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1.
Nutr Cancer ; 73(1): 83-88, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32188289

RESUMO

Malnutrition is prevalent among pediatric oncology patients admitted to the pediatric intensive care unit (PICU), which leads to unfavorable clinical outcomes. This was a secondary data analysis of the nutrition data of 160 pediatric oncology patients admitted to the PICU. Cox's regression (adjusted for sex, age, and pediatric critical illness score) and Chi-square were used to examine the association between nutritional status and outcomes. Most of the patients were diagnosed with leukemia and admitted to PICU for medical reasons. The prevalence of malnutrition was 11.3% according to weight-for-age z-score, 16.3% according to height-for-age z-score, 21.3% according to body mass index-for-age z-score, 14.4% according to weight-for-height z-score, 34.4% according to mid-upper arm circumference-for-age z-score. Anthropometrical parameters that predicted the duration of mechanical ventilation were weight-for-age (hazard ratio [HR], 2.727; 95% confidence interval [CI], 1.729-4.302); height-for-age (HR, 1.969; 95% CI, 1.440-2.693); weight-for-height (HR, 2.645; 95% CI, 1.575-4.441); and upper arm muscle area-for-age (HR, 2.098; 95% CI, 1.430-3.077). Length of PICU stay was predicted by weight-for-age (HR, 1.207; 95% CI, 1.014-1.436). Malnutrition is prevalent among pediatric oncology patients admitted to the PICU, which lead to unfavorable clinical outcomes. Comprehensive nutritional status assessment should be performed for these children.


Assuntos
Desnutrição , Neoplasias , Estado Nutricional , Criança , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Tempo de Internação , Neoplasias/diagnóstico , Resultado do Tratamento
3.
Cancer Nurs ; 42(6): 430-438, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30124482

RESUMO

BACKGROUND: The Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to measure symptoms and functions of children with a variety of chronic diseases. As the Chinese version of pediatric PROMIS (C-Ped-PROMIS) measures was developed, the measurement properties of C-Ped-PROMIS have not been demonstrated. OBJECTIVE: The aim of this study was to examine the reliability, validity, and factorial structure of the C-Ped-PROMIS measures in children with cancer in China. METHODS: A total of 272 children and adolescents were recruited from 3 hospitals in China. The 8 C-Ped-PROMIS measures and Pediatric Quality of Life Inventory General Core Module and Cancer Module were administered in a cross-sectional design. Known-group validity, concurrent validity, and item and scale reliability of these 8 measures were examined by using SPSS 21.0, and factorial structures were tested by using confirmatory factor analysis with Mplus 7.1. RESULTS: All 8 C-Ped-PROMIS measures showed good known-group validity as hypothesized (P < .05) and good concurrent validity measured by significant correlations with the Pediatric Quality of Life Inventory General Core Module and Cancer Module; the correlation coefficients ranged from r = 0.519 to r = 0.655, except for peer relationship with r = 0.255 and r = 0.136, respectively. The Cronbach's α of C-Ped-PROMIS ranged from .758 to .910, and model-estimated scale reliabilities ranged from 0.740 to 0.905. The confirmatory factor analysis models of each measure fit data very well. CONCLUSIONS: All 8 C-Ped-PROMIS measures have a valid factorial structure as theoretically defined with good reliability and validity. IMPLICATIONS FOR PRACTICE: The C-Ped-PROMIS can be readily used to measure symptoms and functions of children and adolescents with cancer in China.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Doença Crônica/psicologia , Neoplasias/psicologia , Medidas de Resultados Relatados pelo Paciente , Psicometria/métodos , Qualidade de Vida/psicologia , Adolescente , Criança , China , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
4.
JMIR Mhealth Uhealth ; 6(11): e195, 2018 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-30455166

