Pub Date : 2021-03-01Epub Date: 2020-11-30DOI: 10.1177/1043454220975463
Qian Liu, Marcia A Petrini, Dan Luo, Bing Xiang Yang, Jiong Yang, Joan E Haase
Background: Understanding parents' experiences is a prerequisite to developing interventions that are sensitive to needs of children and families. In China, little is known about parental experiences of having a young child with acute lymphoblastic leukemia (ALL). This phenomenological study aimed to describe parental experiences of having a young child with ALL in China.
Method: Ten parents, recruited in central China using purposive sampling, participated in face-to-face, in-depth interviews using Haase's adaptation of Colaizzi's phenomenological method.
Results: Five theme categories were identified: (a) The Cancer Diagnosis as a Terrible Disaster-The Sky is Falling, (b) Fighting the Beast, (c) Putting on a Happy Face and Other Coping Strategies, (d) Diagnosis Disclosure: If We Tell and How to Tell, and (e) Hope-Filled Expectations: Returning to Normal Life.
Conclusion: Parents put their child's health as their top priority. They strive to manage uncertainty about prognosis and cope with enormous pressures caused by children's suffering, financial burden, and stigma. Parents also express their resilience and hope throughout their child's cancer journey. Support services to strengthen specific families' protective factors (i.e., family/community support, hope, and positive coping) are needed to foster resilience and quality of life. Health care professionals should systematically assess parents' needs, provide validated education materials, and implement tailored interventions across the cancer continuum. Public education and advocacy about cancer is also necessary to decrease cancer-related stigma, and provide financial aid and health care resources in pediatric oncology.
{"title":"Parents' Experiences of Having a Young Child With Acute Lymphoblastic Leukemia in China.","authors":"Qian Liu, Marcia A Petrini, Dan Luo, Bing Xiang Yang, Jiong Yang, Joan E Haase","doi":"10.1177/1043454220975463","DOIUrl":"https://doi.org/10.1177/1043454220975463","url":null,"abstract":"<p><strong>Background: </strong>Understanding parents' experiences is a prerequisite to developing interventions that are sensitive to needs of children and families. In China, little is known about parental experiences of having a young child with acute lymphoblastic leukemia (ALL). This phenomenological study aimed to describe parental experiences of having a young child with ALL in China.</p><p><strong>Method: </strong>Ten parents, recruited in central China using purposive sampling, participated in face-to-face, in-depth interviews using Haase's adaptation of Colaizzi's phenomenological method.</p><p><strong>Results: </strong>Five theme categories were identified: (a) The Cancer Diagnosis as a Terrible Disaster-The Sky is Falling, (b) Fighting the Beast, (c) Putting on a Happy Face and Other Coping Strategies, (d) Diagnosis Disclosure: If We Tell and How to Tell, and (e) Hope-Filled Expectations: Returning to Normal Life.</p><p><strong>Conclusion: </strong>Parents put their child's health as their top priority. They strive to manage uncertainty about prognosis and cope with enormous pressures caused by children's suffering, financial burden, and stigma. Parents also express their resilience and hope throughout their child's cancer journey. Support services to strengthen specific families' protective factors (i.e., family/community support, hope, and positive coping) are needed to foster resilience and quality of life. Health care professionals should systematically assess parents' needs, provide validated education materials, and implement tailored interventions across the cancer continuum. Public education and advocacy about cancer is also necessary to decrease cancer-related stigma, and provide financial aid and health care resources in pediatric oncology.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220975463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38656870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-09-19DOI: 10.1177/1043454220958672
Marybeth Tetlow, Deborah Allen, Angel Barnes, Ryan J Shaw
Central line associated blood stream infections and complications in children require prevention strategies related to both traditional childhood activities as well as adverse events in the intensive care unit or bone marrow transplant unit. This study evaluated a nurse-invented product, the Line Snuggler, designed to protect intravenous tubing and central lines from contamination or entanglement. Patients (n = 30) were enrolled following the chemotherapy phase of transplant. Using a pre-post intervention design, each subject served as their own control for the control phase of the study (Days 1-3 without a Line Snuggler) and the intervention phase (Days 4-6 with a Line Snuggler), with bacterial levels of product and sheets tested on Days 1, 3, 4, and 6. At study conclusion, staff (n = 44) and parents/guardians (n = 25) completed an online survey assessing satisfaction with the product, and perceived utilization and safety. Using t tests, the Line Snuggler bacterial levels showed no difference in growth in adenosine triphosphate levels compared with the same patient's sheets, thereby supporting no increased risk of bacterial growth. Both staff and parents/guardians reported high satisfaction with their use of the Line Snuggler and noted the benefit of its protecting and bundling intravenous lines into a single organizer. This innovative product designed by nurses was evaluated as a means to provide exceptional, high-quality care to achieve the best outcomes while eliminating hospital-acquired complications (https://www.linesnugglers.com/).
