1
|
Boensvang NN, Weibel M, Wakefield CE, Bidstrup PE, Olsen M, Nissen KB, Spager V, Fridh MK, Larsen HB. Online Ambassador Visits for Hospitalized Children With Cancer: Qualitative Evaluation of Implementation. JMIR Pediatr Parent 2024; 7:e53309. [PMID: 39231427 PMCID: PMC11411222 DOI: 10.2196/53309] [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: 10/03/2023] [Revised: 05/30/2024] [Accepted: 06/12/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Children with cancer or cancer-like disease risk treatment-related isolation, which can negatively impact their peer relationships and social competencies and exacerbate their loneliness. During the COVID-19 pandemic, increased online socialization became the new normal imposed by national isolation guidelines. To adhere to the treatment-related isolation guidelines, children with cancer were offered online classmate "ambassador" visits during hospitalization. OBJECTIVE This study aimed to identify facilitators and barriers to online classmate "ambassador" visits during children with cancer's hospitalization through a qualitative descriptive process evaluation using the Consolidated Framework for Implementation Research. METHODS From January to April 2022, we conducted 39 individual semistructured interviews with hospitalized children (n=16), their classmates (n=16), teachers from their schools (n=3), and study nurses (n=4) from involved hospitals. Most interviews (n=37, 95%) were conducted online using Microsoft Teams or Google Meet, while 2 (5%) interviews were conducted in person at the participants' residences. This approach allowed us to gain a broad understanding of the facilitators and barriers to online ambassador visits. RESULTS We identified four themes: (1) working together, (2) ensuring participation, (3) staying connected, and (4) together online. The themes are described in terms of facilitators and barriers to online ambassador visits with 3 Consolidated Framework for Implementation Research domains: innovation, individuals, and the implementation process. CONCLUSIONS Addressing the social needs of hospitalized children through online visits with their classmates may be relevant when one-on-one meetings are problematic. The online visits are highly dependent on collaboration between study nurses and teachers and assessing the needs of the hospitalized children. While a high degree of adult engagement and a stable internet connection are pivotal, these online visits can promote much-needed social interaction between children across physical settings.
Collapse
Affiliation(s)
- Natasha Nybro Boensvang
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Mette Weibel
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Claire E Wakefield
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School for Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Paediatrics and Adolescent Medicine, Paediatric Haematology and Oncology Section, University Hospital Aalborg, Aalborg, Denmark
| | - Karin Bækgaard Nissen
- Department of Paediatric and Adolescent Medicine, University Hospital Aarhus, Aarhus, Denmark
| | - Vibeke Spager
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Paediatrics and Adolescent Medicine, University Hospital of Copehagen (Rigshospitalet), Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
- The Paediatric Clinic, Juliane Marie Centre, University Hospital of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Rossi F, Botti S, Morri M, Asaftei S, Bertin D, Breggiè S, Casalaz R, Cervo M, Ciullini P, Coppo M, Cornelli A, Esposito M, Ferrarese M, Ghetti M, Longo L, Naretto G, Orsini N, Panzeri D, Pellegrini C, Peranzoni M, Perna A, Petit N, Picone F, Pittorru G, Raffa D, Recchiuti V, Rizzato L, Sarzana M, Sensi R, Fagioli F, Ricci F. The Italian Consensus Conference on the role of rehabilitation for children and adolescents with leukemia, central nervous system tumors, and bone cancer, part 2: general principles for the rehabilitation treatment of motor function impairments. Pediatr Hematol Oncol 2024; 41:346-366. [PMID: 38984654 DOI: 10.1080/08880018.2024.2353360] [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: 09/30/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 07/11/2024]
Abstract
In Italy, 1400 children and 800 adolescents are diagnosed with cancer every year. About 80% of them can be cured but are at high risk of experiencing severe side effects, many of which respond to rehabilitation treatment. Due to the paucity of literature on this topic, the Italian Association of Pediatric Hematology and Oncology organized a Consensus Conference on the role of rehabilitation of motor impairments in children/adolescents affected by leukemia, central nervous system tumors, and bone cancer to state recommendations to improve clinical practice. This paper includes the consensus on the rehabilitation of children and adolescents with these cancers.
