Experience and nursing needs of school‐age children undergoing lumbar puncture during the treatment of acute lymphoblastic leukaemia: a descriptive and qualitative study
Abstract:The experiences described in this study contribute to a better understanding of the needs of acute lymphoblastic leukaemia children undergoing lumbar puncture. They also provide valuable information to professional medical care staff that develops future nursing assessments.
“…Children’s drawings depict sadness as associated with social isolation, separation from siblings, grief, and extending to other family members (Linder, Bratton et al, 2018; Sadruddin & Hameed-ur-Rehman, 2013). School-age children receiving treatment for ALL also experienced sadness in response to lumbar punctures (Xie et al, 2017). Sadness was a prevalent theme of concern among AYAs at the time of diagnosis (Korsvold et al, 2017).…”
Section: Resultsmentioning
confidence: 99%
“…The experience of sadness was common across age-groups and across countries. Children experienced multiple sources of sadness, including treatment-related procedures as well as a sense of isolation and grief (Linder, Bratton, et al, 2018; Sadruddin & Hameed-ur-Rehman, 2013; Xie et al, 2017). Although the prevalence of sadness decreases over the course of treatment and over a cycle of chemotherapy (Hockenberry et al, 2014), persistent sadness, when it occurred, was of greater severity and associated distress (Baggott et al, 2010).…”
Children and adolescents receiving treatment for cancer experience multiple symptoms as a consequence of their disease and its treatment that interfere with the child’s quality of life. Understanding of symptom assessment in children with cancer is foundational to the work of the Children’s Oncology Group Nursing Discipline, whose research aims are to address knowledge gaps including understanding illness-related distress. This article is the second of a two-part summary of current evidence addressing the assessment of symptoms frequently reported by children and adolescents receiving treatment for cancer. Studies reporting assessment of pain, sadness, and symptom clusters published between January 2008 and May 2018 were included. Forty-three publications addressed pain. Pain was highly prevalent and distressing, varied in its trajectory across a cycle of chemotherapy and across multiple cycles of treatment, and correlated with biomarkers associated with the pain response. Consequences of pain were poorer functional status and emotional health. Twenty publications addressed sadness. Sadness was the most prevalent psychosocial symptom. Its prevalence decreased over the course of treatment and over a cycle of chemotherapy. Persistent sadness was of greater severity and distress. Eight publications addressed symptom clusters. These studies identified both groups of co-occurring symptoms and groups of patients with common symptom profiles. This two-article series provides evidence for the distressing nature of symptoms among children receiving cancer treatment. Efforts to support clinicians in routine symptom assessment are needed. Additional research directed at alleviating symptoms and building resilience among the child experiencing symptoms is needed.
“…Children’s drawings depict sadness as associated with social isolation, separation from siblings, grief, and extending to other family members (Linder, Bratton et al, 2018; Sadruddin & Hameed-ur-Rehman, 2013). School-age children receiving treatment for ALL also experienced sadness in response to lumbar punctures (Xie et al, 2017). Sadness was a prevalent theme of concern among AYAs at the time of diagnosis (Korsvold et al, 2017).…”
Section: Resultsmentioning
confidence: 99%
“…The experience of sadness was common across age-groups and across countries. Children experienced multiple sources of sadness, including treatment-related procedures as well as a sense of isolation and grief (Linder, Bratton, et al, 2018; Sadruddin & Hameed-ur-Rehman, 2013; Xie et al, 2017). Although the prevalence of sadness decreases over the course of treatment and over a cycle of chemotherapy (Hockenberry et al, 2014), persistent sadness, when it occurred, was of greater severity and associated distress (Baggott et al, 2010).…”
Children and adolescents receiving treatment for cancer experience multiple symptoms as a consequence of their disease and its treatment that interfere with the child’s quality of life. Understanding of symptom assessment in children with cancer is foundational to the work of the Children’s Oncology Group Nursing Discipline, whose research aims are to address knowledge gaps including understanding illness-related distress. This article is the second of a two-part summary of current evidence addressing the assessment of symptoms frequently reported by children and adolescents receiving treatment for cancer. Studies reporting assessment of pain, sadness, and symptom clusters published between January 2008 and May 2018 were included. Forty-three publications addressed pain. Pain was highly prevalent and distressing, varied in its trajectory across a cycle of chemotherapy and across multiple cycles of treatment, and correlated with biomarkers associated with the pain response. Consequences of pain were poorer functional status and emotional health. Twenty publications addressed sadness. Sadness was the most prevalent psychosocial symptom. Its prevalence decreased over the course of treatment and over a cycle of chemotherapy. Persistent sadness was of greater severity and distress. Eight publications addressed symptom clusters. These studies identified both groups of co-occurring symptoms and groups of patients with common symptom profiles. This two-article series provides evidence for the distressing nature of symptoms among children receiving cancer treatment. Efforts to support clinicians in routine symptom assessment are needed. Additional research directed at alleviating symptoms and building resilience among the child experiencing symptoms is needed.