{"title":"The Line Snuggler: A Central Line Bundling Innovation Evaluated in a High-Risk Pediatric Population.","authors":"Marybeth Tetlow, Deborah Allen, Angel Barnes, Ryan J Shaw","doi":"10.1177/1043454220958672","DOIUrl":"https://doi.org/10.1177/1043454220958672","url":null,"abstract":"<p><p>Central line associated blood stream infections and complications in children require prevention strategies related to both traditional childhood activities as well as adverse events in the intensive care unit or bone marrow transplant unit. This study evaluated a nurse-invented product, the Line Snuggler, designed to protect intravenous tubing and central lines from contamination or entanglement. Patients (<i>n</i> = 30) were enrolled following the chemotherapy phase of transplant. Using a pre-post intervention design, each subject served as their own control for the control phase of the study (Days 1-3 without a Line Snuggler) and the intervention phase (Days 4-6 with a Line Snuggler), with bacterial levels of product and sheets tested on Days 1, 3, 4, and 6. At study conclusion, staff (<i>n</i> = 44) and parents/guardians (<i>n</i> = 25) completed an online survey assessing satisfaction with the product, and perceived utilization and safety. Using <i>t</i> tests, the Line Snuggler bacterial levels showed no difference in growth in adenosine triphosphate levels compared with the same patient's sheets, thereby supporting no increased risk of bacterial growth. Both staff and parents/guardians reported high satisfaction with their use of the Line Snuggler and noted the benefit of its protecting and bundling intravenous lines into a single organizer. This innovative product designed by nurses was evaluated as a means to provide exceptional, high-quality care to achieve the best outcomes while eliminating hospital-acquired complications (https://www.linesnugglers.com/).</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220958672","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38498495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-09-24DOI: 10.1177/1043454220958643
Cecilia Gladbach, Lindsey J Patton, Xiaohan Xu, Victor Aquino
Background: The experience of hematopoietic stem cell transplant (HSCT) on both the patients and their caregivers is complex and challenging during hospitalization and post discharge. Complex patient populations require heightened attention on discharge practices to ensure that they are prepared for home regimens. "Rooming in" is a standardized intervention implemented prior to discharge that allows patients and caregivers to assume post discharge care with the support of staff. Other complex patient populations have reported positive outcomes related to "rooming in." Aims: The purpose of this study was to assess the feasibility of a standardized "rooming in" intervention for discharge of pediatric HSCT patients. An additional aim was to describe the quality of discharge teaching, readiness for hospital discharge, and postdischarge coping difficulty in a cohort of HSCT patients using validated questionnaires. Method: Data were collected via medical chart review. A prospective cohort completed validated study questionnaires at discharge and 30 days postdischarge. Results: All caregivers of post-HSCT patients were able to complete the "rooming in" intervention. There was no statistically significant difference for length of stay between the retrospective and prospective cohorts. Caregivers enrolled on the study rated the Quality of Discharge Teaching Scale-Parent Form high (Mdn = 165). Conclusion: We conclude that "rooming in" is a feasible discharge intervention for caregivers of pediatric HSCT patients.
