and pity-free space.
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Affiliation(s)
- Dina Madi
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | | | - Mohammad Hallal
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maya M Moubarak
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
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Ancheta AJ, Cunningham PB, Liu J, Powell JS, Halliday CA, Bruzzese JM. Asthma is associated with bullying victimization in rural adolescents. J Asthma 2023; 60:1409-1417. [PMID: 36413706 PMCID: PMC10191972 DOI: 10.1080/02770903.2022.2151466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/27/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We characterized bullying among rural adolescents and examined the association between asthma and bullying victimization. METHODS Participants (N = 1905; 44.5% Black) were students attending rural high schools who were screened for a randomized trial to address uncontrolled asthma. Screening questions asked students about asthma diagnosis and symptoms, bullying victimization, and demographic characteristics. Logistic regression analyses with school as a fixed effect were employed to examine the extent to which demographic factors, asthma diagnosis, asthma status (i.e. current asthma, no asthma, possible undiagnosed asthma), and among those with current asthma, asthma severity, were associated with bullying victimization. Sensitivity analyses using bullying frequency as the outcome were also conducted. RESULTS 26.0% reported being bullied. Younger age and self-identifying as White were associated with increased risk of bullying victimization. Compared to those with no asthma, those with current asthma or possible undiagnosed asthma were at increased risk for bullying victimization (adjusted odds ratio [AOR] = 2.46; 95% confidence interval (CI) = 1.76-3.46 and AOR = 2.42; 95% CI = 1.87-3.14, respectively). Among those with current asthma, persistent symptoms increased the risk for bullying victimization (AOR = 2.59; 95% CI = 1.45-4.71). Similar results were obtained with sensitivity analyses. CONCLUSIONS In a large rural community cohort, asthma was associated with bullying victimization. Findings suggest that rural students with asthma, with or without diagnosis, could benefit from schools creating inclusive environments that reduce victimization based on this medical condition. School administrators should foster environments that are accepting of all students' abilities and statuses, and healthcare providers can provide proper asthma management education to these adolescents.
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Affiliation(s)
| | | | - Jianfang Liu
- Office of Scholarship and Research, Columbia University School of Nursing
| | - Jennifer S. Powell
- Division of Global and Community Health, Medical University of South Carolina
| | - Colleen A. Halliday
- Division of Global and Community Health, Medical University of South Carolina
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Thornton CP, Semerjian C, Carey LB, Milla K, Ruble K, Paré-Blagoev J, Jacobson LA. Why Psychosocial Care Matters: Parent Preparedness and Understanding Predict Psychosocial Function When Children Return to School After Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:226-234. [PMID: 37032468 DOI: 10.1177/27527530221147871] [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: 04/11/2023]
Abstract
Introduction: Psychosocial impacts of cancer are well-recognized for pediatric patients but few studies examine challenges specific to schooling after diagnosis and caregiver-related factors that may influence coping. This study describes caregiver experiences of school-related psychosocial functioning and how caregiver preparedness and understanding of these challenges influence coping. Methods: Caregivers of 175 childhood cancer survivors completed a nationally disseminated survey related to caregiver preparedness, clinician-provided education, and school-related experiences. Caregiver-reported preparedness and understanding were evaluated as predictors of psychosocial coping; factor analysis was performed to identify compound scales of preparedness and understanding. Results: Caregivers reported that the cancer treatment experience resulted in their children being more stressed and anxious about returning to school (60.2% and 70.2%, respectively) and more sensitive to peers (73.4%). It also made it harder for them to socialize and fit in with peers (58.2% and 49.7%, respectively). Caregiver preparedness and understanding predicted improved psychosocial coping with regard to child stress regarding socialization, fitting in, and anxiety but not sensitivity to peers. Teacher supportiveness and caregiver perception of clinician understanding also correlated with function. Discussion: Findings highlight the importance of caregiver education and preparedness as these reliably predict child psychosocial function and coping as they return to school after a cancer diagnosis and that all children are at risk for psychosocial challenges following a cancer diagnosis. Opportunities exist for clinicians to provide more education and anticipatory guidance to families as a potential means to reduce poor coping when a child returns to school following cancer.
