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Trigoso V, Vásquez L, Fuentes-Alabi S, Pascual C, Méndez T, Maradiegue E, Villegas M, Perina E, Ahumada E, de Bragança J, Zubieta M, Jiménez MDP, Bernedo H, Ruda L, Sierralta M, Motta A, Rossell N, Vargas D, Salazar Y, López M, Plascencia O, Arita A, Molinas R, Salaverria C, Velásquez O, Ugaz C. Standards for psychosocial care in pediatric cancer: adapted proposal for Latin American and Caribbean countries. Rev Panam Salud Publica 2023; 47:e156. [PMID: 37901443 PMCID: PMC10612524 DOI: 10.26633/rpsp.2023.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/07/2023] [Indexed: 10/31/2023] Open
Abstract
Objective To highlight the objectives, achievements, challenges, and next steps for the World Health Organization's Global Initiative for Childhood Cancer (GICC) framework, a project designed to improve psychosocial care (PSC) in pediatric cancer centers across Latin America and the Caribbean (LAC). Methods The project was launched in Peru, the first GICC focal country, in November 2020. The diagnosis phase included a survey and a semistructured interview with health professionals to assess PSC practices in institutions, and a needs assessment survey for caregivers. In the second phase, a strategic plan was developed to address the identified needs, including the adaptation of PSC standards, the establishment of multicenter working groups, the expansion of the proposal, and the development of materials. Results The study found that PSC was not being adequately provided in accordance with international standards. Six adapted standards were proposed and validated, and more than 50 regional health professionals participated in online activities to support the project. The implementation process is currently ongoing, with the establishment of five multidisciplinary working groups, one regional committee, and the production of 16 technical outputs. Conclusion This project represents a substantial step forward to improve PSC for pediatric patients with cancer and their families in LAC countries. The establishment of working groups and evidence-based interventions strengthen the proposal and its implementation. Development of health policies that include PSC according to standards is needed to achieve sustainable results in the quality of life of children with cancer and their families.
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Affiliation(s)
- Viviana Trigoso
- Unit of Noncommunicable DiseasesDepartment of Noncommunicable Diseases and Mental HealthPan American Health Organization/World Health OrganizationWashingtonUnited States of AmericaUnit of Noncommunicable Diseases, Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization/World Health Organization, Washington, United States of America.
- Departamento de PsicologíaPontificia Universidad Católica del PerúLimaPeruDepartamento de Psicología, Pontificia Universidad Católica del Perú, Lima, Peru.
- Asociación Nacional de Psicooncología del PerúLimaPeruAsociación Nacional de Psicooncología del Perú, Lima, Peru.
| | - Liliana Vásquez
- Unit of Noncommunicable DiseasesDepartment of Noncommunicable Diseases and Mental HealthPan American Health Organization/World Health OrganizationWashingtonUnited States of AmericaUnit of Noncommunicable Diseases, Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization/World Health Organization, Washington, United States of America.
| | - Soad Fuentes-Alabi
- Unit of Noncommunicable DiseasesDepartment of Noncommunicable Diseases and Mental HealthPan American Health Organization/World Health OrganizationWashingtonUnited States of AmericaUnit of Noncommunicable Diseases, Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization/World Health Organization, Washington, United States of America.
| | - Claudia Pascual
- Pan American Health Organization PerúNoncommunicable Diseases UnitLimaPeruPan American Health Organization Perú, Noncommunicable Diseases Unit, Lima, Peru.
| | - Teresa Méndez
- Fundación Natali Dafne FlexerBuenos AiresArgentinaFundación Natali Dafne Flexer, Buenos Aires, Argentina.
| | - Essy Maradiegue
- Departamento de Normatividad, Calidad y Control Nacional de los Servicios OncológicosInstituto Nacional de Enfermedades NeoplásicasLimaPeruDepartamento de Normatividad, Calidad y Control Nacional de los Servicios Oncológicos, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
| | - Mariela Villegas
- Asociación Nacional de Psicooncología del PerúLimaPeruAsociación Nacional de Psicooncología del Perú, Lima, Peru.