{"title":"Transition From Hospital to Home Following Hematopoietic Stem Cell Transplantation: A Feasibility Study for \"Rooming in\".","authors":"Cecilia Gladbach, Lindsey J Patton, Xiaohan Xu, Victor Aquino","doi":"10.1177/1043454220958643","DOIUrl":"https://doi.org/10.1177/1043454220958643","url":null,"abstract":"<p><p><b>Background:</b> The experience of hematopoietic stem cell transplant (HSCT) on both the patients and their caregivers is complex and challenging during hospitalization and post discharge. Complex patient populations require heightened attention on discharge practices to ensure that they are prepared for home regimens. \"Rooming in\" is a standardized intervention implemented prior to discharge that allows patients and caregivers to assume post discharge care with the support of staff. Other complex patient populations have reported positive outcomes related to \"rooming in.\" <b>Aims:</b> The purpose of this study was to assess the feasibility of a standardized \"rooming in\" intervention for discharge of pediatric HSCT patients. An additional aim was to describe the quality of discharge teaching, readiness for hospital discharge, and postdischarge coping difficulty in a cohort of HSCT patients using validated questionnaires. <b>Method:</b> Data were collected via medical chart review. A prospective cohort completed validated study questionnaires at discharge and 30 days postdischarge. <b>Results:</b> All caregivers of post-HSCT patients were able to complete the \"rooming in\" intervention. There was no statistically significant difference for length of stay between the retrospective and prospective cohorts. Caregivers enrolled on the study rated the Quality of Discharge Teaching Scale-Parent Form high (<i>Mdn</i> = 165). <b>Conclusion:</b> We conclude that \"rooming in\" is a feasible discharge intervention for caregivers of pediatric HSCT patients.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220958643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38413974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-09-19DOI: 10.1177/1043454220958636
Jennifer L Harman, Amy Scott, Niki Jurbergs
Pill-swallowing training (PST) is a promising behavioral intervention. However, previous studies of PST have largely reported outcomes only in children aged 6 years and older. In the pediatric oncology setting, younger children may benefit from learning to swallow pills, with motivators such as avoiding bad-tasting liquid medications, simplifying oral medication routines, and accessing trials for patients with poor prognoses. Here, we briefly describe the standard PST intervention protocol and report success with very young patients experiencing a variety of medical, emotional, behavioral, and developmental complications. The current case series illustrates the utility of traditional behavioral PST interventions with novel supplements, such as intervention to increase general compliance or decrease anxiety, in four young children with cancer. These cases highlight the effectiveness of PST and describe the positive impact reported by each family. Developmental considerations for using PST with young children with cancer are offered.
{"title":"Pill-Swallowing Training in Very Young Children With Cancer: A Case Series and Developmental Considerations.","authors":"Jennifer L Harman, Amy Scott, Niki Jurbergs","doi":"10.1177/1043454220958636","DOIUrl":"https://doi.org/10.1177/1043454220958636","url":null,"abstract":"<p><p>Pill-swallowing training (PST) is a promising behavioral intervention. However, previous studies of PST have largely reported outcomes only in children aged 6 years and older. In the pediatric oncology setting, younger children may benefit from learning to swallow pills, with motivators such as avoiding bad-tasting liquid medications, simplifying oral medication routines, and accessing trials for patients with poor prognoses. Here, we briefly describe the standard PST intervention protocol and report success with very young patients experiencing a variety of medical, emotional, behavioral, and developmental complications. The current case series illustrates the utility of traditional behavioral PST interventions with novel supplements, such as intervention to increase general compliance or decrease anxiety, in four young children with cancer. These cases highlight the effectiveness of PST and describe the positive impact reported by each family. Developmental considerations for using PST with young children with cancer are offered.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220958636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38498490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-10-28DOI: 10.1177/1043454220966590
Janice S Withycombe, Aimee Carlson, Carly Coleman, Sharon L Leslie, Micah Skeens, Hanna Tseitlin, Elizabeth A Duffy
Background: Immunotherapy is a new and promising approach to treating pediatric cancers. These types of therapies have unique mechanisms of action for identifying and fighting cancer, as compared with traditional chemotherapy, and therefore are associated with different therapy-related adverse events (AEs). The purpose of this systematic review was to review available evidence to: (a) identify commonly reported AEs associated with immunotherapy agents frequently used in pediatric oncology and (b) generate recommendations for nursing practice.