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Affiliation(s)
- Clifton P Thornton
- Herman & Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing
| | - Claire Semerjian
- Department of Neuropsychology, Kennedy Krieger Institute
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - Lisa B Carey
- Department of Neuropsychology, Kennedy Krieger Institute
- Graduate School of Education, Johns Hopkins University
| | - Kimberly Milla
- Department of Neuropsychology, Kennedy Krieger Institute
| | - Kathy Ruble
- Department of Pediatric Oncology, Johns Hopkins School of Medicine
| | | | - Lisa A Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Johns Hopkins University
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11
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Larsen MH, Hansson KE, Larsen EH, Fridh MK, Petersen NN, Mellblom AV, Ruud E, Larsen HB, Lie HC. The gap between expectations and reality: A qualitative study of psychosocial challenges of young childhood cancer survivors from the PACCS study. Eur J Cancer Care (Engl) 2022; 31:e13696. [PMID: 36029045 PMCID: PMC9787754 DOI: 10.1111/ecc.13696] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/13/2022] [Accepted: 08/12/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE In this sub-study from the 'PACCS' study, we explored the psychosocial experiences of children and adolescents in everyday life post-cancer treatment and the possible factors that can moderate these experiences. METHODS This is a qualitative explorative study using semi-structured interviews with 43 childhood cancer survivors between the ages of nine and 18 from Norway and Denmark. We conducted a secondary thematic analysis using Malterud's systematic text condensation. RESULTS Two main themes were identified: 'The post-treatment gap between expectations and reality' comprised two subthemes: (1) lack of mastery and feeling different and (2) lack of understanding and acceptance. The second main theme, 'Managing the gap', comprised three subthemes: (1) information and knowledge, (2) adjustments and adaptions and (3) social support and openness. The findings reveal that the psychosocial challenges resulted from the remaining ability gap(s). Measures such as tailored information, school adjustments and social support were potential dynamic factors affecting the gap(s) positively or negatively. Psychosocial challenges post-treatment are experiences of lack of acceptance and understanding from others. CONCLUSION To safeguard a positive transition back to everyday life, health care providers should support the survivors' psychosocial care, including getting back to school and re-entering social interactions.
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Affiliation(s)
- Marie Hamilton Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway,Department for Postgraduate StudiesLovisenberg Diaconal University CollegeOsloNorway
| | - Kjerstin Enger Hansson
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Elna Hamilton Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway,Department of Paediatric Haematology and Oncology, Division for Paediatric and Adolescent MedicineOslo University Hospital, RikshospitaletOsloNorway
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescents MedicineUniversity Hospital RigshospitaletCopenhagenDenmark
| | - Natasha Nybro Petersen
- Department of Pediatrics and Adolescents MedicineUniversity Hospital RigshospitaletCopenhagenDenmark
| | - Anneli Victoria Mellblom
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway,Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP)OsloNorway
| | - Ellen Ruud
- Department of Paediatric Haematology and Oncology, Division for Paediatric and Adolescent MedicineOslo University Hospital, RikshospitaletOsloNorway,Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - Hanne Baekgaard Larsen
- Department of Pediatrics and Adolescents MedicineUniversity Hospital RigshospitaletCopenhagenDenmark,Faculty of Health Sciences, The University of Copenhagen and The Pediatric Clinic, Juliane Marie CentreRigshospitaletCopenhagenDenmark
| | - Hanne Cathrine Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
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12
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Sitthi N, In-Iw S, Theppiban S, Manaboriboon B. Cyberbullying Among Adolescents with Chronic Illnesses in Thailand: Prevalence and Relationship with Health-Risk Behaviors. J Dev Behav Pediatr 2022; 43:e533-e540. [PMID: 35858117 DOI: 10.1097/dbp.0000000000001110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The use of social media may enhance the quality of life in adolescents living with chronic illnesses but may increase the risk of cyberbullying. OBJECTIVE The aim of this study was to estimate the prevalence of cyberbullying among adolescents with chronic illnesses and relationship with health-risk behaviors. METHODS This is an online survey of randomly recruited adolescents aged 11 to 18 years with chronic illness managed at Siriraj Hospital, Thailand, during 2019 to 2020. Participants were asked to respond anonymously to validated online questionnaires to evaluate health-risk behaviors, experience with cyberbullying, and depression-screening questions. RESULTS Three hundred forty-one participants with a mean age of 15.02 ± 2.17 years (interquartile range 12.8, 17.2) responded. Reported risk behaviors included sexual activity in 42 participants (12.3%) with almost half (47.6%) having practiced unsafe sex. Alcohol drinking and polysubstance use were also found in 8.5% and 1.2%, respectively. 38 (11.1%) felt depressed within the previous 2-week period. 56 (16.4%) had been a cyberbully victim. Among the victims, 25 (44.6%) were also cyberbullies themselves. Chronically ill adolescents were more likely to be a victim of cyberbullying if they knew someone who had also been a victim (adjusted odds ratio [aOR] 5.25 [95% confidence interval [CI] = 1.80-15.29], p < 0.001) or had a positive depression screening (aOR 6.182 [95% CI = 2.41-15.85], p < 0.001). Underlying diseases, age, sex, risky behaviors, and time spent online were not associated with being cyberbullied. CONCLUSION Thai adolescents with chronic illness were similar to their healthy peers regarding health-risk behaviors and the likelihood of being a victim of cyberbullying. Screening for risky behaviors, evidence of depression, and online activity during routine medical visits was an opportunity to prevent cyberbullying.