Collapse
Affiliation(s)
- Francesca Rossi
- Rehabilitation Service, Public Health and Pediatric Sciences Department, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Stefano Botti
- Haematology Unit, Oncology and Advanced Technology Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Mattia Morri
- Nursing, Technical and Rehabilitation Assistance Service, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | - Sebastian Asaftei
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Daniele Bertin
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Simona Breggiè
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Casalaz
- Paediatric Oncohematology, Unit Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Marta Cervo
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Paola Ciullini
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Monica Coppo
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Annalisa Cornelli
- Pediatric Oncology Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Miriana Ferrarese
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Marina Ghetti
- Pediatric Hematology Department, A.O.U. Policlinico Umberto I-Rome, Rome, Italy
| | - Lucia Longo
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Gabriella Naretto
- Rehabilitation, Department of Pediatric Orthopedics Unit A.O.U. Città della Salute e della Scienza, Regina Margherita Children's Hospital, Turin, Italy
| | - Nicoletta Orsini
- Physical Therapy and Rehabilitation Department, Children's Hospital Giannina Gaslini, Genoa, Italy
| | - Daniele Panzeri
- Neuro-oncological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | - Chiara Pellegrini
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Peranzoni
- Department of Physiotherapy, Hospital of Bolzano, Health Trust, Bolzano, Italy
| | - Antonella Perna
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, University Hospital St. Orsola-Malpighi, Bologna, Italy
| | - Nadine Petit
- Pediatric Hematology Department, A.O.U. Policlinico Umberto I-Rome, Rome, Italy
| | - Fabiola Picone
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Gianna Pittorru
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, University Hospital St. Orsola-Malpighi, Bologna, Italy
| | - Debora Raffa
- Nursing, Technical and Rehabilitation Assistance Service, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | - Veronica Recchiuti
- Physical Therapy Neuroscience Department and Functional Rehabilitation, Children's Hospital Bambino Gesù, Rome, Italy
| | - Lucia Rizzato
- Complex Operative Unit of Orthopaedic Rehabilitation, AO of Padua, Padua, Italy
| | - Marina Sarzana
- Pediatric Immunohematology Unit and Stem Cell Program, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Sensi
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Federica Ricci
- Division of Child Neurology and Psychiatry A.O.U. Città della Salute e della Scienza, Regina Margherita Children's Hospital, Turin, Italy
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Caru M, Heitzenrater J, Schmitz KH. The importance of cardiopulmonary exercise test to improve supportive care in adolescent and young adult survivors of childhood cancer. Pediatr Res 2023; 94:850-851. [PMID: 36934214 PMCID: PMC11225587 DOI: 10.1038/s41390-023-02569-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 02/27/2023] [Accepted: 03/04/2023] [Indexed: 03/20/2023]
Affiliation(s)
- Maxime Caru
- Department of Pediatric, Division of Hematology and Oncology, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Jared Heitzenrater
- Public Health Science, Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, USA
| | - Kathryn H Schmitz
- Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
5
|
Miyatake H, Onishi T, Kaneda Y, Ozaki A, Tanimoto T, Beniya H. Possibility for Children with Medical Complexities to Reach a 3000-m Peak: A Report of 2 Cases. Wilderness Environ Med 2023; 34:383-387. [PMID: 37438154 DOI: 10.1016/j.wem.2023.05.008] [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: 01/02/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 07/14/2023]
Abstract
With the recent development of neonatal medicine, the number of children with medical complexities (CMCs) is increasing. Outdoor activities are important for their psychosocial development, and the principles of accessibility should be addressed. We report the experience of 2 CMCs' high-altitude mountaineering with the necessary support. The participants were a 3-y-old girl with cerebral palsy, symptomatic epilepsy, and a ventriculoperitoneal shunt (Child A) and a 6-y-old girl who underwent bilateral Glenn operations at 11 mo for hypoplastic left heart syndrome (Child B). The support staff consisted of 4 doctors, 1 nurse, 5 nonmedical staff , 3 members from a mountaineering association, and 2 people from an oxygen company. The climbing schedule was 2 days. On the first day, we took a bus to a hut at an altitude of 2450 m and stayed overnight to acclimatize to the altitude. On the second day, we took the beginner's route, which took 3 h to climb 500 m, and our team made an attempt on the summit. During the attempt, Child B panicked. Although her lung sounds did not raise suspicions of pulmonary edema, we decided to leave the mountain with her because her transcutaneous oxygen saturation decreased. Child A had no apparent health problems and made it to the summit. Although CMCs' alpine climbing requires careful planning and staffing considering the risk of high-altitude sickness, our case suggests the feasibility of such activities with CMCs as part of accessibility.
Collapse
Affiliation(s)
| | - Toya Onishi
- School of Medicine, Shiga University of Medical Science, Otsu City, Shiga Prefecture, Japan
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima Prefecture, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato City, Tokyo, Japan
| | - Hiroyuki Beniya
- Orange Home-Care Clinic, Fukui City, Fukui Prefecture, Japan
| |
Collapse
|
6
|
Carniel CF, Rosin BM, de Souza BC, Raimundo RD. Pediatric oncohematological exercise program in hospital: clinical trial study protocol. Future Oncol 2023; 19:1385-1395. [PMID: 37497690 DOI: 10.2217/fon-2023-0189] [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: 07/28/2023] Open
Abstract
Leukemias are the most common types of hematological cancers in children, and negatively impact functional capacity. There is evidence in the literature that therapeutic exercises can have a positive impact on functions. The aim of this study is to evaluate functional capacity, muscle strength, fatigue and quality of life through the application of a protocol of therapeutic exercises during pediatric leukemia hospitalization. Children will be allocated into two groups: one will carry out a protocol of therapeutic exercises, while the other will undergo conventional respiratory physiotherapy. The protocol is approved by the ethics and research committee of the host institution (No. 5.439.594). Results will be disseminated through peer-reviewed journal articles and conferences. Clinical trial registration: RBR-8sxnfyd (https://ensaiosclinicos.gov.br).
Collapse
Affiliation(s)
- Cintia Freire Carniel
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Beatriz M Rosin
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Bruna Cunha de Souza
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Rodrigo Daminello Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| |
Collapse
|
7
|
Pouplier A, Larsen HB, Christensen J, Schmidt-Andersen P, Winther H, Fridh MK. The rehabilitation including structured active play (RePlay) model: A conceptual model for organizing physical rehabilitation sessions based on structured active play for preschoolers with cancer. Front Pediatr 2022; 10:980257. [PMID: 36238603 PMCID: PMC9551994 DOI: 10.3389/fped.2022.980257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022] Open
Abstract
Anti-cancer treatments, as well as cancer itself, reduce children's cardiorespiratory fitness, muscle strength, and gross motor functions. Early rehabilitation programs, including physical activity for childhood cancer patients, can counteract these adverse effects. Previous studies of school-aged children (6-18 years old) indicate that physical activity, including aerobic and resistance training, is safe, feasible, and effective. The goal of structured physical activity rehabilitation for preschool children (1-5 years old) is to support gross motor development and opportunities to move freely in various ways. Specific rehabilitation for preschoolers diagnosed with cancer is needed to promote physical-, social-, and personal development. This paper introduces a conceptual model-The RePlay (Rehabilitation including structured active play) Model-for organizing physical rehabilitation sessions based on structured active play for preschoolers with cancer. The theory and empirically based model combine knowledge of early childhood development, play, physical activity and rehabilitation for children with cancer, and cancer treatment. With this model, we propose how to structure rehabilitation sessions, including goal-oriented, age-sensitive, fun movement activities that facilitate preschoolers to develop gross motor skills while enhancing their social and personal skills, through four core principles: (1) ritual practices, (2) reinforcement of movement through repetition, (3) development through appropriate challenge, and (4) adjusting activities to accommodate treatment-related side effects. This model holds promise for use with preschoolers diagnosed with cancer, as it is scalable and pragmatic and accounts for the children's fluctuating physical capacity and daily wellbeing during cancer treatment.