Method: A clinical question was developed and used to guide the systematic literature review. Five immunotherapy agents (dinutuximab, blinatumomab, rituximab, inotuzumab ozogamicin, brentuximab vedotin) were selected for inclusion secondary to their high relevance to pediatric oncology. A literature search was conducted to locate articles published between January 1, 2003 and October 31, 2018.
Results: Seventeen articles met eligibility criteria for inclusion and were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation criteria. The most commonly reported AEs for the selected immunotherapy agents were identified and summarized. Strong recommendations are made for nurses to become familiar with the unique AE profiles associated with individual immunotherapy agents. Agent-specific recommendations for nursing practice regarding AEs associated with dinutuximab and rituximab were generated.
Conclusions: Immunotherapy is rapidly emerging as an effective therapy for pediatric cancers. Nurses need to be aware of the breadth of agent-specific, immunotherapy-related AEs to appropriately monitor and manage patients receiving these therapies. Additional work is needed to confidently profile immunotherapy-related AEs in pediatric oncology and to develop agent-specific educational materials for patients/families.
{"title":"Commonly Reported Adverse Events Associated With Pediatric Immunotherapy: A Systematic Review From the Children's Oncology Group","authors":"Janice S Withycombe, Aimee Carlson, Carly Coleman, Sharon L Leslie, Micah Skeens, Hanna Tseitlin, Elizabeth A Duffy","doi":"10.1177/1043454220966590","DOIUrl":"10.1177/1043454220966590","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy is a new and promising approach to treating pediatric cancers. These types of therapies have unique mechanisms of action for identifying and fighting cancer, as compared with traditional chemotherapy, and therefore are associated with different therapy-related adverse events (AEs). The purpose of this systematic review was to review available evidence to: (a) identify commonly reported AEs associated with immunotherapy agents frequently used in pediatric oncology and (b) generate recommendations for nursing practice.</p><p><strong>Method: </strong>A clinical question was developed and used to guide the systematic literature review. Five immunotherapy agents (dinutuximab, blinatumomab, rituximab, inotuzumab ozogamicin, brentuximab vedotin) were selected for inclusion secondary to their high relevance to pediatric oncology. A literature search was conducted to locate articles published between January 1, 2003 and October 31, 2018.</p><p><strong>Results: </strong>Seventeen articles met eligibility criteria for inclusion and were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation criteria. The most commonly reported AEs for the selected immunotherapy agents were identified and summarized. Strong recommendations are made for nurses to become familiar with the unique AE profiles associated with individual immunotherapy agents. Agent-specific recommendations for nursing practice regarding AEs associated with dinutuximab and rituximab were generated.</p><p><strong>Conclusions: </strong>Immunotherapy is rapidly emerging as an effective therapy for pediatric cancers. Nurses need to be aware of the breadth of agent-specific, immunotherapy-related AEs to appropriately monitor and manage patients receiving these therapies. Additional work is needed to confidently profile immunotherapy-related AEs in pediatric oncology and to develop agent-specific educational materials for patients/families.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8822201/pdf/10.1177_1043454220966590.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-10-26DOI: 10.1177/1043454220966831
Mina Park, Young-Mi Seo, Yoon Jung Shin, Jung Woo Han, Eunhee Cho, Hyeju Jang
Purpose: The purpose of this study is to identify controllable treatment-environment-related factors affecting the timing of a central line-associated bloodstream infection (CLABSI) onset in children with cancer with central venous catheters (CVC).
Design: This study is a secondary data analysis with the data extracted from electronic medical records in a tertiary hospital in South Korea. This study was conducted by reviewing electronic medical records of 470 pediatric cancer patients younger than the age of 18 years from 2010 to 2016.
Method: The timing of a CLABSI onset was identified through the onset of CLABSI and the duration of catheterization. Cox proportional hazards regression analysis was used to estimate the impact of variables on the timing of CLABSI onset. The duration of catheterization was estimated using the Kaplan-Meier method.
