Psychosocial interventions for childhood cancer survivors: Systematic review and meta-analysis of randomized control trials.

PURPOSE: This study was aimed to review and analyze the evidence of the psychosocial interventions for survivors of childhood cancer. METHODS: Electronic databases (PubMed, Embase, Medline, Web of Science, Science Direct, and Scopus) and manuel search were performed for psychosocial randomised controlled trials (RCTs) conducted with survivors who were diagnosed under the age of 18 and have completed treatment. Meta-analyses were performed to evaluate the effects of interventions on psychosocial health outcomes. The trials were published in English between 1 January 2000 to 30 June 2022 were included. Extracted data were analyzed using Review Manager 5.4. RESULTS: Ten trials conducted with 955 childhood cancer survivors were included in the systematic review. Meta-analysis of six RCTs showed no difference in the general quality of life (SMD, 0.07; 95% CI: [-0.09 to 0.23], I2 0%, (p > 0.05)) and three RCTs showed no difference in the physical activity self-efficacy (SMD, 0.12; 95% CI: [-0.35 to 0.58], I2 75%, (p > 0.05)) between intervention and control group. Interventions longer than 24 weeks (including follow-up) were effective in the quality of life and physical activity self-efficacy of the survivors. The overall quality of the evidence was low due to overall low risk of bias for only half of the studies (50%). CONCLUSIONS: Psychosocial interventions were not effective on quality of life and physical activity self-efficacy of childhood cancer survivors, however, long-term interventions provided improvement in these outcomes. REGISTRATION: The protocol for the meta-analysis was registered at PROSPERO (CRD42022375053/22 Nov 2022).

Qualitative Analysis of School Re-Entry Experiences of Turkish Survivors of Childhood and Adolescent Cancer: Parental Perspective.

OBJECTIVE: This study aimed to explore the school re-entry experiences of Turkish survivors of childhood and adolescent cancer. DATA SOURCES: In this qualitative study, semistructured in-depth interviews were undertaken with parents of childhood cancer survivors who had completed treatment for at least 2 years (n = 20). Interviews were conducted via telephone or video conferencing. The study was conducted and reported according to the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. The components of qualitative rigor were considered to ensure confidence in the methods and data. CONCLUSIONS: The average age of parents was 43.20 ± 4.66 years (range 37-55) (n = 20). The mean age of survivors was 8.45 ± 2.03 years at diagnosis and 15.05 ± 2.08 years during the study. The diagnosis of most of the survivors was lymphoma (35%). Four main themes were developed: worry; challenging situations; negative effects of the disease process; and facilitating situations. Parents stated that both children and parents need support during the school re-entry process. IMPLICATION FOR NURSING PRACTICE: This study revealed that survivors may experience problems that make school re-entry difficult. With cooperation between the health team and the school, arrangements should be made to ensure survivors have a positive experience on school re-entry. Pediatric oncology nurses should know survivors' requirements and take action to deliver school re-entry adjustment programs.

Experiences of Parents of Children with Mucopolysaccharidosis in Türkiye: A Qualitative Study.

PURPOSE: Mucopolysaccharidosis increases morbidity and mortality by causing physical and mental limitations in children. Parents experience various difficulties, mostly due to delayed diagnosis and difficult treatment processes. This study aims to examine the experiences of parents regarding their child's illness process. DESIGN AND METHODS: In this qualitative study, semi-structured in-depth interviews were conducted with parents (n = 10) who had a child who had suffered from MPS for at least six months. Interviews were conducted and recorded after the parents were contacted through the MPS-LH association and informed consent was obtained. The conducting and reporting of the research were carried out according to the "Consolidated criteria for reporting qualitative research (COREQ)" checklist. RESULTS: The mean age of the parents was 41.3 ± 7.83. The diagnosis for most of the children was MPS type 4 A (n = 4) and the mean age of the children was 11.3 ± 6.0. Three main themes were identified: 1) psychosocial effects; 2) difficulties and needs; and 3) coping resources. CONCLUSIONS: It was determined that the parents were affected socially and emotionally due to the child's diagnosis and the subsequent process. IMPLICATIONS TO PRACTICE: It will be possible to provide the necessary support to parents with comprehensive nursing care that is planned according to the differing needs of children with MPS.