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Affiliation(s)
- Natthapong Sitthi
- Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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13
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Arpaci T, Altay N, Yozgat AK, Yaralı HN, Özbek NY. 'Trying to catch up with life': The expectations and views of adolescent survivors of childhood acute lymphoblastic leukaemia about long-term follow-up care: A qualitative research. Eur J Cancer Care (Engl) 2022; 31:e13667. [PMID: 35866542 DOI: 10.1111/ecc.13667] [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: 04/05/2022] [Revised: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to explore adolescent survivors' views and expectations about long-term follow-up care. METHODS Semi-structured, in-depth interviews were conducted with 16 adolescent survivors of childhood acute lymphoblastic leukaemia. Survivors who had completed treatment at least 2 years ago were involved in the study. Interviews were audio-recorded and transcribed verbatim. An inductive thematic approach was used to analyse the data. RESULTS Four main themes and sub-themes were identified from the analysis as follows: information needs with three sub-themes 'long-term follow-up, healthy life and social life', support needs with three sub-themes 'psychosocial (peer relations etc.), school related and social-emotional (fear of relapse, body image, self-esteem, etc.)', perceived benefits with two sub-themes 'social-emotional and related to long-term follow-up' and perceived barriers 'medical-hospital related and social life'. CONCLUSIONS Adolescent survivors mainly need support in terms of psychosocial aspects: self-esteem-body image, school, peer relations and social activities during follow-up. Identified barriers related to follow-up were school absence and not able to participate social activities. Adolescents specify health promotion approaches as benefits aspects of follow-up. The findings of this study will guide nurses in the long-term follow-up care of adolescent survivors of acute lymphoblastic leukaemia and provide an opportunity to plan individualised follow-up care.
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Affiliation(s)
- Tuba Arpaci
- Department of Nursing, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Naime Altay
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ayça Koca Yozgat
- Pediatric Hematology and Oncology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Hüsniye Neşe Yaralı
- Pediatric Hematology and Oncology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Namık Yaşar Özbek
- Pediatric Hematology and Oncology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
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14
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Larsen EH, Mellblom AV, Ruud E, Wahl AK, Lie HC. Prepared for survivorship? Multidisciplinary healthcare professionals' experiences with adolescents’ transition off cancer treatment: A focus group study. Eur J Oncol Nurs 2022; 58:102150. [DOI: 10.1016/j.ejon.2022.102150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/26/2022] [Accepted: 05/13/2022] [Indexed: 11/25/2022]
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15
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Efe YS, Özbey H, Caner N, Erdem E, Kuzucu EG, Karakükçü M, Patıroğlu T, Ünal E, Yılmaz E, Özcan A. Social exclusion and behavior problems in adolescents with cancer and healthy counterparts. J Pediatr Nurs 2022; 64:e95-e101. [PMID: 34998654 DOI: 10.1016/j.pedn.2021.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/16/2021] [Accepted: 12/24/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This cross-sectional study was conducted to determine social exclusion, internalized and externalized behavioral problems in adolescents with cancer and to compare them with healthy counterparts. DESIGN AND METHODS The sample consisted of adolescents age 10-19 years (N = 70) followed up in the hemato-oncology outpatient clinic of a tertiary hospital and healthy adolescents age 10-19 years (N = 92) who were studying in secondary and high schools. The data were collected with a questionnaire for adolescents with cancer and healthy adolescents, The Ostracism Experience Scale for Adolescents (OES-A), Youth Externalizing Behavior Screener (YEBS), and Youth Internalizing Problems Screener (YIPS). RESULTS The OES-A mean scores of cancer and healthy adolescents in the study were 35.68 ± 9.38 and 27.64 ± 5.35 (p ≤ 0.001), the YEBS mean scores were 23.51 ± 4.88 and 20.52 ± 5.42 (p ≤ 0.001), and the YIPS mean scores were 21.72 ± 6.48 and 19.18 ± 7.60 (p = 0.007), respectively. There was a low-level positive correlation between the mean scores of the OES-A and YEBS (r = 0.345, p < 0.05) and mean scores of the YEBS and YIPS (r = 0.308, p < 0.05) of adolescents with cancer. CONCLUSIONS Adolescents with cancer had higher scores on social exclusion, internalized and externalized behavioral problems than healthy counterparts in the current study. PRACTICE IMPLICATIONS The current study should lead pediatric oncology nurses to be more aware of social exclusion and internalized and externalized behavioral problems in adolescents with cancer after clinical treatment, and to provide appropriate psycho-oncological care.