Finding: Multivariable analysis by Cox proportional model analysis showed that there are six independent variables affecting the timing of a CLABSI onset: length of stay in hospital, catheter insertion location, use of antibiotics on day of catheter insertion, catheter function, number of blood transfusions per 100 days, and number of blood tests per 100 days.
Conclusions: The findings of this study provide a foundation for the development of EBP-based CVC guidelines to effectively reduce CLABSIs and maintain a long-term CVC without a CLABSI.
{"title":"Factors Affecting the Timing of a Central Line Associated Bloodstream Infection Onset in Children with Cancer.","authors":"Mina Park, Young-Mi Seo, Yoon Jung Shin, Jung Woo Han, Eunhee Cho, Hyeju Jang","doi":"10.1177/1043454220966831","DOIUrl":"https://doi.org/10.1177/1043454220966831","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to identify controllable treatment-environment-related factors affecting the timing of a central line-associated bloodstream infection (CLABSI) onset in children with cancer with central venous catheters (CVC).</p><p><strong>Design: </strong>This study is a secondary data analysis with the data extracted from electronic medical records in a tertiary hospital in South Korea. This study was conducted by reviewing electronic medical records of 470 pediatric cancer patients younger than the age of 18 years from 2010 to 2016.</p><p><strong>Method: </strong>The timing of a CLABSI onset was identified through the onset of CLABSI and the duration of catheterization. Cox proportional hazards regression analysis was used to estimate the impact of variables on the timing of CLABSI onset. The duration of catheterization was estimated using the Kaplan-Meier method.</p><p><strong>Finding: </strong>Multivariable analysis by Cox proportional model analysis showed that there are six independent variables affecting the timing of a CLABSI onset: length of stay in hospital, catheter insertion location, use of antibiotics on day of catheter insertion, catheter function, number of blood transfusions per 100 days, and number of blood tests per 100 days.</p><p><strong>Conclusions: </strong>The findings of this study provide a foundation for the development of EBP-based CVC guidelines to effectively reduce CLABSIs and maintain a long-term CVC without a CLABSI.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220966831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38624694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-10-07DOI: 10.1177/1043454220958675
Sophie C Junak
Leukemias and lymphomas account for more than half of new cancer cases in children each year. As a result of advancements in clinical protocols, survival rates for hematological malignancies in children now approximately 80% to 90%. The short-term effects of chemotherapy are well documented; however, many late effects remain unclear, notably those on the humoral immune system. The recent resistance toward childhood vaccination in some communities in conjunction with a growing number of potentially underprotected survivors could place this population at increased risk for common communicable diseases. Additionally, survivors could serve as a significant reservoir for further spread of disease within the general population. The state of the scientific knowledge regarding humoral immunity in this population is insufficient for concrete conclusions. An intensive search of the literature on various platforms was performed to identify articles reporting on the rates of protection to common vaccine-preventable diseases in survivors of pediatric hematological malignancies. Articles were selected with respect to inclusion and exclusion criteria. Quality was evaluated against specific methodological standards. Each study shows evidence that participants were lacking immunity to at least one vaccination following treatment. A majority of participants recovered immunity after revaccination, with a small percentage remaining unprotected. There is no consistency between studies regarding the rates at which immunity is present; furthermore, there are no particulars on how long immunity persists following revaccination. Vaccination represents an instrumental public health initiative for reducing morbidity and mortality globally. The clinical ramifications of losing protection against vaccine preventable diseases are therefore serious.