Collapse
Affiliation(s)
- Anna Pouplier
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Center of Head and Orthopedic Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Peter Schmidt-Andersen
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational Therapy and Physiotherapy, Center of Head and Orthopedic Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Helle Winther
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
8
|
Schmidt-Andersen P, Fridh MK, Müller KG, Anna Pouplier, Hjalgrim LL, Faigenbaum AD, Schmiegelow K, Hasle H, Lykkedegn S, Zhang H, Christensen J, Larsen HB. Integrative Neuromuscular Training in Adolescents and Children Treated for Cancer (INTERACT): Study Protocol for a Multicenter, Two-Arm Parallel-Group Randomized Controlled Superiority Trial. Front Pediatr 2022; 10:833850. [PMID: 35359909 PMCID: PMC8964065 DOI: 10.3389/fped.2022.833850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/19/2022] Open
Abstract
Background Improved survival rates for children and adolescents diagnosed with cancer call for novel strategies for reducing short- and long-term treatment-related side effects. These include the physical and metabolic sequelae that are exacerbated by sedentary behavior and treatment-induced toxicities. We aim to investigate the effect of an integrative neuromuscular training intervention during the first 6 months of anti-cancer treatment primarily on muscle strength, and secondarily on exercise capacity, physical function, markers of metabolic syndrome, dysmetabolism, and health-related quality of life during and after ended treatment. Methods One hundred and twenty-seven children and adolescents, newly diagnosed with malignant and benign neoplasia, aged 6-17 years, and treated with chemotherapy or radiation will be randomized to either the intervention or the control arm of the study. The intervention group will, in addition to usual care, be offered a combination of 6 months of supervised physical exercise (integrative neuromuscular training) and home-based exercise. The active control group will, in addition to usual care, receive information along an unsupervised written home-based training program. All participants, including parents, will receive information about the importance of physical exercise during the course of cancer treatment, at the start of treatment, and in 5 monthly sessions. The primary outcome is measured in terms of isometric quadriceps muscle strength. Secondary outcomes include muscle strength and endurance, markers of metabolic syndrome and dysmetabolism, exercise capacity, physical function and activity, days of hospitalization, and health-related quality of life. Assessment will be conducted at treatment initiation (baseline), at 3 and 6 months after inclusion, and 1 month and 1 year after ended treatment. The primary endpoint for lower-body muscle strength is at 6 months after treatment initiation. The effects of the intervention will be evaluated through a constrained linear mixed model. Discussion This national randomized controlled study has the potential to provide new knowledge concerning the short- and long-term effects of a novel, inclusive approach for youth exercise programming (integrative neuromuscular exercise) in children and adolescents during anti-cancer treatment. Using a pragmatic, low-cost, and time-efficient training design, this intervention can be easily adapted to both hospital and home settings. Clinical Trial Registration ClinicalTrials.gov (NCT04706676), first released January 5, 2021.
Collapse
Affiliation(s)
- Peter Schmidt-Andersen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Klaus Gottlob Müller
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Avery D. Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, United States
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Sine Lykkedegn
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - He Zhang
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
9
|
Wibroe M, Ingersgaard MV, Larsen HB, Juhler M, Piil K. Living with the cerebellar mutism syndrome: long-term challenges of the diagnosis. Acta Neurochir (Wien) 2021; 163:1291-1298. [PMID: 32621064 DOI: 10.1007/s00701-020-04479-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/30/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND After posterior fossa tumour surgery, up to 39% of children experience postoperative cerebellar mutism syndrome (CMS) characterized by mutism and other motor and cognitive impairments. There is a lack of knowledge on the patient-reported challenges and long-term needs. Consequently, no specific recommendations exist for rehabilitative and supportive interventions for patients with CMS. The aims of this study were to explore the patients' experiences related to the sequelae of CMS, to identify challenges and needs regarding support and rehabilitation in the period of growing from child to adult and to add perspectives for future developments of supportive care and rehabilitative guidelines. METHODS Ten semi-structured interviews were conducted with young adults diagnosed with CMS as children. A thematic analysis identified four themes describing challenges impacting aspects of the participants' lives. RESULTS Four main themes were identified and highlight the rehabilitative need for focus on verbal and non-verbal communication skills in addition to the physical impairments. We found that brain tumour survivors with CMS can benefit from social and educational rehabilitation, straightforward and truthful information, support in structuring their everyday lives and increased public knowledge of CMS. CONCLUSION Children with CMS face a variety of challenges affecting many aspects of their everyday lives. They should be entitled to the elements of a current rehabilitation initiative for childhood cancer to support patients' social disability and educational decline. Finally, we identified a need for an official information publication.
