The purpose of this study was to develop and test three instruments to measure fatigue in children with cancer from the perspectives of the child, parents and staff. The study consisted of three phases: instrument development, content validation, and estimations of psychometric properties of the three fatigue instruments. One hundred forty-nine children between the ages of 7-12 years presently receiving chemotherapy for cancer, 147 parents and 124 staff participated in this study. The instruments demonstrated strong initial validity and reliability estimates. This study is the first to provide valid and reliable instruments to measure fatigue in children with cancer.

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Tobacco cessation counseling by health care professionals has been associated with increased tobacco cessation rates. In this study we compare the effectiveness of two smoking cessation approaches administered by nurse practitioners--a stepped care approach (n = 34) and a routine care approach (n = 41), using a pre- and post-test control group study design. Additionally, this study was guided by the "stages of change" construct of the transtheoretical model. Study results indicated that nurse practitioners delivered consistent office-based advice about tobacco use. In addition, nurse practitioner smoking cessation interventions contributed to positive shifts in stage of change for smoking cessation.