{"title":"Lack of Consensus on Humoral Immune Status Among Survivors of Pediatric Hematological Malignancies: An Integrative Review.","authors":"Sophie C Junak","doi":"10.1177/1043454220958675","DOIUrl":"https://doi.org/10.1177/1043454220958675","url":null,"abstract":"<p><p>Leukemias and lymphomas account for more than half of new cancer cases in children each year. As a result of advancements in clinical protocols, survival rates for hematological malignancies in children now approximately 80% to 90%. The short-term effects of chemotherapy are well documented; however, many late effects remain unclear, notably those on the humoral immune system. The recent resistance toward childhood vaccination in some communities in conjunction with a growing number of potentially underprotected survivors could place this population at increased risk for common communicable diseases. Additionally, survivors could serve as a significant reservoir for further spread of disease within the general population. The state of the scientific knowledge regarding humoral immunity in this population is insufficient for concrete conclusions. An intensive search of the literature on various platforms was performed to identify articles reporting on the rates of protection to common vaccine-preventable diseases in survivors of pediatric hematological malignancies. Articles were selected with respect to inclusion and exclusion criteria. Quality was evaluated against specific methodological standards. Each study shows evidence that participants were lacking immunity to at least one vaccination following treatment. A majority of participants recovered immunity after revaccination, with a small percentage remaining unprotected. There is no consistency between studies regarding the rates at which immunity is present; furthermore, there are no particulars on how long immunity persists following revaccination. Vaccination represents an instrumental public health initiative for reducing morbidity and mortality globally. The clinical ramifications of losing protection against vaccine preventable diseases are therefore serious.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220958675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38459771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01Epub Date: 2020-09-19DOI: 10.1177/1043454220958652
Karen Kalbfeld, Janet A Parkosewich, Wei Teng, Marjorie Funk
Background: To reduce the risk of renal toxicity, urine specific gravity (SG) and pH (potential of hydrogen) parameters should be met before nephrotoxic chemotherapeutic agents are administered. The purpose of this study was to compare laboratory urine SG and pH values with those obtained with urine point-of-care (POC) testing methods commonly used when caring for children receiving nephrotoxic chemotherapeutic agents.
Method: A method-comparison design was used to compare the values of three POC methods for SG (dipstick, automated dipstick reader, refractometer) and three pH (dipstick, automated dipstick reader, litmus paper) methods with laboratory analysis of 86 urine samples from 43 children hospitalized on a pediatric hematology oncology unit in a large academic medical center. The Bland-Altman method was used to calculate bias and precision between POC and laboratory values.
Results: Except for the SG refractometer, bias values from Bland-Altman graphs demonstrated poor agreement between POC and laboratory urine SG and pH results. The precision values between these methods indicated overestimation or underestimation of hydration or urine pH status. Compared with laboratory methods, 31% of POC visual reading of dipstick SG values were falsely low-putting the patient at risk of not receiving necessary hydration and subsequent nephrotoxicity.
Discussion: In conclusion, most POC urine testing methods for SG and pH are not accurate compared with laboratory analysis. Because laboratory analyses can take longer than POC methods to obtain results, clinicians need to collaborate with laboratory medicine to ensure that an expedited process is in place in order to prevent chemotherapy administration delays.
{"title":"Comparison of Point-of-Care Testing Methods and Laboratory Analysis for Assessing Urine Specific Gravity and pH of Children Undergoing Chemotherapy.","authors":"Karen Kalbfeld, Janet A Parkosewich, Wei Teng, Marjorie Funk","doi":"10.1177/1043454220958652","DOIUrl":"https://doi.org/10.1177/1043454220958652","url":null,"abstract":"<p><strong>Background: </strong>To reduce the risk of renal toxicity, urine specific gravity (SG) and pH (potential of hydrogen) parameters should be met before nephrotoxic chemotherapeutic agents are administered. The purpose of this study was to compare laboratory urine SG and pH values with those obtained with urine point-of-care (POC) testing methods commonly used when caring for children receiving nephrotoxic chemotherapeutic agents.</p><p><strong>Method: </strong>A method-comparison design was used to compare the values of three POC methods for SG (dipstick, automated dipstick reader, refractometer) and three pH (dipstick, automated dipstick reader, litmus paper) methods with laboratory analysis of 86 urine samples from 43 children hospitalized on a pediatric hematology oncology unit in a large academic medical center. The Bland-Altman method was used to calculate bias and precision between POC and laboratory values.</p><p><strong>Results: </strong>Except for the SG refractometer, bias values from Bland-Altman graphs demonstrated poor agreement between POC and laboratory urine SG and pH results. The precision values between these methods indicated overestimation or underestimation of hydration or urine pH status. Compared with laboratory methods, 31% of POC visual reading of dipstick SG values were falsely low-putting the patient at risk of not receiving necessary hydration and subsequent nephrotoxicity.</p><p><strong>Discussion: </strong>In conclusion, most POC urine testing methods for SG and pH are not accurate compared with laboratory analysis. Because laboratory analyses can take longer than POC methods to obtain results, clinicians need to collaborate with laboratory medicine to ensure that an expedited process is in place in order to prevent chemotherapy administration delays.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220958652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38401000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