| | - Elisa Perina
- Faculdade de Ciências Médicas de Minas GeraisBelo HorizonteBrazilFaculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
| | - Eugenia Ahumada
- Unidad de OncologíaHospital de Niños Roberto del RíoSantiagoChileUnidad de Oncología, Hospital de Niños Roberto del Río, Santiago, Chile.
| | - João de Bragança
- Childhood Cancer InternationalAmsterdamNetherlandsChildhood Cancer International, Amsterdam, Netherlands.
| | - Marcela Zubieta
- Childhood Cancer International LATAMChildhood Cancer International LATAM.
- Fundación Nuestros HijosSantiagoChileFundación Nuestros Hijos, Santiago, Chile.
| | - María del Pilar Jiménez
- Servicio de Psicología de la Sub Unidad de Atención Integral Especializada Pediátrica y Sub EspecialidadesInstituto Nacional de Salud del Niño San BorjaLimaPeruServicio de Psicología de la Sub Unidad de Atención Integral Especializada Pediátrica y Sub Especialidades, Instituto Nacional de Salud del Niño San Borja, Lima, Peru.
| | - Hernan Bernedo
- Unidad Funcional de Salud Mental OncológicaInstituto Nacional de Enfermedades NeoplásicasLimaPeruUnidad Funcional de Salud Mental Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
| | - Lourdes Ruda
- Departamento de PsicologíaPontificia Universidad Católica del PerúLimaPeruDepartamento de Psicología, Pontificia Universidad Católica del Perú, Lima, Peru.
- Asociación Nacional de Psicooncología del PerúLimaPeruAsociación Nacional de Psicooncología del Perú, Lima, Peru.
| | - Melisa Sierralta
- Asociación Nacional de Psicooncología del PerúLimaPeruAsociación Nacional de Psicooncología del Perú, Lima, Peru.
| | - Alessandra Motta
- Programa de Pós-Graduação em PsicologiaUniversidade Federal do Espírito SantoVitóriaBrazilPrograma de Pós-Graduação em Psicologia, Universidade Federal do Espírito Santo, Vitória, Brazil.
| | - Nuria Rossell
- Independent researcherAmsterdamNetherlandsIndependent researcher, Amsterdam, Netherlands.
| | - Daniela Vargas
- Asociación Nacional de Psicooncología del PerúLimaPeruAsociación Nacional de Psicooncología del Perú, Lima, Peru.
| | - Yurfa Salazar
- Unidad Funcional de Salud Mental OncológicaInstituto Nacional de Enfermedades NeoplásicasLimaPeruUnidad Funcional de Salud Mental Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
| | - Marisa López
- Servicio de PsicologíaInstituto Nacional de Salud del Niño BreñaLimaPeruServicio de Psicología, Instituto Nacional de Salud del Niño Breña, Lima, Peru.
| | - Oscar Plascencia
- Servicio de Psicología de la Sub Unidad de Atención Integral Especializada Pediátrica y Sub EspecialidadesInstituto Nacional de Salud del Niño San BorjaLimaPeruServicio de Psicología de la Sub Unidad de Atención Integral Especializada Pediátrica y Sub Especialidades, Instituto Nacional de Salud del Niño San Borja, Lima, Peru.
| | - Armando Arita
- Fundación Niñez PrimeroSan SalvadorEl SalvadorFundación Niñez Primero, San Salvador, El Salvador.
| | - Raquel Molinas
- Instituto Nacional del CáncerAsunciónParaguayInstituto Nacional del Cáncer, Asunción, Paraguay.
| | - Carmen Salaverria
- Fundación Ayúdame a VivirSan SalvadorEl SalvadorFundación Ayúdame a Vivir, San Salvador, El Salvador.
| | - Oscar Velásquez
- Servicio de PsicologíaHospital Nacional Guillermo AlmenaraLimaPeruServicio de Psicología, Hospital Nacional Guillermo Almenara, Lima, Peru.