Nursing care approaches to oral mucositis in pediatric oncology clinics: a cross-sectional study from Türkiye.

PURPOSE: It is important to determine the approaches for oral mucositis (OM) care in pediatric oncology clinics to reflect the profile of practices. The aim of this study was to report on current nursing care approaches for OM in Türkiye. METHODS: The descriptive, cross-sectional study was conducted with nurse managers in pediatric oncology centers in Türkiye between April and December 2022. The data were obtained online by reaching pediatric oncology nurse managers. The data was collected with the "Oral Mucositis Care Application Form" developed by the researchers based on current literature. RESULTS: The study reached approximately 60% (n = 41) of pediatric oncology clinics across Türkiye. Oral assessment of children was mainly conducted by nurses (95.1%), and 53.7% of clinics used the WHO Oral Mucositis Assessment Scale. To prevent OM, oral care routines were performed twice a day (36.6%) using sodium bicarbonate (61%) and 0.9% sodium chloride (26.8%) agents. For oral mucositis management, pharmacological agents included glutamine (oral) (51.2%), chlorhexidine (43.9%), and benzydamine hydrochloride (36.6%), while non-pharmacological agents included black mulberry syrup (41.5%), honey (19.8%), and chewing gum (9.8%). Chlorhexidine and benzydamine hydrochloride were used for all mucositis grades, while glutamine was frequently used for grades 2 and above. CONCLUSIONS: The study revealed that the practices related to preventing and managing oral mucositis in pediatric oncology clinics in Türkiye are heterogeneous. These findings will contribute to the existing literature on the multidisciplinary, systematic, and evidence-based approaches used in oral mucositis care in Türkiye.

Celebrating Nursing Week during the COVID-19 pandemic: The example of Twitter in Turkey for 2020-2021.

AIM: To explore how the nursing profession reflected on Twitter in Turkey about the Nursing Week celebration during the COVID-19 pandemic. BACKGROUND: The COVID-19 pandemic affected the whole world, made every aspect of life extremely difficult, and required excessive involvement by healthcare professionals-especially nurses. Nurses have played a key role in meeting the care needs of people during this time. METHODS: A qualitative research design was used for this study. Turkish social media data were analysed via a data crawler on Twitter. Tweets regarding the COVID-19 pandemic during 12-18 May 2020 and 12-18 May 2021-dates celebrated as Nursing Week in Turkey-and tweets containing at least one of the following relevant hashtags: #nurse, #nursesday, #nursesweek, #nursingweek, #12May, or #12Maynursesday, were considered. RESULTS: The hashtag #12May was used the most in both years, and the most tweets were posted with the hashtag #12May (n = 2996) in 2020. Three categories, 'Being a nurse in the pandemic', 'Nursing Week with celebrations', and 'Nursing Week with definitions', were identified through a thematic analysis. The categories included the importance of nursing, respectability, difficult working conditions, insufficiency in the number of nurses, difficulties in social life, etc. DISCUSSION: Turkish society posted tweets to celebrate Nursing Week. In addition to the celebration, there were many statements revealing the positive aspects of nurses and the nursing profession, as well as the difficulties nurses faced during the COVID-19 pandemic. CONCLUSION: Our findings revealed that in the celebrations of Nursing Week in Turkey, the important role of nursing in the health system, difficulties experienced during the COVID-19 pandemic, and definitions describing the roles of nursing were reflected on Twitter. IMPLICATION FOR NURSING AND HEALTH POLICIES: This presents a source for perspective on the opinions reflected on social media about nurses and the nursing profession via Nursing Week celebrations during the pandemic. The findings can guide the development of policies on the rights and social privileges of the nursing profession that need to be improved in exceptional situations like a pandemic.

Evaluation of the Effectiveness of a Technology-Based Psychosocial Education and Counseling Program for Adolescent Survivors of Childhood Leukemia: A Randomized Controlled Trial.

