The effectiveness of play therapy in children with leukemia: A systematic review.

PROBLEM: Leukemia is the most common form of childhood cancer worldwide. Children living with leukemia experience various problems because of the disease's progression, harmful effects of treatment, and prolonged hospitalization process. To increase their well-being and alleviate their problems, these children require ongoing support. One solution that both parents and professionals can use is play therapy. This systematic review aimed to identify the type and effectiveness of play therapy in children living with leukemia. ELIGIBILITY CRITERIA: We searched PubMed, Scopus, ScienceDirect, and ProQuest databases. Additionally, we performed manual searches on Google Scholar, Google Web, and grey literature. Inclusion criteria comprised: 1) Studies that implemented play therapy on leukemia children, 2) Full-text articles available in English or Indonesian languages from January 2000 to December 2021 and updated until July 2023, and 3) Intervention studies employing quasi-experimental or randomized controlled trial (RCT) designs. SAMPLE: From 1099 articles, 16 studies were selected. Several forms of play therapy were found, including pretend, music, art, and sand play therapy. RESULTS: Of the sixteen studies in this systematic review, fifteen demonstrated beneficial effects on psychological issues, particularly anxiety, despair, stress, and physical problems (fatigue and pain). CONCLUSION: Play therapy effectively alleviates some physical and psychosocial problems in children living with leukemia. IMPLICATION: Nurses can utilize play therapy as an intervention for children living with leukemia. Additionally, comparative research is recommended with a similar research strategy concerning studies with the same design. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022318549.

Self-Efficacy to Obtain Human Papillomavirus Vaccination among Indonesian Adolescent Girls.

OBJECTIVE: This study aimed to examine self-efficacy to obtain the HPV vaccination among adolescent girls in Indonesia. Furthermore, factors affecting HPV vaccination self-efficacy was investigated. METHODS: A cross-sectional study was conducted 337 among adolescent girls in junior high school (aged 12-15 years). Participants were recruited from four junior high schools in Yogyakarta using consecutive sampling. A self-administered questionnaire requested demographic information, knowledge of HPV and HPV vaccine and self-efficacy to obtain HPV vaccine. School teachers facilitate the data collection adolescent girls using the listed questionnaires. Data analysis used Pearson correlation, chi-squared tests and logistic regression analysis. RESULTS: As many as 50.1% of the adolescent girls reported high self-efficacy to obtain HPV vaccine and 57.9% reported high knowledge about HPV and HPV vaccine. There were significant correlations between self-efficacy and age, vaccination experience, recommendation from health care providers, parental support, social persuasion and anxiety. Parental support contributed to almost 18 times (95% CI:3.837 - 83.648; p<0.0001) while social persuasion was nearly 9 times (95% CI: 3.875-20.011; p<0.0001) more likely to predict the self-efficacy to obtain HPV vaccination. CONCLUSION: Parental support and social persuasion significantly predict self-efficacy to obtain HPV vaccination. Parental support is the main factor in the decision making of adolescent to obtain HPV vaccination.

Human Papillomavirus (HPV) Health Savings as an Alternative Solution: HPV Vaccination Behavior in Adolescents.

OBJECTIVE: This study aimed to measure the effects of reproductive health savings (tabungan kesehatan reproduksi, Takespro) on human papillomavirus (HPV) vaccine initiation program and the quality of the decision making to get vaccinated, as measured by knowledge, attitudes, beliefs, and self-efficacy toward HPV vaccination. METHODS: This quasi-experimental study was conducted on 128 students randomly allocated to intervention and control groups. This research was conducted in junior high schools. The intervention group received the health education "Takespro HPV" intervention through videos and booklets for 6 months at school. Participants in the control group received usual care from the school. Data were collected using a questionnaire of knowledge, attitudes, beliefs, and self-efficacy about HPV vaccination modified by researchers based on previous research and tested for validity and reliability. Data were analyzed using Mann-Whitney test and independent t-test. RESULTS: A total of 40 participants were actively enrolled in the intervention group, and 88 were passively enrolled in the control group. The health education that was part of the Takespro HPV intervention improved the knowledge (p < 0.05) and self-efficacy (p < 0.05) of the intervention group compared with the control group. The attitude and belief variables showed no significant difference (p > 0.05). Forty students exhibited the health reproduction savings behavior at schools. However, the savings amount was insufficient to get HPV vaccination at the initiation phase. CONCLUSION: "Takespro" HPV intervention can be considered an alternative to increasing the coverage of HPV vaccination in adolescents in Yogyakarta.
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Need vs. Financing Capability: Human Papillomavirus Vaccinations among Adolescents.

BACKGROUND: The incidence of Human Papillomavirus (HPV) infection and cervical cancer in adulthood may be prevented by HPV vaccination in adolescence. Currently, the HPV vaccination coverage rate in developing countries is about 15%. The reason for this low vaccination coverage is most likely due to a lack of information among adolescents and adults. PURPOSE: To explore adolescents, parents and teachers' needs, obstacles, and expectations around the HPV vaccination. METHODS: This research used a qualitative method with a focus group discussion. The research participants were divided into three groups: 21 female students, 17 parents, and 20 teachers. This research was conducted in junior high schools that have programs run by their adolescent reproductive health counseling information centers. The data were analyzed by employing content analysis. RESULTS: HPV vaccination has not been made a priority for adolescents because: 1) There is a lack of available education about HPV and HPV vaccinations for adolescents, parents, and teachers. 2) The high cost for parents to vaccinate their children. 3) Adolescents, parents and teachers believe that the HPV vaccine needs to be administered to adolescents, but they feel that the vaccine is not affordable. CONCLUSION: It is important to consider a program which will provide accurate information about the HPV vaccination to the community, especially adolescents. Financial management, such as insurance or vaccination savings schemes, may be one way to overcome the problem of the HPV vaccination's cost.