| | - Cecilia Ugaz
- Departamento de Oncología PediátricaInstituto Nacional de Enfermedades NeoplásicasLimaPeruDepartamento de Oncología Pediátrica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
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Vásquez L, Fuentes-Alabi S, Benitez-Majano S, Ribeiro KB, Abraham M, Agulnik A, Baker JN, Blanco DB, Caniza MA, Cardenas-Aguirre A, Salaverria C, Sullivan CE, Damasco-Avila E, García-Quintero X, Loggetto P, McNeil MJ, Luna-Fineman S, Rossell N, Garcia de Lima RA, de Mendonca RH, Trigoso V, Segovia L, Vasquez R, Moreno F, Friedrich P, Luciani S, Lam C, Metzger ML, Rodríguez-Galindo C, Maza M. Collaboration for success: the Global Initiative for Childhood Cancer in Latin America. Rev Panam Salud Publica 2023; 47:e144. [PMID: 37799823 PMCID: PMC10548891 DOI: 10.26633/rpsp.2023.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/17/2023] [Indexed: 10/07/2023] Open
Abstract
The Global Initiative for Childhood Cancer (GICC) aims to increase the cure rate for children with cancer globally by improving healthcare access and quality. The Pan American Health Organization (PAHO), St. Jude Children's Research Hospital (St. Jude), and collaborators have joined efforts to improve outcomes of children with cancer in Latin America and the Caribbean (LAC) using the CureAll framework. In this article, we describe the process of developing regional resources aimed at accelerating the GICC implementation in LAC. In March 2021, PAHO formed regional working groups to develop core projects aligned with CureAll pillars and enablers. Seven working groups emerged from regional dialogues: early detection, nursing, psychosocial, nutrition, supportive care, treatment abandonment, and palliative care. PAHO arranged regular online meetings under the mentorship and support of St. Jude regional/transversal programs and international mentors. Between April and December 2021, 202 multidisciplinary experts attended 43 online meetings to promote the dialogue between stakeholders to improve childhood cancer outcomes. Fourteen technical outputs were produced: four regional snapshots, four technical documents, two virtual courses, one set of epidemiological country profiles, one educational content series for parents/caregivers, and two communication campaigns. The ongoing dialogue and commitment of PAHO, St. Jude, LAC working committees, and international collaborators are essential foundations to successfully accelerate GICC implementation. This is achievable through the development of materials of regional and global relevance. Further research and evaluation are needed to determine the impact of these strategies and resources on childhood cancer outcomes in LAC and other regions.
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Affiliation(s)
- Liliana Vásquez
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Soad Fuentes-Alabi
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Sara Benitez-Majano
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Karina Braga Ribeiro
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Monnie Abraham
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Asya Agulnik
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Justin N. Baker
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Daniel Bastardo Blanco
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Miguela A. Caniza
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Adolfo Cardenas-Aguirre
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Carmen Salaverria
- Ayúdame a Vivir FoundationSan SalvadorEl SalvadorAyúdame a Vivir Foundation, San Salvador, El Salvador
| | - Courtney E. Sullivan
- University of Alabama at BirminghamBirminghamUnited States of AmericaUniversity of Alabama at Birmingham, Birmingham, United States of America
| | - Erika Damasco-Avila
- Columbia University Irving Medical CenterNew YorkUnited States of AmericaColumbia University Irving Medical Center, New York, United States of America
| | - Ximena García-Quintero
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Patricia Loggetto
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Michael J. McNeil
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Sandra Luna-Fineman
- University of ColoradoAuroraUnited States of AmericaUniversity of Colorado, Aurora, United States of America
| | - Nuria Rossell
- University of AmsterdamAmsterdamNetherlandsUniversity of Amsterdam, Amsterdam, Netherlands
| | - Regina Aparecida Garcia de Lima
- University of São Paulo at Ribeirão Preto College of NursingRibeirão PretoBrazilUniversity of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | | | - Viviana Trigoso
- Pontifical Catholic University of PeruLimaPeruPontifical Catholic University of Peru, Lima, Peru