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Affiliation(s)
- Yağmur Sezer Efe
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey.
| | - Harun Özbey
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey.
| | - Nuray Caner
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey.
| | - Emine Erdem
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey.
| | | | - Musa Karakükçü
- Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Türkan Patıroğlu
- Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
| | - Ekrem Ünal
- Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ebru Yılmaz
- Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Alper Özcan
- Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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16
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Kim HY, Kang KA, Han SJ, Chun J. Web-Based Research Trends on Child and Adolescent Cancer Survivors Over the Last 5 Years: Text Network Analysis and Topic Modeling Study. J Med Internet Res 2022; 24:e32309. [PMID: 35103615 PMCID: PMC8848247 DOI: 10.2196/32309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/06/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Being diagnosed with cancer during childhood or adolescence can disrupt important periods in an individual’s physical, psychosocial, and spiritual development and potentially reduce the quality of life (QOL) after treatment. Research is urgently required to improve the QOL for child and adolescent cancer survivors, and it is necessary to analyze the trends in prior research reported in international academic journals to identify knowledge structures. Objective This study aims to identify the main keywords based on network centrality, subgroups (clusters) of keyword networks by using a cohesion analysis method, and the main theme of child and adolescent cancer survivor–related research abstracts through topic modeling. This study also aims to label the subgroups by comparing the results of the cohesion and topic modeling. Methods A text network analysis method and topic modeling were used to explore the main trends in child and adolescent cancer survivor research by structuring a network of keyword (semantic morphemes) co-occurrence in the abstracts of articles published in 5 major web-based databases from 2016 to 2020. A total of 1677 child and adolescent cancer survivor–related studies were used for data analyses. Data selection, processing, and analyses were also conducted. Results The top 5 keywords in terms of degree and eigenvector centrality were risk, control interval, radiation, childhood cancer treatment, and diagnosis. Of the 1677 studies used for data analyses, cluster 1 included 780 (46.51%) documents under risk management, cluster 2 contained 557 (33.21%) articles under health-related QOL and supportive care, and cluster 3 consisted of 340 (20.27%) studies under cancer treatment and complications. Conclusions This study is significant in that it confirms the knowledge structure based on the main keywords and cross-disciplinary trends in child and adolescent cancer survivor research published in the last 5 years worldwide. The primary goal of child and adolescent cancer survivor research is to prevent and manage the various aspects of the problems encountered during the transition to a normal life and to improve the overall QOL. To this end, it is necessary to further revitalize the study of the multidisciplinary team approach for the promotion of age-specific health behaviors and the development of intervention strategies with increased feasibility for child and adolescent cancer survivors.