Collapse
Affiliation(s)
- Morten Wibroe
- Department of Neurosurgery and Paediatric Department, 2092, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Marianne Vie Ingersgaard
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Bonkolab 5704, Blegdamsvej 9, Copenhagen, Denmark
| | - Marianne Juhler
- Department of Neurosurgery, 2092, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Center for Cancer and Organ diseases, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Department of Public Health, Aarhus University, Aarhus, Denmark.
| |
Collapse
|
10
|
Andrés-Jensen L, Skipper MT, Mielke Christensen K, Hedegaard Johnsen P, Aagaard Myhr K, Kaj Fridh M, Grell K, Pedersen AML, Leisgaard Mørck Rubak S, Ballegaard M, Hørlyck A, Beck Jensen R, Lambine TL, Gjerum Nielsen K, Tuckuviene R, Skov Wehner P, Klug Albertsen B, Schmiegelow K, Frandsen TL. National, clinical cohort study of late effects among survivors of acute lymphoblastic leukaemia: the ALL-STAR study protocol. BMJ Open 2021; 11:e045543. [PMID: 33563628 PMCID: PMC7875271 DOI: 10.1136/bmjopen-2020-045543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION More than 90% of patients diagnosed with childhood acute lymphoblastic leukaemia (ALL) today will survive. However, half of the survivors are expected to experience therapy-related chronic or late occurring adverse effects, reducing quality of life. Insight into underlying risk trajectories is warranted. The aim of this study is to establish a Nordic, national childhood ALL survivor cohort, to be investigated for the total somatic and psychosocial treatment-related burden as well as associated risk factors, allowing subsequent linkage to nation-wide public health registers. METHODS AND ANALYSIS This population-based observational cohort study includes clinical follow-up of a retrospective childhood ALL survivor cohort (n=475), treated according to a common Nordic ALL protocol during 2008-2018 in Denmark. The study includes matched controls. Primary endpoints are the cumulative incidence and cumulative burden of 197 health conditions, assessed through self-report and proxy-report questionnaires, medical chart validation, and clinical examinations. Secondary endpoints include organ-specific outcome, including cardiovascular and pulmonary function, physical performance, neuropathy, metabolic disturbances, hepatic and pancreatic function, bone health, oral and dental health, kidney function, puberty and fertility, fatigue, and psychosocial outcome. Therapy exposure, acute toxicities, and host genome variants are explored as risk factors. ETHICS AND DISSEMINATION The study is approved by the Regional Ethics Committee for the Capital Region in Denmark (H-18035090/H-20006359) and by the Danish Data Protection Agency (VD-2018-519). Results will be published in peer-reviewed journals and are expected to guide interventions that will ameliorate the burden of therapy without compromising the chance of cure.
Collapse
Affiliation(s)
- Liv Andrés-Jensen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette Tiedemann Skipper
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kathrine Grell
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - A M L Pedersen
- Section of Oral Medicine/Oral Biology and Immunopathology, Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | | | - Martin Ballegaard
- Department of Neurology, Zealand University Hospital Roskilde, Roskilde, Denmark
- Institute of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Arne Hørlyck
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Rikke Beck Jensen
- Department of Growth and Reproduction, Copenhagen University Hospital, Copenhagen, Denmark
| | - Trine-Lise Lambine
- Department of Radiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kim Gjerum Nielsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Ruta Tuckuviene
- Department of Pediatrics, Aalborg University Hospital, Aalborg, Denmark
| | - Peder Skov Wehner
- Department of Pediatric Hematology and Oncology, Odense University Hospital, Odense, Denmark
| | - Birgitte Klug Albertsen
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Thomas Leth Frandsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
11
|
Ingersgaard MV, Fridh MK, Thorsteinsson T, Adamsen L, Schmiegelow K, Baekgaard Larsen H. A qualitative study of adolescent cancer survivors perspectives on social support from healthy peers - A RESPECT study. J Adv Nurs 2021; 77:1911-1920. [PMID: 33470450 DOI: 10.1111/jan.14732] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/17/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adolescents' psychosocial development is generally influenced by their peers. Those facing hospital-based cancer treatment are particularly challenged as they are isolated from their social network and lack sufficient coping resources. AIM This study explores the adolescent cancer survivor's perceptions and experiences with healthy classmate socialization support efforts via hospital co-admittance, from diagnosis to reinstatement in school, as an intervention of the RESPECT (REhabilitation including Social and Physical Activity and Education in Children and Teenagers with cancer) Study. DESIGN A phenomenological, descriptive study. METHODS Using variation sampling, 14 adolescents (aged 14-19), who completed the RESPECT intervention (April 2016-July 2017), participated in qualitative, in-depth, semi-structured interviews that were thematically analysed. FINDINGS Four themes emerged: (a) Ambassadors as liaison persons; (b) Ambassadors as promoters of normalization and identity continuity; (c) Ambassadors as 'behind the scenes' friends; and (d) feelings of vulnerability and inferiority. Ambassadors reinstated a sense of normalcy in the adolescents' daily life. They supported identity construction and served as liaison persons who buffered loneliness and social isolation as well as bridging a continued sense of belonging to one's school peer network. In contrast with other peers, ambassadors understood cancer-related issues, knowledge which they partially gained witnessing the impact of treatment-related side effects on their hospitalized classmates. However, the consequence of this trade-off was an asymmetry in their relationship, with the adolescents requiring a certain level of safeguard from their ambassadors to maintain equal power in the relationship. CONCLUSION The ambassadors enhanced the adolescents' ability to cope with their altered social position during treatment and to psychosocially reinstate it on their return to school. IMPACT Future interventions should offer opportunities for healthy peers to be educated in what it means to live with cancer. Future programs to sustain socialization in adolescents with cancer should involve healthy peers for the entirety of the treatment period.
