Efficacy, Safety, and Pain Level of Subcutaneous Catheter Use for Administration of Granulocyte Colony-Stimulating Factor (G-CSF) in Children With Cancer: A Randomized Pilot Study.

Background: The aim of this study was to explore the efficacy, safety, and pain level of granulocyte colony-stimulating factor (G-CSF) administration via a subcutaneous catheter compared with direct injection in children with cancer. Method: This was a pilot randomized controlled trial of standard G-CSF administration versus subcutaneous catheter administration. Children 2-15 years of age who were beginning G-CSF after their first chemotherapy cycle and anticipated to receive G-CSF following the next three cycles of chemotherapy were eligible. Efficacy, safety, and pain were as outcomes of the study. Results: Twenty-nine children with cancer (median age 12 years) were enrolled in the study (16 children in the subcutaneous catheter group and 13 children in the direct injection group). During Cycle 2, the median number of days to reach absolute neutrophil count (ANC) ≥ 500/mm3 was greater among those in the subcutaneous catheter group (12 vs. 10; p = .02). In Cycle 3, however, the subcutaneous catheter group received fewer doses of G-CSF (8 vs. 12; p = .004). No complications related to subcutaneous catheter use were observed. No differences in the visual analog scale pain score were observed between groups in Cycles 1 to 3; however, in Cycle 4, children in the subcutaneous catheter group had lower median pain scores than those in the direct subcutaneous injection group (Mdn = 0, [IQR] = 0-2 vs. Mdn = 1, IQR = 0-6; p < 0.01). Conclusion: Results demonstrated administering G-CSF via a subcutaneous catheter enables ANC to recover with no pain or complications associated with its use. Thus, oncology teams may consider this administration method to be used in children with cancer.

Autocuidado en adolescentes portadores de cáncer / Self-care in adolescents with cancer

El diagnóstico de cáncer en la adolescencia es un factor estresante que dificulta el auto- cuidado. La adolescencia se caracteriza por cambios físicos, cognitivos y sexuales, funda- mentales en construcción de autoestima y consecución de autonomía. La práctica del autocuidado contribuye al logro de dichas tareas. El fomento del autocuidado se considera esencial para lograr que el adolescente se desenvuelva como agente de autocuidado. Este estudio describe las conductas de autocuidado realizadas por adolescentes con cáncer, con el propósito de sensibilizar a enfermería respecto a la importancia del fomento del autocuidado para mejorar el nivel de vida. Se realizó búsqueda en bases de datos, seleccionando 20 artículos de investigación publicados entre 2000-2010. Se encontró que los adolescentes realizan diferentes actividades y/o conductas en el ámbito espiritual, psicológico y físico para satisfacer sus requisitos. El requisito más mencionado fue "promoción de la normalidad". Los mayores niveles de autoeficacia fueron logrados por quienes reciben apoyo de familia y amigos. Los jóvenes con cáncer se interesan e involucran en su cuidado, con el objeto de recuperar la normalidad. La práctica de autocuidado empodera al adolescente en la mantención y recuperación de la salud y aumenta la calidad de vida.

The diagnosis of cancer in adolescence is a stressful factor that hampers self-care. Adolescence is characterized by physical, cognitive and sexual changes fundamental in building of self-esteem and achievement of autonomy. The practice of self-care contributes to the achievement of these tasks. Promoting self-care is considered essential to ensure that the adolescent becomes a self-care agent. This study describes self-care behaviors by adolescents with cancer, with the purpose of sensitizing nurses to the importance of promoting self-care to improve the standard of living. A search was conducted in databases, and 20 research articles published between 2000-2010 were selected. It found that teens do different activities and/or behavior in the spiritual, psychological and physical fields to meet their requirements. The most often mentioned requisite was "promoting normality." The highest levels of self-efficacy were made by those who receive support from family and friends. The young people with cancer are interested and involved in their care, in order to return to normality. The self-care practice empowers the adolescent in maintaining and restoring health and increases quality of life.