Development and psychometric analysis of a pediatric cancer survivors Psychosocial Late Effects Scale (PCSLES).

PURPOSE: Although the physiological late effects of childhood cancer survivors are more obvious, appropriate assessment of psychosocial effects is needed. Therefore, it was aimed to develop a scale to evaluate psychosocial late effects in cancer survivors and to test its validity and reliability. DESIGN AND METHODS: This methodological study was conducted with 100 children and adolescents who survived were collected at the oncology center in the south of Türkiye in 2022. Data were collected with the "Personal Information Form" and "Pediatric Cancer Survivors Psychosocial Late Effects Scale (PCSLES)" IBM SPSS 24.0 and IBM AMOS 24.0 software programs were used for data analysis, and descriptive statistics were used to analyze numeric variables. Exploration and confirmatory factor analyses were performed to determine the scale's factorial structure. RESULTS: The factorial analysis was used to test the structural validity of the scale. A four-factor structure consisting of 17 items was developed. The Cronbach's alpha coefficient for "1" was 0.89, "2" was 0.87, "3" was 0.80, "4" was 0.82 and the total score was 0.92. Fit indices resulting from the study were χ2/SD: 1.497, root mean square error of approximation (RMSEA): 0.071, goodnessof-fit index (GFI): 0.85, comparative-of-fit index (CFI): 0.94, and normed fit index (NFI): 0.85. CONCLUSION: The scale is a valid and reliable scale that can be used to determine psychosocial late effects in pediatric cancer patients. PRACTICE IMPLICATIONS: Utilizing the PCSLES can assist in identifying the psychosocial symptoms of child survivors/adolescents and facilitate the planning of appropriate interventions.

Rebuilding and Guiding the Self With Spirituality: A Grounded Theory of Experiences of Adolescents and Young Adults With Cancer.

PURPOSE: To clarify the experiences of spirituality among adolescents and young adults (AYAs) with cancer following diagnosis. PARTICIPANTS & SETTING: Participants were recruited at a clinic and on an oncology unit in Turkey. A combination of purposive sampling and theoretical sampling strategy was used to identify 14 participants. METHODOLOGIC APPROACH: A grounded theory design was used for this study. Semistructured interviews were conducted with each participant between October 2021 and January 2022. The data were analyzed using open, axial, and selective coding. FINDINGS: All the participants were Muslim, were aged 15-39 years, spoke Turkish, and had undergone treatment for any type of cancer. The core category was identified as rebuilding and guiding the self with spirituality. AYAs connected more closely with their sense of spirituality after being diagnosed with cancer. IMPLICATIONS FOR NURSING: This study demonstrated the importance of providing a supportive healing environment to address the spiritual dimension of the cancer experience for AYAs. Individualized interventions ensuring an appropriate level of spiritual care based on clinical standards are essential to meet the needs of patients and ensure positive long-term health outcomes.

A grounded theory study to explore the digital gameplay experiences of adolescents at risk of addiction in Turkey.

PURPOSE: This study aimed to explore the experiences of adolescents at risk of digital game addiction in Turkey. DESIGN AND METHODS: Guided by a grounded theory design, data were collected from 14 adolescents through one-on-one in-depth interviews between January and April 2021. Simultaneous data collection and analysis involved theoretical sampling, constant comparison, and memo writing. Open, axial, and selective coding were used in data analysis, while analytic coding identified the core category and subcategories and provided the foundation for the substantive theory. RESULTS: The core category, "I want to limit my time playing digital games, but I need the support of my family to do so," demonstrated the adolescents' awareness of their situation. The analysis yielded an interpretive theory comprising three inter-related categories: causal factors, effects on life, and solution pathways. CONCLUSIONS: The participants' reasons for playing digital games included meeting their need for socialization and passing the time. However, digital gaming affects adolescents physically, psychosocially, and culturally. Solutions include early childhood education and family support, which can significantly reduce the risk of digital game addiction. PRACTICE IMPLICATIONS: Preventing digital game addiction is an important goal, and identifying risks contributing to digital game addiction is fundamental to establishing preventive measures. This study's findings may increase awareness of the subject for teachers, school nurses, and parents. Among the potential remedial measures are future studies focused on preventing digital game addiction and adding instruction to school curricula regarding necessary and beneficial uses of digital technologies.

The effectiveness of mandala drawing in reducing psychological symptoms, anxiety and depression in hospitalised adolescents with cancer: A randomised controlled trial.