BACKGROUND: In addition to increased survivorship in childhood leukemia, a small but significant number of survivors experience psychosocial challenges that affect their health-related quality of life (QOL) that require interventions to address these challenges. OBJECTIVE: The aim of this study was to evaluate the efficacy of the technology-based, psychosocial education and counseling program on survivors' QOL, self-efficacy, and coping skills within the scope of a health promotion model for adolescent survivors of childhood leukemia. METHODS: The randomized controlled trial was conducted with adolescent survivors of childhood leukemia who were between the ages of 12 and 18 and had completed treatment at least 2 years previously. Survivors were randomized to a technology-based intervention (n = 24) or a control group (n = 31). Survivors' QOL, self-efficacy, and coping skills were measured at 4 time points (baseline, postintervention, 1 month postintervention, and 3 months postintervention). RESULTS: The 3-month postintervention QOL total and psychosocial subscale scores in the intervention group were significantly higher than those in the control group ( P < .05). In addition, the emotional self-efficacy subscale scores and the active coping scores of the intervention group adolescents were significantly higher than those in the control group ( P < .05). Negative coping scores were lower in the intervention group than in the control group ( P < .05). CONCLUSION: Technology-based, psychosocial counseling and education positively affects the QOL, emotional self-efficacy, and coping skills of adolescent survivors of childhood leukemia. IMPLICATIONS FOR PRACTICE: This program could be integrated into follow-up care and used as one of the support methods in providing and maintaining long-term follow-up care by pediatric oncology nurses.

'Trying to catch up with life': The expectations and views of adolescent survivors of childhood acute lymphoblastic leukaemia about long-term follow-up care: A qualitative research.

OBJECTIVE: The aim of this study was to explore adolescent survivors' views and expectations about long-term follow-up care. METHODS: Semi-structured, in-depth interviews were conducted with 16 adolescent survivors of childhood acute lymphoblastic leukaemia. Survivors who had completed treatment at least 2 years ago were involved in the study. Interviews were audio-recorded and transcribed verbatim. An inductive thematic approach was used to analyse the data. RESULTS: Four main themes and sub-themes were identified from the analysis as follows: information needs with three sub-themes 'long-term follow-up, healthy life and social life', support needs with three sub-themes 'psychosocial (peer relations etc.), school related and social-emotional (fear of relapse, body image, self-esteem, etc.)', perceived benefits with two sub-themes 'social-emotional and related to long-term follow-up' and perceived barriers 'medical-hospital related and social life'. CONCLUSIONS: Adolescent survivors mainly need support in terms of psychosocial aspects: self-esteem-body image, school, peer relations and social activities during follow-up. Identified barriers related to follow-up were school absence and not able to participate social activities. Adolescents specify health promotion approaches as benefits aspects of follow-up. The findings of this study will guide nurses in the long-term follow-up care of adolescent survivors of acute lymphoblastic leukaemia and provide an opportunity to plan individualised follow-up care.

Development and psychometric evaluation of the nursing students' attitude towards e-learning scale.

BACKGROUND: E-learning is a relatively recent and rapidly expanding trend of nursing education that increased particularly during the COVID-19 pandemic. Therefore, assessing the attitudes of nursing students towards e-learning with standardized tools has gained importance. AIM: To determine the validity and reliability of nursing students' attitudes towards e-learning (NSA-E-learning) scale. METHOD: This methodological study was performed from 1 July to 15 August 2021 with 404 nursing students in Turkey. The item pool of the scale was created based on the relevant literature. The data were evaluated using descriptive statistics, explanatory and confirmatory factor analysis (CFA), Pearson correlation analysis, t-test for dependent variables and Cronbach alpha coefficient. RESULTS: The content validity index of this scale calculated according to experts' opinions ranged from 0.87 to 1.00. According to the exploratory factor analysis, 4 factors had an eigenvalue > 1. These 4 factors accounted for 69.66 % of the total variance. CFA showed favorable results for Chi square/degrees of freedom (χ2/df), comparative fit index (CFI) and root mean square error of approximation (RMSEA). The Cronbach alpha of the scale was 0.96 and the Cronbach alpha coefficient of the sub-dimensions ranged from 0.82 to 0.94. The NSA-E-learning scale had moderate test-retest reliability. CONCLUSION: The 29-item NSA-E-learning scale was a valid and reliable tool for assessing the attitude of the nursing students towards e-learning.

The development of a self-evaluation scale for simulation laboratory practices.