Collapse
Affiliation(s)
- Marianne Vie Ingersgaard
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Martin Kaj Fridh
- 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
| | - Lis Adamsen
- Department of Public Health and Faculty of Health Sciences, The University Hospitals Centre for Nursing and Care Research (UCSF), Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Department of Public Health and Faculty of Health Sciences, The University Hospitals Centre for Nursing and Care Research (UCSF), Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| |
Collapse
|
12
|
Rossi F, Ricci F, Botti S, Bertin D, Breggiè S, Casalaz R, Cervo M, Ciullini P, Coppo M, Cornelli A, Esposito M, Ferrarese M, Ghetti M, Longo L, Morri M, Naretto G, Orsini N, Fagioli F. The Italian consensus conference on the role of rehabilitation for children and adolescents with leukemia, central nervous system, and bone tumors, part 1: Review of the conference and presentation of consensus statements on rehabilitative evaluation of motor aspects. Pediatr Blood Cancer 2020; 67:e28681. [PMID: 32940000 DOI: 10.1002/pbc.28681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 11/06/2022]
Abstract
Because of increasing survival rates in pediatric oncology, attention is focusing on cancer and its treatment-related side effects. Rehabilitation may reduce their impact. However, the literature does not provide strong evidence regarding rehabilitation pathways. Therefore, the Italian Association of Pediatric Hematology and Oncology organized a consensus conference on the role of rehabilitation of motor impairments in children/adolescents affected by leukemia, central nervous system, and bone tumors to define recommendations for daily practice. The grading of recommendation assessment, developing and evaluation (GRADE) method was used in order to formulate questions, select outcomes, evaluate evidence, and create recommendations. This paper includes the results on the rehabilitation assessment.
Collapse
Affiliation(s)
- Francesca Rossi
- Rehabilitation Service, Public Health and Pediatric Sciences Department, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, Turin, Italy
| | - Federica Ricci
- Division of Child Neurology and Psychiatry, A.O.U. Città della Salute e della Scienza, Regina Margherita Children's Hospital, Turin, Italy
| | - Stefano Botti
- Haematology Unit, Oncology and Advanced Technology Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Daniele Bertin
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, Turin, Italy
| | - Simona Breggiè
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Casalaz
- Paediatric Oncohematology Unit Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Marta Cervo
- Functional Rehabilitation Unit-A.O.U. Meyer, Florence, Italy
| | - Paola Ciullini
- Functional Rehabilitation Unit-A.O.U. Meyer, Florence, Italy
| | - Monica Coppo
- Health Professions of Rehabilitation Sciences, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Annalisa Cornelli
- Pediatric Oncology Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maria Esposito
- Rehabilitation Service, Public Health and Pediatric Sciences Department, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, Turin, Italy
| | - Miriana Ferrarese
- Health Professions of Rehabilitation Sciences, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Marina Ghetti
- Pediatric Hematology Department, A.O.U. Policlinico Umberto I-Rome, Rome, Italy
| | - Lucia Longo
- Health Professions of Rehabilitation Sciences, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Mattia Morri
- IRCCS Rizzoli Orthopedic Institute, Nursing, Technical and Rehabilitation Assistance Service, Bologna, Italy
| | - Gabriella Naretto
- Rehabilitation Department of Pediatric Orthopedics Unit, A.O.U. Cittàdella Salute e dellaScienza, Regina Margherita Children's Hospital, Turin, Italy
| | - Nicoletta Orsini
- Physical Therapy and Rehabilitation, Department Children's Hospital Giannina Gaslini, Genoa, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, Turin, Italy
| | | |
Collapse
|
13
|
Andrés‐Jensen L, Larsen HB, Johansen C, Frandsen TL, Schmiegelow K, Wahlberg A. Everyday life challenges among adolescent and young adult survivors of childhood acute lymphoblastic leukemia: An in‐depth qualitative study. Psychooncology 2020; 29:1630-1637. [DOI: 10.1002/pon.5480] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Liv Andrés‐Jensen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Christoffer Johansen
- Late Effects Research Unit CASTLE, Finsen Center Copenhagen University Hospital Copenhagen Denmark
- Survivorship Research Unit Danish Cancer Society Center Copenhagen Denmark
| | - Thomas Leth Frandsen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Copenhagen Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Ayo Wahlberg
- Department of Anthropology University of Copenhagen Copenhagen Denmark
| |
Collapse
|
14
|
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 .
Collapse
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.
| |
Collapse
|
15
|
Feasibility and Validity of the Actiheart Activity Monitor in Children Who Were Hospitalized With Cancer Coadmitted With Classmates: A RESPECT Study. Pediatr Phys Ther 2020; 32:226-233. [PMID: 32604366 DOI: 10.1097/pep.0000000000000712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE We investigated the feasibility of the Actiheart monitor to determine total daily energy expenditure and the validity of the Actiheart step test as an accurate estimate of peak oxygen uptake. METHODS (Equation is included in full-text article.)O2 peak was estimated with the Actiheart step test and compared with a cardiopulmonary exercise test. Total daily energy expenditure was measured using the Actiheart monitor on days with and without classmate coadmission. RESULTS Of 26 eligible measurement periods (15 children), 89% participated and 91% could participate safely; however, 35% fulfilled demands for valid monitoring. The percentage of children not completing the monitoring period was 10% (attrition) and adherence to classmate visits was 84%. Forty-eight percent of the measurement periods provided data, and only 27% was calibrated data. Actiheart step test significantly overestimated (Equation is included in full-text article.)O2 peak compared with the Cardio Pulmonary Exercise Test. CONCLUSION Measuring total daily energy expenditure using Actiheart is not feasible, nor implementable in children with cancer. Furthermore, the Actiheart step test is not a valid test to estimate (Equation is included in full-text article.)O2 peak in children with cancer.