| | - Lorena Segovia
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Roberto Vasquez
- Hospital Nacional de Niños Benjamin BloomSan SalvadorEl SalvadorHospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
| | - Florencia Moreno
- Registro Onco-pediátrico Hospitalario ArgentinoBuenos AiresArgentinaRegistro Onco-pediátrico Hospitalario Argentino, Buenos Aires, Argentina
| | - Paola Friedrich
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Silvana Luciani
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Catherine Lam
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Monika L. Metzger
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Carlos Rodríguez-Galindo
- St. Jude Children’s Research HospitalMemphisUnited States of AmericaSt. Jude Children’s Research Hospital, Memphis, United States of America
| | - Mauricio Maza
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
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Gomez S, Salaverria C, Plenert E, Gonzalez G, D'Angelo G, Grimes A, Sugalski A, Langevin AM, Dupuis L, Sung L. Translating the Symptom Screening in Pediatrics Tool (SSPedi) into Argentinian Spanish for paediatric patients receiving cancer treatments, and evaluating understandability and cultural relevance in a multiple-phase descriptive study. BMJ Open 2021; 11:e048287. [PMID: 33795312 PMCID: PMC8023739 DOI: 10.1136/bmjopen-2020-048287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To translate a symptom screening tool developed for paediatric patients receiving cancer therapies called Symptom Screening in Pediatrics Tool (SSPedi) into Argentinian Spanish and to evaluate the understandability and cultural relevance of the translated version of SSPedi among children with cancer and paediatric haematopoietic stem cell transplant (HSCT) recipients. METHODS We conducted a multiphase, descriptive study to translate SSPedi into Argentinian Spanish. Using two translators, forward and backward translations were performed. The translated version was evaluated by Spanish-speaking paediatric patients 8-18 years of age receiving cancer treatments in two centres in Argentina and El Salvador. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was patient self-reported difficulty with understanding of the SSPedi instructions and each symptom using a 5-point Likert scale. Secondary outcomes were incorrect understanding of the SSPedi instructions, symptoms and response scale determined by cognitive interviews with the patients and rated using a 4-point Likert scale. Cultural relevance was assessed qualitatively. RESULTS There were 30 children enrolled and included in cognitive interviews; 16 lived in Argentina and 14 lived in El Salvador. The most common types of Spanish spoken were Central American (17, 57%) followed by South American (10, 33%) and Castilian (3, 10%). No changes to Argentinian Spanish SSPedi were required based on the outcomes or qualitative comments. No issues with cultural relevance were identified by any of the respondents. CONCLUSIONS We translated and finalised Argentinian Spanish SSPedi. Future research will focus on its use to describe bothersome symptoms by Argentinian Spanish-speaking children.
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Affiliation(s)
- Sergio Gomez
- Stem Cell Transplantation Unit, Hospital de Niños Sor María Ludovica, La Plata, Argentina
| | - Carmen Salaverria
- Department of Oncology, Hospital Nacional De Ninos Benjamin Bloom, San Salvador, El Salvador
| | - Erin Plenert
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Gisela Gonzalez
- Stem Cell Transplantation Unit, Hospital de Niños Sor María Ludovica, La Plata, Argentina
| | - Gisela D'Angelo
- Stem Cell Transplantation Unit, Hospital de Niños Sor María Ludovica, La Plata, Argentina
| | - Allison Grimes
- Division of Hematology-Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Aaron Sugalski
- Division of Hematology-Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Anne-Marie Langevin
- Division of Hematology-Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Lee Dupuis
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lillian Sung