RESUMO

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Caring for children with ALL is challenging for parents. A mobile health (mHealth) supportive care intervention was developed to meet parents' needs. OBJECTIVE: This study aims to evaluate the potential effectiveness of this mHealth supportive care intervention on emotional distress, social support, care burden, uncertainty in illness, quality of life, and knowledge. METHODS: We conducted a quasi-experimental pre- and postdesign study from June 2015 to January 2016. In total, 101 parents were enrolled in the study, with 50 in the observation group and 51 in the intervention group. Parents in the observation group received the standard health education and were observed for 3 months. Parents in the intervention group received the mHealth supportive care intervention, in addition to the standard health education. The intervention consisted of 2 parts-an Android smartphone app "Care Assistant (CA)" and a WeChat Official Account. The CA with 8 modules (Personal Information, Treatment Tracking, Family Care, Financial and Social Assistance, Knowledge Center, Self- Assessment Questionnaires, Interactive Platform, and Reminders) was the main intervention tool, whereas the WeChat Official Account was supplementary to update information and realize interaction between parents and health care providers. Data of parents' social support, anxiety, depression, care burden, uncertainty in illness, quality of life, their existing knowledge of ALL and care, and knowledge need were collected before and after the 3-month study period in both groups. For the intervention group, parents' experience of receiving the intervention was also collected through individual interviews. RESULTS: Overall, 43 parents in the observation group and 49 in the intervention group completed the study. Results found that the intervention reduced parents' anxiety (Dint(Post-Pre)=-7.0 [SD 13.1], Dobs(Post-Pre)=-0.4 [SD 15.8], t90=-2.200, P=.03) and uncertainty in illness (Dint(Post-Pre)=-25.0 [SD 8.2], Dobs(Post-Pre)=-19.8 [SD 10.1], t90=-2.761, P=.01), improved parents' social function (Dint(Post-Pre)=9.0 [SD 32.8], Dobs(Post-Pre)=-7.5 [SD 30.3], t90=2.494, P=.01), increased parents' knowledge of ALL and care (Dint(Post-Pre)=28.4 [SD 12.4], Dobs(Post-Pre)=17.2 [SD 11.9], t90=4.407, P<.001), and decreased their need for knowledge (Dint(Post-Pre)=-9.9 [SD 11.6], Dobs(Post-Pre)=-1.9 [SD 6.4], t90=-4.112, P<.001). Qualitative results showed that parents were satisfied with the intervention and their role in the caregiving process. CONCLUSIONS: The mHealth intervention in supporting parents of children with ALL is effective. This study is informative for other future studies on providing mHealth supportive care for parents of children with cancer.

5.
Eur J Pediatr ; 177(1): 7-17, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29128883

RESUMO

Oral mucositis is one of the most frequent complications after chemotherapy, occurring in approximately 52 to 80% of children receiving treatment for cancer. Recently, it has been suggested that the use of low-energy laser could reduce the grade of oral mucositis and alleviate the symptoms. In 2014, Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology has recommended low-level laser therapy in prevention of mucositis for hematopoietic stem cell transplantation patients because of its beneficial effects in majority of recent studies. However, the recommendation was made for adult patients, not pediatric patients. Data about the effect of low-level laser therapy in pediatric patients is limited. This study aims to synthesize the available clinical evidences on the effects of low-level laser therapy (LLLT) in the prevention and treatment of chemotherapy-induced oral mucositis (OM). A meta-analysis was performed using trials identified through the Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Web of Science, China Biology Medicine (CBM), Wanfang Database, and China National Knowledge Infrastructure (CNKI). Data on occurrence, duration, and severity of oral mucositis were collected. All randomized controlled studies and clinical controlled studies comparing LLLT to routine qualified prevention or treatment during or after chemotherapy were critically appraised and analyzed. We found 8 qualified clinical trials with a total of 373 pediatric patients; the methodological quality was acceptable. After prophylactic LLLT, the odds ratio for developing OM was significantly lower compared with placebo(OR = 0.50, 95% CI 0.29 to 0.87, P = 0.01), the odds ratio for developing grade III OM or worse was statistically significantly lower compared with placebo (OR = 0.30, 95% CI (0.10, 0.90), P = 0.03), and the OM severity was statistically significantly lower compared with placebo (SMD = - 0.56, 95% CI (- 0.98, - 0.14), P = 0.009). For therapeutic LLLT, the OM severity was significantly reduced compared to routine care (SMD = - 1.18, 95% CI (- 1.52, - 0.84), P < 0.00001). Oral pain was also reduced after LLLT over routine care (MD = - 0.73, 95% CI (- 1.36, - 0.11), P = 0.02). CONCLUSION: Prophylactic LLLT reduces mucositis and severe mucositis and decreases the average severity of oral mucositis in pediatric and young patients with cancer. Therapeutic LLLT also reduces the average severity of oral mucositis and oral pain. Further research should investigate the optimal parameter of LLLT in pediatric and young patients, and studies with higher methodological quality should be performed. What is known: • Low-level laser therapy (LLLT) was recommended by Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology; however, evidences about LLLT on oral mucositis in pediatric and young patients were insufficient and lack supportive synthesized data. • Recently, there have been several new RCTs or CCTs for pediatric patients or young adults. What is new: • Prophylactic LLLT reduces the occurrence of mucositis and severe mucositis and decreases the average severity of oral mucositis in pediatric and young patients. • Therapeutic LLLT reduces the average severity of oral mucositis and oral pain.