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Affiliation(s)
- Hyun-Yong Kim
- Logos Health Design Institute, Sahmyook University, Seoul, Republic of Korea
| | - Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Suk-Jung Han
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Jiyoung Chun
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
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17
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Powell T, Cohen J, Patterson P. Keeping Connected With School: Implementing Telepresence Robots to Improve the Wellbeing of Adolescent Cancer Patients. Front Psychol 2021; 12:749957. [PMID: 34867634 PMCID: PMC8636051 DOI: 10.3389/fpsyg.2021.749957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Adolescent cancer patients experience considerable absence from their education, contributing to poorer academic attainment and isolation from peers, and impacting wellbeing. Telepresence robots have been used to support the educational and social needs of young people with chronic illness. This article presents the results of the development and pilot-testing of a telepresence robot service in schools for adolescent cancer patients – the TRECA (Telepresence Robots to Engage CAncer patients in education) service. Methods: Phase I used semi-structured interviews (n = 25) to assess the views of patients, parents, schools and clinicians on the benefits, acceptability, barriers, and enablers of utilizing robots in schools for adolescent cancer patients. Results from Phase I informed the development of the TRECA service. Phase II used semi-structured interviews (n = 22) to assess the implementation experiences of adolescent cancer patients, and their families, schools, and keyworkers who pilot-tested the TRECA service. Results: Phase I demonstrated the need for telepresence technology in connecting adolescent cancer patients to school. Given the variable support during treatment, a telepresence robot service was considered an acceptable method of facilitating a school-patient connection. The recommendations provided in Phase I, such as the need for provision of ongoing education, training, and support to the patient and school, informed the development of the TRECA service. In Phase II, the themes of The necessity of stakeholder buy-in, A facilitator of meaningful connection, and One size does not fit all were generated. The TRECA service’s flexibility in meeting the needs of its users helped facilitate meaningful connections. Participants reported that these connections provided patients an enhanced sense of agency and wellbeing. The importance of stakeholder buy-in and taking an individualized approach to service delivery were also highlighted. Stakeholder miscommunication and lack of knowledge were key aspects of implementation needing improvement as the service is rolled out on a larger scale. Conclusion: Using telepresence robots to connect adolescents to school during cancer treatment was regarded as highly acceptable, facilitating peer and academic connection. By making stakeholder-recommended improvements to the TRECA service’s existing processes, the service will continue to grow in effectiveness and capacity.
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Affiliation(s)
| | - Jennifer Cohen
- Canteen Australia, Sydney, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Pandora Patterson
- Canteen Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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18
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Björklund AC, Granlund M, Santacroce SJ, Enskär K, Carlstein S, Björk M. Using ICF to Describe Problems With Functioning in Everyday Life for Children Who Completed Treatment for Brain Tumor: An Analysis Based on Professionals' Documentation. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:708265. [PMID: 36188761 PMCID: PMC9397836 DOI: 10.3389/fresc.2021.708265] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/25/2021] [Indexed: 01/13/2023]
Abstract
Background: Children treated for brain tumors often experience persistent problems affecting their activity performance and participation in everyday life, especially in school. Linking these problems to the International Classification of Functioning, Disability and Health (ICF) classification system can be described as affecting body function, activity performance, and/or participation. Services involved in the everyday life of the child have different focus and goals when meeting the child in context, which advantage the use of ICF to overcome this impediment to follow-up and provide comprehensive support for children who have completed treatment for a brain tumor. Aim: The aim of the study was to use the ICF classification system to describe how professionals in healthcare, habilitation, and school document problems with everyday life functioning at body, activity, and participation levels for children who completed treatment for a brain tumor. Materials and Methods: A retrospective review of records from healthcare, habilitation, and school concerning nine children completed treatment for brain tumor was implemented. Identified problems in everyday life were linked to ICF codes. Descriptive statistics of ICF-linked code frequency supplemented by network visualization diagrams viewing the co-occurrence between codes within the body, activity participation, and environmental components were performed. Results: Most documented problems were found in healthcare records, whereas the documentation in habilitation and school was sparse. The frequently occurring codes, independent of record source, were linked to the body function component, and ICF-linked problems in habilitation and school were salient in the activity and participation component. To gain a holistic picture of relations between ICF codes and problems, network visualization diagrams were used to illustrate clusters of problems. Conclusion: Code prevalence likely reflects where healthcare professionals and educators focus their attention when meeting the needs of children treated for a brain tumor in context. To maximize the comprehensive view of functioning and participation of children in everyday life, the full range of difficulties regarding body impairments, activity limitations, and participation restrictions must be identified and linked to each other in patterns of co-occurrence, which the ICF facilitate. However, ICF provides no guidance on how to identify networks of problems within the body, activity, and participation. Identifying such networks is important for building comprehensive interventions for children.