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Salaverria C, Plenert E, Vasquez R, Fuentes-Alabi S, Tomlinson GA, Sung L. Paediatric relapsed acute leukaemia: curative intent chemotherapy improves quality of life. BMJ Support Palliat Care 2021:bmjspcare-2020-002722. [PMID: 33455915 DOI: 10.1136/bmjspcare-2020-002722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/18/2020] [Accepted: 01/03/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Paediatric patients with leukaemia with relapse or induction failure have poor prognosis. Anticipated quality of life (QoL) is important in treatment decision making. The objective was to determine if curative intent at relapse or induction failure, when compared with palliative intent, was associated with child's physical health, pain or general fatigue and parents' QoL over time among patients with paediatric leukaemia in El Salvador. METHODS This was a prospective observational cohort study. Children 2-18 years with acute leukaemia at first relapse or induction failure were eligible. Assessments occurred every 2 months for up to 2 years using validated proxy report and self-report scales, where guardians were the primary respondents. Initial curative or palliative intent was categorised at enrolment by physicians. The impact of initial intent on QoL was assessed using linear mixed effects models and interaction between QoL and time. RESULTS Of the 60 families enrolled, initial treatment intent was curative in 31 (51.7%) and palliative in 29 (48.3%). During the 2-year observation period, 44 children died. Initial curative intent significantly improved child's physical health (estimate=8.4, 95% CI 5.1 to 11.6), pain (estimate=5.4, 95% CI 1.5 to 9.2) and fatigue (estimate=6.6, 95% CI 3.2 to 9.9) compared with palliative intent, but not parents' QoL (estimate=1.0, 95% CI -0.8 to 2.8). CONCLUSIONS Among paediatric patients with acute leukaemia at relapse or induction failure, initial curative intent treatment plan was associated with better physical health, pain and fatigue when compared with palliative intent. A curative approach may be a reasonable option for patients with acute leukaemia even when prognosis is poor.
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Affiliation(s)
- Carmen Salaverria
- Division of Hematology and Oncology, Hospital Nacional De Ninos Benjamin Bloom, San Salvador, El Salvador
| | - Erin Plenert
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Roberto Vasquez
- Division of Hematology and Oncology, Hospital Nacional De Ninos Benjamin Bloom, San Salvador, El Salvador
| | - Soad Fuentes-Alabi
- Division of Hematology and Oncology, Hospital Nacional De Ninos Benjamin Bloom, San Salvador, El Salvador
| | - George A Tomlinson
- Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada
| | - Lillian Sung
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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Plenert E, Grimes A, Sugalski A, Langevin AM, Nieto D, Salaverria C, Gomez S, Gonzalez G, D'Angelo G, Dupuis L, Sung L. Translating the Symptom Screening in Paediatrics Tool (SSPedi) into North American Spanish and Among Spanish-speaking children receiving cancer treatments: evaluating understandability and cultural relevance in a multiple-phase descriptive study. BMJ Open 2020; 10:e037406. [PMID: 33184077 PMCID: PMC7662419 DOI: 10.1136/bmjopen-2020-037406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Symptom screening is important to achieving symptom control. Symptom Screening in Paediatrics Tool (SSPedi) is validated for English-speaking children. Objectives were to translate SSPedi into Spanish, and to evaluate the understandability and cultural relevance of the translated version among Spanish-speaking children with cancer and paediatric haematopoietic stem cell transplant recipients. METHODS We conducted a multiphase, descriptive study to translate SSPedi into Spanish. The first step was to determine whether one Spanish version would be appropriate for both North America and Argentina. Once this decision was made, forward and backward translations were performed. The translated version was evaluated by Spanish-speaking children 8-18 years of age receiving cancer treatments. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was child self-reported difficulty with understanding of the entire instrument and each symptom using a 5-point Likert scale. Secondary outcomes were incorrect understanding of SSPedi items identified by cognitive interviews with the children using a 4-point Likert scale and cultural relevance, which was assessed qualitatively. RESULTS This report focuses on North American Spanish as a separate version will be required for Argentinian Spanish SSPedi based on different common vocabulary and grammatical structure. There were 20 children from Toronto and San Antonio included in cognitive interviews. The most common types of Spanish spoken were Mexican (13, 65%), Central American (2, 10%) and South American (2, 10%). No child reported that it was hard or very hard to complete Spanish SSPedi. Changes to the instrument itself were not required based on understanding or cultural relevance. CONCLUSIONS We translated and finalised Spanish SSPedi appropriate for use in North America. Future research will translate and evaluate SSPedi for use in Argentina and other Spanish-speaking countries.