Collapse
|
16
|
Weibel M, Nielsen MKF, Topperzer MK, Hammer NM, Møller SW, Schmiegelow K, Bækgaard Larsen H. Back to school with telepresence robot technology: A qualitative pilot study about how telepresence robots help school-aged children and adolescents with cancer to remain socially and academically connected with their school classes during treatment. Nurs Open 2020; 7:988-997. [PMID: 32587717 PMCID: PMC7308694 DOI: 10.1002/nop2.471] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/23/2019] [Accepted: 02/16/2020] [Indexed: 11/06/2022] Open
Abstract
Aim To explore how an AV1 telepresence robot helps school-aged children and adolescents with cancer to remain socially and academically connected with their school classes during cancer treatment. Design Qualitative pilot study. Methods Data were collected through semi-structured interviews with school-aged children and adolescents (N = 3, 12-14 years) diagnosed with cancer, their parents (N = 3), teachers (N = 2), classmates (12-14 years, N = 15, focus group interviews) and healthcare professionals (N = 4). Participant observation was performed in the child or adolescents' homes and in the classrooms during education participation via an AV1 telepresence robot. Results Five themes emerged: expectations, sociality, learning, spatiality and technology. Participants experienced the robots as facilitating social interaction processes with classmates and inclusion in learning activities, reducing their sense of loneliness and lacking behind educationally. Nevertheless, multiple factors determine whether the robot is perceived as exclusive, including the technical functionality of the robot, spatiality in the classroom and mutual expectations of the parties involved.
Collapse
Affiliation(s)
- Mette Weibel
- Pediatric Oncology Research LaboratoryDepartment of Pediatrics and Adolescent MedicineThe Juliane Marie CenterUniversity Hospital (Rigshospitalet)CopenhagenDenmark
- Faculty of Health and Medical ScienceInstitute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Martin Kaj Fridh Nielsen
- Pediatric Oncology Research LaboratoryDepartment of Pediatrics and Adolescent MedicineThe Juliane Marie CenterUniversity Hospital (Rigshospitalet)CopenhagenDenmark
- Faculty of Health and Medical ScienceInstitute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Martha Krogh Topperzer
- Pediatric Oncology Research LaboratoryDepartment of Pediatrics and Adolescent MedicineThe Juliane Marie CenterUniversity Hospital (Rigshospitalet)CopenhagenDenmark
- Faculty of Health and Medical ScienceInstitute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Nanna Maria Hammer
- Pediatric Oncology Research LaboratoryDepartment of Pediatrics and Adolescent MedicineThe Juliane Marie CenterUniversity Hospital (Rigshospitalet)CopenhagenDenmark
- Faculty of Health and Medical ScienceInstitute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Copenhagen Palliative Team for Children and AdolescentsPediatric Oncology ResearchUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | | | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent MedicineRigshospitalet University HospitalCopenhagenDenmark
- Institute of Clinical MedicineFaculty of MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Hanne Bækgaard Larsen
- Pediatric Oncology Research LaboratoryDepartment of Pediatrics and Adolescent MedicineRigshospitaletUniversity Hospital of CopenhagenCopenhagenDenmark
| |
Collapse
|
17
|
Tan BWZ, Clarke A, Teo LL, Tong JWK, Chan MY. The parental experiences of caring for children with childhood cancers in Singapore: a pilot focus group study. PROCEEDINGS OF SINGAPORE HEALTHCARE 2020. [DOI: 10.1177/2010105820935915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Research on the parental experiences of caring for children diagnosed with cancer in Singapore are limited and not well understood. Objectives: We conducted a pilot focus group to understand the experiences of Singaporean parents whose child had survived cancer. Methods: Using convenience sampling, five parents were invited to participate in a focus group discussion regarding the psychosocial needs at the time of cancer diagnosis and into survivorship. The discussion was transcribed verbatim and analysed using Braun and Clarke’s 6-step approach to thematic analysis. Results: The analysis revealed three major themes of intrapersonal impact, interpersonal connectedness and financial implications. Conclusions: The identified themes indicated some universal and unique caregiving experiences among Singaporean parents and those reported in western and other Asian cultures. In particular, the findings provided an update on the parental experiences of caring for children with cancer in Singapore and highlighted the need for ongoing research and the development of early and holistic psychosocial support services for these parents.
Collapse
Affiliation(s)
| | - Alexis Clarke
- Psychology Service, KK Women’s and Children’s Hospital, Singapore
| | - Lois Ling’en Teo
- Psychology Service, KK Women’s and Children’s Hospital, Singapore
| | | | - Mei-Yoke Chan
- Haemotology/Oncology Service, KK Women’s and Children’s Hospital, Singapore
| |
Collapse
|
18
|
Thorsteinsson T, Schmiegelow K, Thing LF, Andersen LB, Helms AS, Ingersgaard MV, Lindgren LH, Larsen HB. Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study. Eur J Cancer Care (Engl) 2019; 28:e13121. [PMID: 31215079 DOI: 10.1111/ecc.13121] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 11/02/2018] [Accepted: 04/12/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Children with cancer experience reduced physical fitness and compromised social relationships during and following intensive treatment. This may negatively impact their quality of life. As part of the RESPECT study, we explored the motivations for participation in a physical activity programme during treatment. METHODS Thirteen semi-structured interviews were conducted with seven boys and six girls, diagnosed with paediatric cancer in 2013 and treated with chemotherapy (age 8-16 years; time from diagnosis to interview 6-16 months). Interviews were conducted in the children's homes. RESULTS The qualitative analysis showed that children's motivations for engaging in the physical activity programme during intensive medical treatment were primarily influenced by (a) opportunity for physical activity with a classmate; (b) participation in group physical activity sessions; (c) support from significant others; and (d) improvement of physical well-being. Main barriers included (a) poor physical well-being; (b) compliance with medical procedures and being treated in protective isolation; and (c) limited physical activity facilities. CONCLUSION Despite barriers, it is possible to motivate and engage children with cancer in physical activity during intensive treatment in a paediatric oncology ward. Physical exercise and activity should be recommended and promoted from diagnosis throughout the treatment period and should include psychosocial and professional support.