More than one fourth of primary caregivers report clinically significant distress during the hematopoietic stem cell transplantation (HSCT) process. Providing early support to primary caregivers could reduce caregiver distress and improve the quality of life. This study examined the effects of a three-stage caregiver support intervention designed to reduce caregiver distress and improve quality of life during pediatric HSCT hospitalization. A two-group comparative study was conducted with repeated measures. Participants were randomly assigned to an intervention group or a control group. The intervention group received the support intervention 5 days before the transplant, 14 days after transplant, and 1 week before hospital discharge. The control group received standard support provided in the hospital ward. Measures were obtained at all three time points from self-report questionnaires, which were related to anxiety, depression, perceived stress, and quality of life. Findings indicated that primary caregivers in the intervention group (n = 22) reported significantly lower levels of perceived stress and higher levels of quality of life than the control group (n = 23) at 14 days after transplant. In the intervention group, caregiver distress significantly decreased from pretransplant through 14 days after transplant, while over the same period caregiver quality of life significantly increased. The intervention effectively changed the trend of distress and quality of life for caregivers of children during the process of HSCT and hospitalization. The findings of this study suggest that it is important to provide early targeted interventions at critical junctures for caregivers at risk of adverse outcomes.
{"title":"Effectiveness of a Three-Stage Intervention in Reducing Caregiver Distress During Pediatric Hematopoietic Stem Cell Transplantation: A Randomized Controlled Trial.","authors":"Ying-Mei Liu, Yu-Chuan Wen, Pei-Yin Weng, Tang-Her Jaing, Shih-Hsiang Chen","doi":"10.1177/1043454220911358","DOIUrl":"https://doi.org/10.1177/1043454220911358","url":null,"abstract":"<p><p>More than one fourth of primary caregivers report clinically significant distress during the hematopoietic stem cell transplantation (HSCT) process. Providing early support to primary caregivers could reduce caregiver distress and improve the quality of life. This study examined the effects of a three-stage caregiver support intervention designed to reduce caregiver distress and improve quality of life during pediatric HSCT hospitalization. A two-group comparative study was conducted with repeated measures. Participants were randomly assigned to an intervention group or a control group. The intervention group received the support intervention 5 days before the transplant, 14 days after transplant, and 1 week before hospital discharge. The control group received standard support provided in the hospital ward. Measures were obtained at all three time points from self-report questionnaires, which were related to anxiety, depression, perceived stress, and quality of life. Findings indicated that primary caregivers in the intervention group (<i>n</i> = 22) reported significantly lower levels of perceived stress and higher levels of quality of life than the control group (<i>n</i> = 23) at 14 days after transplant. In the intervention group, caregiver distress significantly decreased from pretransplant through 14 days after transplant, while over the same period caregiver quality of life significantly increased. The intervention effectively changed the trend of distress and quality of life for caregivers of children during the process of HSCT and hospitalization. The findings of this study suggest that it is important to provide early targeted interventions at critical junctures for caregivers at risk of adverse outcomes.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220911358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37865415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-01Epub Date: 2020-08-04DOI: 10.1177/1043454220944122
Anne Ingalls Gillespie, Madalynn Neu
Introduction: YAPS™ (Youth and Pet Survivors™) is a form of virtual animal-assisted therapy (AAT), a pen pal program designed for children and adolescents with cancer and/or having a bone marrow transplant (BMT) to engage in virtual visits with a dog or a cat (who has also been treated for cancer or serious medical illness) through letter writing and pictures. The purpose of this qualitative descriptive study was to explore the experiences of YAPS participants over time and to explore how virtual AAT may be an additional or alternative intervention to the traditional form of AAT, which involves live visits with animals, primarily dogs. Method: Open-ended, face-to-face interviews were conducted throughout the participants' involvement with their animal pen pal. Interviews were digitally recorded. Data were analyzed using a content analysis method. Results: Fifteen children and adolescents, aged 7 to 16 years, participated. Three main themes and five subthemes were found, including connection, shared experience, and friendship. Themes suggested that a virtual AAT letter writing program can provide a source of fun and a way to process the cancer experience with a dog or cat pen pal who has also faced cancer or serious medical treatment. Discussion: Interventions that promote well-being for pediatric oncology and BMT patients are needed, and virtual AAT seems to be one such intervention suited for those who have an affinity for animals and enjoy letter writing. The findings of this study also presented an exciting and intriguing gap for further research in virtual AAT.