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Affiliation(s)
- Ann-Christin Björklund
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Pediatric Hematology and Oncology, Uppsala University Hospital, Uppsala, Sweden
- *Correspondence: Ann-Christin Björklund
| | - Mats Granlund
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Sheila Judge Santacroce
- School of Nursing and Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Karin Enskär
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
| | - Stefan Carlstein
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maria Björk
- CHILD Research Group, Swedish Institute for Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
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19
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Parents' perception of their children's process of reintegration after childhood cancer treatment. PLoS One 2020; 15:e0239967. [PMID: 33002084 PMCID: PMC7529258 DOI: 10.1371/journal.pone.0239967] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 09/16/2020] [Indexed: 02/02/2023] Open
Abstract
Our objective was to further the understanding of the process of reintegration of childhood cancer patients after treatment and to identify factors influencing that process. Using a qualitative approach, we conducted 49 interviews with parents (n = 29 mothers, n = 20 fathers) from 31 families with a child (<18 years) with leukemia or CNS tumor. Interviews were conducted about 16 to 24 months after the end of the treatment. We used a semi-structured interview guideline and analyzed the data using content analysis. Average age of pediatric cancer patients was 5.5 years at the time of diagnosis; mean time since diagnosis was 3.5 years. Parents reported immediate impact of the disease on their children. Reintegration had gone along with delayed nursery/school enrollment or social challenges. In most cases reintegration was organized with a gradual increase of attendance. Due to exhaustion by obligatory activities, reintegration in leisure time activities was demanding and parents reported a gradual increase of activity level for their children. Parents described several barriers and facilitators influencing the reintegration process into nursery/school and leisure time activities (structural support, social support, health status, intrapersonal aspects). Although many children reintegrate well, the process takes lots of effort from parents and children. Childhood cancer survivors and their families should be supported after the end of intensive treatment to facilitate reintegration.
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20
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Nielsen MKF, Christensen JF, Frandsen TL, Thorsteinsson T, Andersen LB, Christensen KB, Wehner PS, Hasle H, Adamsen LØ, Schmiegelow K, Larsen HB. Effects of a physical activity program from diagnosis on cardiorespiratory fitness in children with cancer: a national non-randomized controlled trial. BMC Med 2020; 18:175. [PMID: 32624004 PMCID: PMC7336676 DOI: 10.1186/s12916-020-01634-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Children with cancer experience impaired cardiorespiratory fitness and physical function during and after treatment restricting their possibilities to engage in social activities including sport, leisure activities, and school. The objectives were to determine the effects of classmate-supported, controlled, supervised, in-hospital, physical activity program to preserve cardiorespiratory fitness and physical function from time of diagnosis in children with cancer. METHODS National non-randomized controlled trial including schoolchildren aged 6-18 years at diagnosis treated with chemo-/radiotherapy. We included 120 of 128 eligible patients (94%) in the intervention group (62.5% boys, 11.2 ± 3.1 years) from East Denmark and 58 patients in the control group (57% boys, 11.0 ± 3.2 years) from West Denmark. Eight children from the control group withdrew from participation. The groups were comparable in anthropometrics and cancer diagnoses (p > 0.05). The intervention consisted of (i) supervised in-hospital physical activity from diagnosis and throughout intensive treatment, (ii) 90-min general educational session on cancer and therapy in the child's school class, and (iii) selection of two classmates as ambassadors who took turns to support the child's physical training during the daytime. The primary outcome was cardiorespiratory fitness (VO2peak, mL/min/kg) at 6 months after diagnosis (sex, age, diagnosis adjusted). Secondary outcomes were sit-to-stand, timed-up-and-go, handgrip strength, and balance test scores. RESULTS Ambassadors were identified for all, and 2542 individual and 621 group training sessions were held. VO2peak deteriorated over time in the control group (- 0.17 [95% CI - 0.32 to - 0.02] per week, p = 0.02), but not in the intervention group (p = 0.14). At 6 months from diagnosis, VO2peak was higher in the intervention group (29.6 ± 5.6 mL/kg/min) than in the control group (22.1 ± 5.6 mL/kg/min) (p = 0.01), and the intervention group had a better physical function at 3 and 6 months (p < 0.0001). CONCLUSIONS Peer-supported, supervised, in-hospital, physical activity is safe and feasible in children with cancer during treatment. Further, the results suggest that the intervention might mitigate impairments in cardiorespiratory fitness during treatment in children with cancer. TRIAL REGISTRATION The study was prospectively registered on the 11 January 2013. Clinicaltrial.gov NCT01772849 and NCT01772862 .