Assuntos
Antineoplásicos/efeitos adversos , Terapia com Luz de Baixa Intensidade , Estomatite/radioterapia , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Índice de Gravidade de Doença , Estomatite/induzido quimicamente , Estomatite/prevenção & controle , Resultado do Tratamento , Adulto Jovem
6.
Support Care Cancer ; 25(12): 3703-3713, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28714044

RESUMO

PURPOSE: Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors. METHODS: A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis. RESULTS: The mean score of parents' care burden overall was 37.74 ± 16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR = 37.500, 95% CI = 4.515-311.348, P = 0.001). CONCLUSION: The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.


Assuntos
Cuidadores/psicologia , Pais/psicologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Apoio Social , Centros Médicos Acadêmicos , Adulto , Pré-Escolar , China , Feminino , Humanos , Masculino , Inquéritos e Questionários
7.
Comput Inform Nurs ; 35(11): 590-598, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28471762

RESUMO

Patient-reported outcomes are increasingly emphasized in clinical trials and population health studies. Our research team developed a smartphone app to track patient-reported outcomes of children with chronic diseases. The purpose of this study is to develop a patient-reported outcome reporting app and evaluate its usability. A multidisciplinary research team including health services researchers, pediatric nurses, and software engineers worked collaboratively in developing the patient-reported outcome app and administration portal. Group discussions and several rounds of feedback and modification were used. Ten pediatric patients with cancer, five parents, and two nurses participated in the usability study. We conducted content analyses in app development and usability evaluation. The app collected demographic information and patient-reported outcomes. Patient-reported outcomes were collected by Chinese versions of pediatric Patient-Reported Outcomes Measurement Information System Short Forms and Patient-Reported Outcomes Measurement Information System Parent Proxy Report Scales for Children. Pediatric patients aged 8 to 17 years and parents with a 5- to 7-year-old pediatric child used different age-appropriate questionnaires. The Web-based administration portal helped to manage demographic information, questionnaires, administrators, and survey-conducting organizations. The users liked the app. All participants felt that this app was easy to use and the interfaces were friendly to children. Nurses thought the administration portal interfaces were simple and the data were convenient to download for further analysis. We conclude that the app and its administration portal meet researchers and clinical nurses' demand and have potential to promote patient-reported outcomes in assessing quality of life and symptoms of pediatric patients.