Collapse
Affiliation(s)
- Troels Thorsteinsson
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark.,Division of Paediatric Haematology/Oncology, Perlmutter Cancer Centre, New York University Langone Medical Centre, New York, New York
| | - Lone Friis Thing
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen N, Denmark
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Teacher Education and Sport, Western Norway University of Applied Sciences, Haugesun, Norway
| | - Anne Sofie Helms
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Marianne Vie Ingersgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Lea Hjortshøj Lindgren
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| |
Collapse
|
19
|
Nielsen MKF, Christensen JF, Frandsen TL, Thorsteinsson T, Andersen LB, Christensen KB, Nersting J, Faber M, Schmiegelow K, Larsen HB. Testing physical function in children undergoing intense cancer treatment-a RESPECT feasibility study. Pediatr Blood Cancer 2018; 65:e27100. [PMID: 29741279 DOI: 10.1002/pbc.27100] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/21/2018] [Accepted: 03/23/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND The physical function of children with cancer is reduced during treatment, which can compromise the quality of life and increase the risk of chronic medical conditions. The study, "REhabilitation, including Social and Physical activity and Education in Children and Teenagers with cancer" (Clinicaltrials.gov: NCT01772862) examines the efficacy of multimodal rehabilitation strategies introduced at cancer diagnosis. This article addresses the feasibility of and obstacles to testing physical function in children with cancer. METHODS The intervention group comprised 46 males and 29 females aged 6-18 years (mean ± SD: 11.3 ± 3.1 years) diagnosed with cancer from January 2013 to April 2016. Testing at diagnosis and after 3 months included timed-up-and-go, sit-to-stand, flamingo balance, handgrip strength, and the bicycle ergometer cardiopulmonary exercise test (CPET). RESULTS Of the 75 children, 92% completed a minimum of one test; two children declined testing and four were later included. Completion was low for CPET (38/150, 25%) but was high for handgrip strength (122/150, 81%). Tumor location, treatment-related side effects, and proximity to chemotherapy administration were primary obstacles for testing physical function. Children with extracranial solid tumors and central nervous system tumors completed significantly fewer tests than those with leukemia and lymphoma. Children with leukemia demonstrated reduced lower extremity function, that is, 24% reduction at 3 months testing in timed-up-and-go (P = 0.005) and sit-to-stand (P = 0.002), in contrast with no reductions observed in the other diagnostic groups. CONCLUSION Children with cancer are generally motivated to participate in physical function tests. Future studies should address diagnosis specific obstacles and design testing modalities that facilitate physical function tests in this target group.
Collapse
Affiliation(s)
- Martin K F Nielsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Science, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jesper F Christensen
- Center for Inflammation and Metabolism/Center for Physical Activity (CIM/CFAS), University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Thomas L Frandsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Troels Thorsteinsson
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Lars B Andersen
- Department of Sports Medicine, Norwegian School for Sports Sciences, Oslo, Norway.,Department of Sports Medicine, Norwegian School for Sports Sciences, Oslo, Norway
| | - Karl B Christensen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Nersting
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Marianne Faber
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital (Rigshospitalet), Copenhagen, Denmark.,Faculty of Health Science, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Hanne B Larsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital (Rigshospitalet), Copenhagen, Denmark
| |
Collapse
|
20
|
Thorsteinsson T, Larsen HB, Schmiegelow K, Thing LF, Krustrup P, Pedersen MT, Christensen KB, Mogensen PR, Helms AS, Andersen LB. Cardiorespiratory fitness and physical function in children with cancer from diagnosis throughout treatment. BMJ Open Sport Exerc Med 2017; 3:e000179. [PMID: 28761697 PMCID: PMC5530132 DOI: 10.1136/bmjsem-2016-000179] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2016] [Indexed: 01/13/2023] Open
Abstract
Background Children with cancer experience severe reductions in physical fitness and functionality during and following intensive treatment. This may negatively impact their quality of life. Purpose To describe the physical capacity and functionality of children with cancer during and after treatment as well as the feasibility of physical activity intervention in the Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer study. Patients and methods The study included children diagnosed from January 2013 to April 2016 with paediatric cancer or Langerhans cell histiocytosis, all treated with chemotherapy. Seventy-five of 78 consecutively eligible children (96.2%) were included. Median age was 11 years (range 6‒18). The physical capacity and function were assessed based on testing of physical strength, balance and cardiorespiratory fitness. Children were tested at diagnosis, 3 and 6 months after diagnosis and 1 year after cessation of treatment. The feasibility evaluation was inspired by the criteria for reporting the development and evaluation of complex interventions in healthcare. Results All children participated in the physical intervention programme with no dropouts. Strenuous physical exercise and physiological testing during paediatric cancer treatment was safe and feasible, with only five minor adverse events during the intervention. Cardiorespiratory fitness was significantly lower in children with cancer than norms for healthy age-matched children at diagnosis (difference 19.1 mL/kg/min, 95% CI 15.4 to 22.7; p <0.0001), during treatment 3 and 6 months from diagnosis (difference 21.0 mL/kg/min, 95% CI 17.4 to 24.6; p <0.0001 and difference 21.6 mL/kg/min, 95% CI 17.3 to 25.8; p <0.0001, respectively) and 1 year after cessation of treatment (difference 6.9 mL/kg/min, 95% CI 1.1 to 12.7; p <0.0072). Furthermore, children with cancer experienced a pronounced decline in physical function. Conclusion This study shows that it is safe and feasible to perform strenuous physical exercise and testing during paediatric cancer treatment and that children with cancer have significantly lower physical capacity and functionality than healthy age-matched norms. Trial registration number ClinicalTrials.gov: NCT01772862.