BACKGROUND: Simulation is an important learning-teaching tool for integrating theory and practice in nursing education. OBJECTIVE: The aim of this study was to develop and to conduct the validity and reliability of a self-evaluation scale for simulation laboratory practices (SES-SLP) with undergraduate nurses. METHODS: The study sample consisted of 220 undergraduate nursing students. Data were collected using a Descriptive Characteristic Form (DCF) and the 23-item Self-Evaluation Scale for Simulation Laboratory Practices (SES-SLP). RESULTS: Cronbach's alpha value of the scale was 0.94. The scale comprised of two subscales: the developing factor (19 items) and the challenging factor (4 items). All items showed a statistically significant correlation (p < 0.05). CONCLUSIONS: The SES-SLP is a valid and reliable scale that can be used to evaluate students' learning experience for simulation laboratory practices.

Meaning and Affecting Factors of Spirituality in Adolescents.

Purpose: The aim of this study was to explore the perceptions of adolescents about spirituality via semistructured, in-depth interviews. Method/Design: A qualitative research design using interviews was performed with 17 adolescents in a mostly Muslim region in Turkey. Interviews were conducted via five open-ended questions. Findings: Three main categories and eight themes emerged from the analysis. The "Spirituality Meaning" category included five themes, such as mind, emotions, mind/emotions, ethical principles, and religion. Personal practices and environmental factors as well as mind, emotions, ethical principles, and religion themes were in the "Factors That Increase Spirituality" category. The theme living negativity was in the "Factors That Decrease Spirituality" category. Most of the adolescents (58.8%) stated that the meaning of spirituality was love, respect, and the ability to think, analyze, and synthesize. Conclusion: It is important to determine and evaluate the perceptions and experiences of children about spirituality in different cultures to improve the quality of care.

Symptoms and Problems in Children with Inherited Metabolic Diseases and Factors Affecting the Caregiver Burden of Mothers.

Parents need to constantly monitor their children with inherited metabolic diseases (IMDs) and have difficulty coordinating care. The aim of this descriptive study was to determine the symptoms and problems in children with IMDs and factors affecting caregiver burden. The study was conducted in a pediatric hospital. The study sample consisted of 47 mothers of children with IMDs. Data were collected using a descriptive characteristics form (DCF), a data collection form related to symptoms and problems (DCFSP), and a caregiver burden inventory (CBI). The most common specific problems were hepatomegaly (36.2%), developmental delay (27.7%), and muscle weakness (14.9%). Mothers' CBI mean total score was 30.23 ± 19.65. Mothers whose children were partially or completely dependent had significantly higher scores than others. Mothers who expressed the family income status as "an expenses more than income" had higher CBI scores. Understanding the problems of children with IMD and factors effecting caregiver burden of mothers can help health-care professionals to identify patients' and their families' needs and facilitate the development of nursing interventions for effective care and reduction of caregiver burden. These results can be used to improve the nursing care of children with IMDs and their families.

Assessment of Nutritional Problems in Pediatric Patients with Cancer and the Information Needs of Their Parents: A Parental Perspective.

OBJECTIVE: The majority of problems and symptoms occur in the gastrointestinal system in children with cancer. Parents have difficulty in coping with the nutritional problems and changing routines of children and need support in this respect. This study aimed to assess the nutritional problems of children with cancer and the information needs of their parents. METHODS: This descriptive study was performed among children with cancer aged 3-18 years and their parents (n = 69). The data were collected through a data collection form developed by the researchers based on the literature. RESULTS: The most prominent nutritional problems experienced by children were loss of appetite (85.5%), nausea (84.1%), vomiting (81.2%), fatigue (79.7%), and mucositis (66.7%). According to the parents, the factors causing these nutritional problems in children were physiological factors (100%) and the foods given to children in the hospital (65.2%). The parents mostly needed information about food-drug interactions (58.0%), food-disease interactions (52.2%), foods that children with neutropenia should avoid or should eat (neutropenic diet) (46.4%), and frequency of nutritional intake (36.2%). CONCLUSIONS: This study has shown that most children experience at least one nutritional problem, and the parents need comprehensive and regular information about nutrition. Pediatric oncology nurses have a significant responsibility in the evaluation, education, and monitoring of these children.