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Affiliation(s)
- Erin Plenert
- CHES, Hospital for Sick Children SickKids Learning Institute, Toronto, Ontario, Canada
| | - Allison Grimes
- Division of Hematology-Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Aaron Sugalski
- Division of Hematology-Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Anne-Marie Langevin
- Division of Hematology-Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Dominica Nieto
- Division of Hematology-Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Carmen Salaverria
- Department of Oncology, Hospital Nacional De Ninos Benjamin Bloom, San Salvador, El Salvador
| | - Sergio Gomez
- Stem Cell Transplantation Unit, Hospital de Niños Sor María Ludovica, La Plata, Argentina
| | - Gisela Gonzalez
- Stem Cell Transplantation Unit, Hospital de Niños Sor María Ludovica, La Plata, Argentina
| | - Gisela D'Angelo
- Stem Cell Transplantation Unit, Hospital de Niños Sor María Ludovica, La Plata, Argentina
| | - Lee Dupuis
- University of Toronto Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada
| | - Lillian Sung
- CHES, Hospital for Sick Children SickKids Learning Institute, Toronto, Ontario, Canada
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
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Rossell N, Salaverria C, Hernandez A, Alabi S, Vasquez R, Bonilla M, Lam CG, Ribeiro R, Reis R. Community resources support adherence to treatment for childhood cancer in El Salvador. J Psychosoc Oncol 2018; 36:319-332. [PMID: 29452054 DOI: 10.1080/07347332.2018.1427174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE In order to reduce nonadherence and treatment abandonment of children with cancer in El Salvador, institutions located nearby the patients' homes were involved to provide support. Methodological approach: Health clinics and municipality offices in the patients' communities were asked to assist families who were not promptly located after missing hospital appointments, or those whose financial limitations were likely to impede continuation of treatment. Data was collected about the number of contacted institutions, the nature of help provided, staff's time investments, and parents' perceptions about the intervention. FINDINGS Local institutions (133 from 206 contacts) conducted home visits (83), and/or provided parents with money (55) or transportation (60). Parents found this support essential for continuing the treatment but they also encountered challenges regarding local institutions' inconsistencies. Nonadherence and abandonment decreased. IMPLICATIONS Economic burden was reduced on both the families and the hospital. Involvement of external institutions might become regular practice to support families of children with cancer.
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Affiliation(s)
- Nuria Rossell
- a Amsterdam Institute for Social Science Research (AISSR), Amsterdam University , Amsterdam , The Netherlands.,b Department of Oncology , Benjamin Bloom Hospital , San Salvador , El Salvador
| | - Carmen Salaverria
- b Department of Oncology , Benjamin Bloom Hospital , San Salvador , El Salvador
| | - Angelica Hernandez
- b Department of Oncology , Benjamin Bloom Hospital , San Salvador , El Salvador
| | - Soad Alabi
- b Department of Oncology , Benjamin Bloom Hospital , San Salvador , El Salvador
| | - Roberto Vasquez
- b Department of Oncology , Benjamin Bloom Hospital , San Salvador , El Salvador
| | - Miguel Bonilla
- c International Outreach Program, St. Jude Children's Research Hospital , Memphis , Tennessee , USA
| | - Catherine G Lam
- c International Outreach Program, St. Jude Children's Research Hospital , Memphis , Tennessee , USA.,d Department of Oncology , St. Jude Children's Research Hospital , Memphis , Tennessee , USA.,e College of Medicine, University of Tennessee , Memphis , Tennessee , USA
| | - Raul Ribeiro
- d Department of Oncology , St. Jude Children's Research Hospital , Memphis , Tennessee , USA.,e College of Medicine, University of Tennessee , Memphis , Tennessee , USA
| | - Ria Reis
- a Amsterdam Institute for Social Science Research (AISSR), Amsterdam University , Amsterdam , The Netherlands.,f Leiden University Medical Center , Leiden , The Netherlands.,g School of Child and Adolescent Health, University of Cape Town, The Children's Institute , Cape Town , South Africa