Assuntos
Aplicativos Móveis/estatística & dados numéricos , Medidas de Resultados Relatados pelo Paciente , Pediatria , Smartphone , Adolescente , Adulto , Criança , Pré-Escolar , Doença Crônica , Feminino , Humanos , Masculino , Pais/educação , Portais do Paciente/estatística & dados numéricos , Inquéritos e Questionários
8.
J Nurs Manag ; 25(3): 184-193, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27910215

RESUMO

AIM: To identify stressors of newly graduated paediatric nurses at a children's hospital in Shanghai, China. BACKGROUND: Stress is an international phenomenon in nursing generally, but little is known about its effect on new paediatric nurses at the Shanghai paediatric hospital. METHOD: Participants in this research were 25 newly graduated paediatric nurses. Their behaviours and perceptions were explored by field observations and interviews. RESULTS: Findings indicated that participants experienced numerous stressors: low work status, insufficient professional competence, heavy workload, inadequate supportive systems and uncertainty of career development. CONCLUSION: The results of the present study provide useful information for administrators to develop and improve postgraduate programmes to support novice paediatric nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Our research highlights the importance of identifying the stressors of new paediatric nurses in the light of a serious nurse shortage and an increasing birth rate.


Assuntos
Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/normas , Enfermagem Pediátrica , Estresse Psicológico/etiologia , Adaptação Psicológica , Adulto , Mobilidade Ocupacional , China , Competência Clínica/normas , Teoria Fundamentada , Hospitais Pediátricos/organização & administração , Humanos , Satisfação no Emprego , Enfermeiras e Enfermeiros/provisão & distribuição , Preceptoria , Pesquisa Qualitativa , Apoio Social , Recursos Humanos , Carga de Trabalho/psicologia , Carga de Trabalho/normas
9.
J Nurs Manag ; 24(1): E87-94, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25807983

RESUMO

AIM: To identify core competencies needed in the transition of nurse managers on the way to excellence. BACKGROUND: There is growing recognition of the importance of nurse managers in hospitals. Most managers still learn through their failures and few studies have described the perceptions of nurse managers in China. It is vital to understand what competencies Chinese nurse managers should have in order to establish suitable training programmes and improve their management skills. METHOD: A phenomenological approach that included in-depth interviews with 12 nurse managers in six Chinese hospitals was conducted. RESULTS: The transition to management included four phases: the adaptive phase, the running-in and stable phase, the stagnation phase and the maturation phase. CONCLUSION: In order to fulfil their clinical responsibilities, nurse managers need to develop multifaceted competencies, specifically in communication and stress management. Ideally, nurse managers should progress through the four phases mentioned above to achieve excellence. IMPLICATIONS: There is a requirement for utilising various methods for nurse managers in adapting new roles, improving communication and relieving stress.


Assuntos
Competência Clínica/normas , Liderança , Enfermeiras Administradoras/normas , Autoeficácia , Adulto , China , Feminino , Humanos , Enfermeiras Administradoras/psicologia , Percepção , Pesquisa Qualitativa
10.
J Pediatr Nurs ; 30(1): 160-73, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25450446

RESUMO

This study was designed to determine the key predictors for each aspect of family management of families with children who have chronic conditions in China. The participants included 399 caregivers whose children have chronic illnesses. We used the following instruments: Child Behavior Checklist; Feetham Family Functioning Survey; and Family Management Measures. The final modes of the hierarchical regression explained 29-48% of the variance in aspects of family management. More family support should be provided for those with low family income, children with renal and genetic disorders and rheumatic diseases and those living in rural areas. Child and family functioning affects family management.


Assuntos
Cuidadores/psicologia , Doença Crônica/enfermagem , Enfermagem Familiar/organização & administração , Relações Familiares/psicologia , Adaptação Psicológica , Adulto , Cuidadores/estatística & dados numéricos , Lista de Checagem , Criança , Pré-Escolar , China , Gerenciamento Clínico , Feminino , Humanos , Assistência de Longa Duração/métodos , Estudos Longitudinais , Masculino , Fatores de Risco , Amostragem
11.
Qual Life Res ; 24(6): 1491-501, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25510214