“…,[22][23][24][27][28][29]31,33,35,37,40,41,43,44,47,56,57,97,[100][101][102][103][107][108][109][110][111][112][113][114] Fear and Worry for the Future Paralyzed by devastating news • At first I did not think I was sick at all, I thought they had mixed up the tests. But after becoming better from the medication I was aware that I was sick, but I did not want to understand it 29.…”
mentioning
confidence: 99%
“…[9][10][11]20,21,24,30,33,35,[41][42][43]46,50,51,56,61,94,96,101,105,106,112,115,116,118,120,122,126,136 from the same spot every time. 21 10,11,20,21,23,24,39,41-43,47,49,52,58-61,97,105,115,116,119,120, 122,124,129,136,139,140 .…”
Effective communication is challenging in childhood cancer, where decisions carry unpredictable and life-threatening implications. We aimed to describe patients' experiences of communicating with clinicians during treatment of childhood cancer. A systematic review of qualitative studies to April 2019 was performed. Eligible studies included patients diagnosed with cancer at age ≤ 18 years and reported their perspectives of communicating with clinicians during treatment of childhood cancer. Data were extracted from primary studies for thematic synthesis. From 101 articles across 25 countries involving 1870 participants who were diagnosed with cancer between ages 3 to 18 years, we identified 6 themes: 1) rendered invisible and powerless (displaced and undermined by adult authority; betrayed and distrustful; feeling neglected; helpless and intimidated; disempowered by lack of information); 2) fear and worry for the future (paralyzed by devastating news; uncertainty, anticipation, and dread; broaching intimate and private topics); 3) burdened with responsibility (pressured and unprepared; balancing external expectations; protecting hope); 4) therapeutic patient-provider relationships (emotional support and encouragement; validated personhood and companionship); 5) safety in trust (truthfulness and transparency; prepared by awareness and understanding; reassured by reliable expertise; depending on adults for protection and difficult decisions; security in expressing opinions and needs); and 6) empowerment and assertive agency (right to individual knowledge and choice; control over own life; partnership and respect; enhancing capacity for self-management). During treatment of childhood cancer, patients gain a sense of respect, safety, and control when they feel clinicians address their information and developmental needs. However, communication that is perceived to be parent-centered can be disempowering. Promoting child agency and partnership may improve care and outcomes for children with cancer. Cancer 2020;126:701-716.
“…Fear and attachment: According to the ndings of this study, for children with leukemia between 2 and 7 years old, medical staff should pay attention to their emotional reactions during hospitalization, and rst ensure a comfortable and warm environment when conducting diagnosis and treatment. Anwei Xie [21] found that children with leukemia hoped that pictures of kids could be hung on the wall during waist puncture, and that medical staff could wear overalls with colorful cartoon patterns, which may eliminate the children's fear on the hospital environment and medical staff. Liu Qun [22] stated that the implementation of comfort care could obviously eliminate the nervousness and fear of children with leukemia, and medical staff should pay attention to a kind attitude and establish a trusting relationship with the children, increasing the children's sense of security and improving their attachment mood.…”
Background Leukemia is a pediatric malignancy with the highest incidence rate and large onset age span. Children with leukemia at different ages show various social maladjustments after illness, which are mainly reflected in psychological and behavioral changes. It is of great significance to improve children's social adaptation level and purposefully prevent children from having social adaptation problems. Objective To describe the social adaptation problems faced by Chinese children with leukemia at different ages, and to provide the basis for formulating targeted preventive intervention strategies. Method The purpose sampling method was adopted to conduct semi-structured interviews on 20 Chinese children with leukemia and their main caregivers, and the Colaizzi phenomenological research method in the qualitative research was used to organize and analyze the data. Results The existing social adaptation problems of children with leukemia at different ages were summarized. In terms of psychological maladjustment, children with leukemia aged 2~7 years showed "fear and excessive attachment"; Children with leukemia aged 8-18 years are characterized by "Impatience, irritability and anxiety". In terms of behavioral maladjustment, children with leukemia aged 2~7 years have the problem of "less independent behavior" and "dependence on electronic products"; Children with leukemia aged 8-18 years showed "learning obstruction" and "indulging in mobile games". Conclusions Develop targeted intervention strategies based on the physical and mental characteristics of children with leukemia at different ages to improve their existing social adaptation problems. Pay attention to early intervention in the social adaptation of children with leukemia. Predictably improve the social adaptation level of children to prevent more adaptation problems, so that children can smoothly return to their families and society and improve their quality of life in the long term.
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