OBJECTIVE: This study aimed to evaluate the effectiveness of individual mandala drawing methods on psychological symptoms, anxiety and depression in hospitalised adolescents with cancer. METHODS: A randomised controlled trial design with repeated measures was conducted. The study was carried out in a paediatric haematology and oncology clinic in Turkey. The study protocol is registered at ClinicalTrials.gov NCT04297982. The study sample consisted of 60 hospitalised adolescents aged between 12 and 17. Participants were randomly assigned to receive two 1- to 2-h mandala drawing sessions (intervention group, n = 30) or routine care only (control group, n = 30). Each adolescent was assessed using the Hospital Anxiety and Depression Scale and the Memorial Symptom Assessment Scale (Psychological subscale) questionnaires and was evaluated at baseline and after 5 days. RESULTS: The anxiety and depression scores significantly decreased in the intervention group, compared with the control group, after 5 days of intervention, F(1, 57) = 28.9, p < 0.01, η2 = 0.337. Similarly, the psychological symptoms scores significantly decreased in the intervention group, compared with the control group, F(1, 57) = 69.7, p < 0.001, η2 = 0.550). CONCLUSION: The individual mandala activity intervention was effective in reducing on psychological symptoms, anxiety and depressive symptoms in adolescents with cancer.

Examining the expectations of healing care environment of hospitalized children with cancer based on Watson's theory of human caring.

AIM: To describe the expectations of children with cancer about the healing care environment during hospitalization based on Watson's Theory of Human Caring. DESIGN: A descriptive qualitative research design was used in this study. METHODS: Data were collected between December 2019 and February 2020 from purposively selected children with cancer in a paediatric haematology and oncology clinic at a university hospital in Turkey. Twelve participants (7 females and 5 males) aged 10-17 were recruited to carry out individual semi-structured interviews. All interviews were recorded via a digital audio recorder and transcribed verbatim. The content analysis method was used to analyse the data. FINDINGS: As a result of the analysis, three main themes with related sub-themes were identified that revealed the expectations of children with cancer: 'healing care behaviors', 'creating the physical environment of the hospital' and 'support from the social environment'. CONCLUSION: Watson's Theory of Human Caring may be a useful and applicable guide for drawing a conceptual framework of the expectations of children with cancer regarding a healing care environment. The study revealed these children's need for humanistic, compassionate, honest and problem-focused care. In addition, participants wished for improvements in the physical environment. They also stated that they feel lonely and need social support from their family, peers and society. IMPACT: This study presents a comprehensive picture of the expectations regarding a healing care environment (caring behaviours and physical and social aspects) of hospitalized children with cancer undergoing treatment. The qualitative findings generated by our study have the potential to facilitate these children's healthy adjustment to the hospital environment and procedures during hospitalization. Knowledge acquired through this study may be used to shape nursing care, enhance the healing care environment, and ensure that hospital design and setting are acceptable to and appropriate for paediatric patients.

Experiences of Turkish Parents of Hospitalized Children With Cancer During the COVID-19 Pandemic: A Qualitative Study.

PURPOSE: To describe the experiences of Turkish parents of hospitalized children with cancer during the COVID-19 pandemic. PARTICIPANTS & SETTING: Participants were recruited at the pediatric hematology-oncology clinic of a university hospital in Turkey. A purposive sampling strategy was used to identify participants. Parents who had a child aged 0-18 years with cancer were eligible. METHODOLOGIC APPROACH: This study was conducted using a descriptive qualitative research design. Semistructured individual interviews with 14 parents of children with cancer were used for data collection. Data were analyzed using the content analysis method. FINDINGS: Two main themes with related subthemes were identified that revealed the lived experiences of parents of children with cancer. IMPLICATIONS FOR NURSING: Pediatric oncology nurses can develop clinical practices that help parents to cope with anxiety about COVID-19. Nurses should share with parents current and valid information about the child's care during the pandemic. Future research should examine the experiences of children with cancer and their parents from different cultures during the COVID-19 pandemic.

The experiences of adolescents receiving cancer treatment in Turkey: A qualitative study.

OBJECTIVE: The adolescents with cancer usually receive intensive chemotherapy in the hospital. Their experiences of the process can affect their lives. This study aimed to describe the experiences of hospitalised adolescents receiving cancer treatment. METHODS: This study was conducted using a descriptive qualitative research design. Data were collected from 12 adolescents receiving cancer treatment in the paediatric haematology/oncology clinic at a university hospital in Turkey. Adolescents participated in one session of individual, unstructured mandala drawing. Individual interviews were then conducted using a semi-structured interview guide. The interviews, researcher observations and document analysis methods were used to produce and analyse data. Interview transcripts of the study were analysed using the content analysis method. RESULTS: Two main themes with related sub-themes each were obtained: being an adolescent with cancer, with the sub-themes of changes in health, restriction of freedom and feeling lonely; and coping with cancer with the sub-themes of psychological growth and hope for healing. CONCLUSION: Adolescents felt lonely and as though their freedom was restricted while they were hospitalised. Participants also noticed changes in their perspective on life and experienced psychological growth. Most of them hoped for healing and prayed to cope with cancer.