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Affiliation(s)
- Martin Kaj Fridh Nielsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark.,The University of Copenhagen, Faculty of Health Science, Institute for Clinical Medicine, Copenhagen, Denmark
| | - Jesper Frank Christensen
- Center for Inflammation and Metabolism/Center for Physical Activity (CIM/CFAS), University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Thomas Leth Frandsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Troels Thorsteinsson
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School for Sports Sciences, Oslo, Norway.,Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences,Western Norway University of Applied Sciences, Post box 133, 6851, Sognal, Norway
| | | | - Peder Skov Wehner
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Henrik Hasle
- Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lis Ørgaard Adamsen
- Faculty of Health Science, Department of Public Health, Institute for Clinical Medicine, The University of Copenhagen, Copenhagen, Denmark.,The University Hospitals Centre for Health Research (UCSF), University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark.,The University of Copenhagen, Faculty of Health Science, Institute for Clinical Medicine, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
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21
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Smith J, Rapport F, O’Brien TA, Smith S, Tyrrell VJ, Mould EVA, Long JC, Gul H, Cullis J, Braithwaite J. The rise of rapid implementation: a worked example of solving an existing problem with a new method by combining concept analysis with a systematic integrative review. BMC Health Serv Res 2020; 20:449. [PMID: 32438909 PMCID: PMC7240003 DOI: 10.1186/s12913-020-05289-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 05/03/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The concept of rapid implementation has emerged in the literature recently, but without a precise definition. Further exploration is required to distinguish the concept's unique meanings and significance from the perspective of implementation science. The study clarifies the concept of rapid implementation and identifies its attributes, antecedents, and consequences. We present a theoretical definition of rapid implementation to clarify its unique meaning and characteristics. METHODS Rodgers evolutionary concept analysis method, combined with a systematic integrative review, were used to clarify the concept of rapid implementation. A comprehensive search of four databases, including EMBASE, MEDLINE, SCOPUS, and WEB OF SCIENCE was conducted, as well as relevant journals and reference lists of retrieved studies. After searching databases, 2442 papers were identified from 1963 to 2019; 24 articles were found to fit the inclusion criteria to capture data on rapid implementation from across healthcare settings in four countries. Data analysis was carried out using descriptive thematic analysis. RESULTS The results locate the introduction of rapid implementation, informed by implementation science. Guidance for further conceptualisation to bridge the gap between research and practice and redefine rigour, adapting methods used (current approaches, procedures and frameworks), and challenging clinical trial design (efficacy-effectiveness-implementation pipeline) is provided. CONCLUSIONS It is possible that we are on the cusp of a paradigm shift within implementation brought about by the need for faster results into practice and policy. Researchers can benefit from a deeper understanding of the rapid implementation concept to guide future implementation of rapid actionable results in clinical practice.
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Affiliation(s)
- James Smith
- Centre for Healthcare Resilience and Implementation Science, Australian Institute for Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Frances Rapport
- Centre for Healthcare Resilience and Implementation Science, Australian Institute for Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Tracey A. O’Brien
- Faculty of Medicine, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Sydney, Australia
| | - Stephanie Smith
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 Australia
- Perth Children’s Hospital, Nedlands, Perth, Australia
| | - Vanessa J. Tyrrell
- Lowy Cancer Research Centre, Children’s Cancer Institute, University of New South Wales, C25/9 High Street, University of New South Wales, Kensington NSW, Sydney, 2750 Australia
| | - Emily V. A. Mould
- Lowy Cancer Research Centre, Children’s Cancer Institute, University of New South Wales, C25/9 High Street, University of New South Wales, Kensington NSW, Sydney, 2750 Australia
| | - Janet C. Long
- Centre for Healthcare Resilience and Implementation Science, Australian Institute for Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Hossai Gul
- Centre for Healthcare Resilience and Implementation Science, Australian Institute for Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Jeremy Cullis
- Clinical librarian, Information Access and Advisory Services, Macquarie University Library, Macquarie University, 16 Macquarie Walk, North Ryde, NSW 2109 Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute for Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
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