Collapse
Affiliation(s)
- Troels Thorsteinsson
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lone Friis Thing
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter Krustrup
- Department of Sport and Health Sciences, University of Exeter, College of Life and Environmental Sciences, Exeter, UK.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
| | | | | | - Pernille Rudebeck Mogensen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Diabetes and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Anne Sofie Helms
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Teacher Education and Sport, Western Norway University of Applied Sciences, Røyrgata, Norway
| |
Collapse
|
21
|
Lindgren LH, Schmiegelow K, Helms AS, Thorsteinsson T, Larsen HB. In sickness and in health: classmates are highly motivated to provide in-hospital support during childhood cancer therapy. Psychooncology 2016; 26:37-43. [PMID: 26872002 DOI: 10.1002/pon.4094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/16/2015] [Accepted: 01/15/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Extended hospitalization for school-aged cancer patients increases their risk of social marginalization. School-aged children mature through peer-interaction, but healthcare providers fail to incorporate this in rehabilitation efforts. The RESPECT study offers classmates to cancer patients to become ambassadors during hospital stays. This study explores classmate decision-making patterns about ambassadorship. METHODS An open-ended question was prospectively and consecutively provided to classmates (N = 221) (and parents) of 10 children diagnosed with cancer in 2014 and enrolled in the RESPECT study. Statements were analysed using thematic content analysis. RESULTS Of 221 classmates, 140 responded (63%). Of these, 81 applied for ambassadorship (median 8/patient), 58 declined, one was undecided. Nine forms were incomplete; leaving 131 in total that revealed 303 statements for analysis. Five major themes emerged: existing friendship (132/303 statements), personal resources (academic, emotional and social) (107/303), attitudes towards the ambassadorship (34/303), hospital environment (18/303) and logistics (12/303). Of the classmates with pre-existing friendships, 77% applied for ambassadorship and 80% with a surplus of personal resources applied. These were predominant predictors for ambassadorship application. Classmate motives were condensed into four archetypes: pre-existing friendship with a surplus of resources (100% applied), non-friend classmates with a surplus of resources (63% applied), pre-existing friendship with limited resources (22% applied) and non-friend classmates with limited resources (0% applied). CONCLUSION Classmates are highly motivated to support patients during serious illness, irrespective of pre-existing friendships. Ambassadors offer a novel in-hospital approach to promote rehabilitation in children with severe/chronic diseases. Results need validation in other settings. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Lea H Lindgren
- Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark.,Institute of Clinical Medicine, The Faculty of Medicine, University of Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark.,Institute of Clinical Medicine, The Faculty of Medicine, University of Copenhagen, Denmark.,Division of Pediatric Hematology/Oncology, Perlmutter Cancer Center and the Langone Medical Center, New York University, New York, NY, USA
| | - Anne Sofie Helms
- Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Troels Thorsteinsson
- Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Hanne B Larsen
- Department of Paediatrics and Adolescent Medicine, The University Hospital (Rigshospitalet), Copenhagen, Denmark
| |
Collapse
|
22
|
Yelton L, Forbis S. Influences and Barriers on Physical Activity in Pediatric Oncology Patients. Front Pediatr 2016; 4:131. [PMID: 28066750 PMCID: PMC5165656 DOI: 10.3389/fped.2016.00131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/21/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To determine the influence of family, peers, school, and physicians on exercise in pediatric oncology patients and evaluate the barriers to physical activity (PA) levels in this population. METHODS A search of PubMed and Google Scholar resulted in 12 related articles. The articles were assessed for the influence of school systems, family, peers, self-efficacy, and physicians on exercise. Additionally, barriers and interventions to PA were also assessed. Limitations and research methodologies of each article were also evaluated. RESULTS Many school systems were unsure of expectations in regards to PA for their returning students with cancer. Most schools acknowledged willingness to increase exercise for these students; however, there is a communication gap between the medical field and the school system on what expectations should be. Family is associated with increased PA levels and healthier diets in this population with children preferring mothers as exercise partners more than fathers. While physician interventions have been shown to positively impact PA, it has been reported that physicians are not engaging in exercise counseling with their patients. CONCLUSION Several issues and barriers related to PA in pediatric oncology population were identified. Studies have demonstrated that it is feasible to increase PA and self-efficacy in this population. Further research is needed to better understand and quantify these issues as well as further test the interventions that have been suggested in this review and have been successful in other pediatric populations.
Collapse
Affiliation(s)
- Larrilyn Yelton
- Boonshoft School of Medicine, Wright State University , Dayton, OH , USA
| | - Shalini Forbis
- Boonshoft School of Medicine, Wright State University , Dayton, OH , USA
| |
Collapse
|
23
|
Bonneau J, Dugas K, Louis A, Morel L, Toughza J, Frappaz D. [Educational and social outcome after childhood cancer]. Bull Cancer 2015; 102:691-7. [PMID: 25917346 DOI: 10.1016/j.bulcan.2015.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/22/2015] [Indexed: 11/26/2022]
Abstract
The survival rate improvement of childhood cancer survivors lead to question about their educational and social outcome. Authors suggest an international review in order to find risk factors of school or social failure after cancer experience. Principal cohort is studied in USA (the Children Cancer Survivor Study). Nevertheless, European studies are also published. The results vary, depending on subpopulation studied and on control choice (siblings or general population). Treatment improvement and supportive care make difficult to compare studies with current situations. Moreover, there are not international standard of education or social outcome. School and social behaviour are influenced by: types of tumor (cerebral tumor but also sometimes hemopathy and osteosarcoma), age at diagnosis (very young children and adolescent), treatments (neurotoxical treatments, hematopoietic stem cell transplant), and social or educational status of the parents.
Collapse
Affiliation(s)
- Jacinthe Bonneau
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France.
| | - Karyn Dugas
- CHU de Pellegrin, maison Aquitaine ressources pour les adolescents et jeunes adultes (MARADJA), 33000 Bordeaux, France
| | - Aurélien Louis
- Centre hospitalier de Chalon-sur-Saône, unité de Pédiatrie, 71321 Chalon-sur-Saone, France
| | - Laëtitia Morel
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France
| | - Jihane Toughza
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
| | - Didier Frappaz
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
| |
Collapse
|