简介:YAPS™(Youth and Pet Survivors™)是一种虚拟动物辅助疗法(AAT),是一个为患有癌症和/或接受骨髓移植(BMT)的儿童和青少年设计的笔友程序,通过写信和照片与狗或猫(也接受过癌症或严重疾病的治疗)进行虚拟访问。这项定性描述性研究的目的是探索YAPS参与者随着时间的推移的经历,并探索虚拟AAT如何成为传统形式的AAT的额外或替代干预,传统形式的AAT包括与动物(主要是狗)进行现场访问。方法:在参与者与他们的动物笔友交往的整个过程中,进行了开放式的面对面访谈。访谈被数字化记录。采用内容分析法对数据进行分析。结果:15名7 ~ 16岁的儿童和青少年参与了调查。研究发现了三个主要主题和五个次要主题,包括联系、共同经历和友谊。主题表明,虚拟AAT写信程序可以提供一个有趣的来源,并提供一种与同样面临癌症或严重医疗治疗的狗或猫笔友处理癌症经历的方式。讨论:促进儿科肿瘤学和BMT患者健康的干预措施是必要的,虚拟AAT似乎是适合那些对动物有亲和力并喜欢写信的人的一种干预措施。本研究的发现也为虚拟AAT的进一步研究提供了一个令人兴奋和有趣的空白。
{"title":"Youth and Pet Survivors: Exploring the Experiences of Pediatric Oncology and Bone Marrow Transplant Patients in a Virtual Animal-Assisted Therapy Pen Pal Program.","authors":"Anne Ingalls Gillespie, Madalynn Neu","doi":"10.1177/1043454220944122","DOIUrl":"https://doi.org/10.1177/1043454220944122","url":null,"abstract":"<p><p><b>Introduction:</b> YAPS™ (Youth and Pet Survivors™) is a form of virtual animal-assisted therapy (AAT), a pen pal program designed for children and adolescents with cancer and/or having a bone marrow transplant (BMT) to engage in virtual visits with a dog or a cat (who has also been treated for cancer or serious medical illness) through letter writing and pictures. The purpose of this qualitative descriptive study was to explore the experiences of YAPS participants over time and to explore how virtual AAT may be an additional or alternative intervention to the traditional form of AAT, which involves live visits with animals, primarily dogs. <b>Method:</b> Open-ended, face-to-face interviews were conducted throughout the participants' involvement with their animal pen pal. Interviews were digitally recorded. Data were analyzed using a content analysis method. <b>Results:</b> Fifteen children and adolescents, aged 7 to 16 years, participated. Three main themes and five subthemes were found, including connection, shared experience, and friendship. Themes suggested that a virtual AAT letter writing program can provide a source of fun and a way to process the cancer experience with a dog or cat pen pal who has also faced cancer or serious medical treatment. <b>Discussion:</b> Interventions that promote well-being for pediatric oncology and BMT patients are needed, and virtual AAT seems to be one such intervention suited for those who have an affinity for animals and enjoy letter writing. The findings of this study also presented an exciting and intriguing gap for further research in virtual AAT.</p>","PeriodicalId":50093,"journal":{"name":"Journal of Pediatric Oncology Nursing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1043454220944122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38233484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}