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Salaverria C, Rossell N, Hernandez A, Alabi SF, Vasquez R, Bonilla M, Lam CG, Ribeiro RC. Interventions targeting absences increase adherence and reduce abandonment of childhood cancer treatment in El Salvador. Pediatr Blood Cancer 2015; 62:1609-15. [PMID: 25925227 PMCID: PMC4418179 DOI: 10.1002/pbc.25557] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 02/27/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND In El Salvador, about 200 new cases of pediatric cancer are diagnosed each year, and survival rates approach 70%. Although treatment is available at no cost, abandonment of therapy has remained at a steady yearly rate of 13% during the past decade. A time sensitive adherence tracking procedure (TS-ATP) was recently implemented to detect missed appointments, identify their causes, and intervene promptly. Procedure The study team was informed daily of patient/family failure to attend medical appointments in the pediatric oncology unit; the families were contacted and interviewed to ascertain and address the reasons. Patients who did not return after this initial contact were contacted again through local health clinics and municipalities. Law enforcement was a last resort for patients undergoing frontline treatment with a good prognosis., The system was adapted to clinical urgency: families of patients undergoing induction therapy were contacted within 24 hr, those in other therapy phases, within 48 hr, and those who had completed treatment, within one week. Reasons for absence were obtained by telephone or in person. RESULTS The annual rate of abandonment was reduced from 13-3% during the 2 years period. There were 1,111 absences reported and 1,472 contacts with caregivers and institutions. The three main reasons for absences were financial needs (165, 23%), unforeseen barriers (116, 16%), and domestic needs (86, 12%). CONCLUSIONS Use of the treatment adherence tracking system to locate and communicate with patients/families after missed appointments and the allocated aid stemming from these interviews substantially reduced abandonment and non-adherence.
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Affiliation(s)
- Carmen Salaverria
- Department of Oncology, Benjamin Bloom Hospital, San Salvador, El Salvador
| | - Nuria Rossell
- Department of Oncology, Benjamin Bloom Hospital, San Salvador, El Salvador
- Amsterdam Institute for Social Sciences Research (AISSR), Amsterdam University, the Netherlands
| | - Angelica Hernandez
- Department of Oncology, Benjamin Bloom Hospital, San Salvador, El Salvador
| | - Soad Fuentes Alabi
- Department of Oncology, Benjamin Bloom Hospital, San Salvador, El Salvador
| | - Roberto Vasquez
- Department of Oncology, Benjamin Bloom Hospital, San Salvador, El Salvador
| | - Miguel Bonilla
- International Outreach Program, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Catherine G. Lam
- International Outreach Program, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
- University of Tennessee, College of Medicine, Memphis, TN, USA
| | - Raul C. Ribeiro
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
- University of Tennessee, College of Medicine, Memphis, TN, USA
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Affiliation(s)
| | | | | | | | | | - Carmen Salaverria
- National Children's Hospital Benjamin Bloom, San Salvador, El Salvador
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Bonilla M, Rossell N, Salaverria C, Gupta S, Barr R, Sala A, Metzger ML, Sung L. Prevalence and predictors of abandonment of therapy among children with cancer in El Salvador. Int J Cancer 2009; 125:2144-6. [DOI: 10.1002/ijc.24534] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Miguel Bonilla
- Pediatric Oncology, Hospital Nacional de Ninos Benjamin Bloom, San Salvador, El Salvador
| | - Nuria Rossell
- Pediatric Oncology, Hospital Nacional de Ninos Benjamin Bloom, San Salvador, El Salvador
| | - Carmen Salaverria
- Pediatric Oncology, Hospital Nacional de Ninos Benjamin Bloom, San Salvador, El Salvador
| | - Sumit Gupta
- Division of Haematology/Oncology and Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald Barr
- Division of Hematology/Oncology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Alessandra Sala
- Department of Pediatrics, University of Milano‐Bicocca, Monza, Italy
| | - Monika L. Metzger
- Pediatric Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Lillian Sung
- Division of Haematology/Oncology and Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
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