RESUMO

PURPOSE: The pediatric patient-reported outcomes measurement information system (PROMIS) was developed to provide self-reported item banks and short forms for children and adolescents (aged 8-17 years) experiencing a chronic illness to assess their quality of life and symptoms. The pediatric PROMIS short forms have been translated into Chinese and applied in children with cancer in China. This study aimed to describe psychometric properties of the Anxiety and Depression measures. METHODS: A total of 232 children and adolescents with cancer were recruited in hospital-based inpatient and outpatient clinics. Eight Chinese versions of pediatric PROMIS (C-Ped-PROMIS) measures were administered. Categorical confirmatory factor analysis (CCFA) were conducted to evaluate scale dimensionality and item local dependence of the C-Ped-PROMIS Anxiety and Depression items. Multiple indicator multiple cause models were used to analyze differential item functioning (DIF), item response theory parameters were calculated, and test information against T scores was reported for each measure. RESULTS: The results of the CCFA confirmed that both C-Ped-PROMIS Anxiety and Depression scales appropriately measure the theoretical constructs as designed. No significant DIF was found for the items of the two scales according to age and gender. Both scales have high test reliability as long as their T scores are not on the low or high extremes. CONCLUSIONS: The pediatric PROMIS Anxiety and Depression measures were developed to provide efficient and flexible assessment of emotional distress domains. Our results provide evidence that the two C-Ped-PROMIS measures can be readily applied to measure anxious and depressive symptoms in Chinese children with cancer.


Assuntos
Ansiedade/diagnóstico , Depressão/diagnóstico , Neoplasias/psicologia , Autorrelato/normas , Estresse Psicológico/diagnóstico , Inquéritos e Questionários , Adolescente , Criança , China , Análise Fatorial , Feminino , Humanos , Masculino , Modelos Teóricos , Psicometria , Qualidade de Vida/psicologia , Reprodutibilidade dos Testes
12.
J Spec Pediatr Nurs ; 19(1): 39-53, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24393227

RESUMO

PURPOSE: This study compared the management of chronic childhood conditions in Chinese families and identified predictors of management style. DESIGN AND METHOD: A survey was conducted in 2008-2009 on a convenience sample of 387 caregivers of children with chronic conditions. RESULTS: Six family management styles (FMSs) were identified: accomplished, uncertain managing, joint managing, managing with difficulty, struggling, and competent managing. The FMSs were related to the functioning of the family and the child. Changes in parents' employment, geographic location, and diagnosis predicted family placement in a cluster. PRACTICE IMPLICATIONS: Understanding Chinese FMSs will further aid in providing culturally appropriate family-centered care. Awareness of the predictors of FMSs can assist nurses in detecting which families need more help.


Assuntos
Doença Crônica/etnologia , Doença Crônica/terapia , Saúde da Família , Adaptação Psicológica , Cuidadores , Análise por Conglomerados , Cultura , Emprego , Humanos , Enfermagem Pediátrica , Inquéritos e Questionários
13.
West J Nurs Res ; 35(7): 920-42, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23539321

RESUMO

Family management is an important concept in caring for chronically ill children. The purpose of this study is to determine the applicability of the Family Management Style Framework for Chinese families with a child who has a chronic condition. The children ranged in age from 6 to 16 years. The structural equation modeling approach was utilized to examine the relationships among the contextual variables, the family management, the child, and the family functioning. A total of 538 caregivers from seven hospitals in China were included in this study. The final model adequately fitted the data. The predictor variables accounted for 23%, 26%, 7.8%, and 12% of the variance in the easy and the challenging parts of family management and the child and family unit, respectively. These findings indicated that the framework is applicable to Chinese families. This result reinforces the importance of interventions designed to enable caregivers to improve family management.


Assuntos
Família , Adolescente , Adulto , Cuidadores , Criança , China , Estudos Transversais , Feminino , Humanos , Masculino , Modelos Teóricos
14.
Int J Nurs Stud ; 47(1): 49-59, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19709657

RESUMO

BACKGROUND: Although cancer-related fatigue has been given priority status for study in Western countries, unfortunately, it has not received enough attention in China. Based on a different cultural perspective, qualitative study regarding cancer-related fatigue in China can provide a cultural context for enriching the system of knowledge about fatigue. OBJECTIVES: To explore the real-life experiences of fatigue from the perspectives of Chinese Children with leukaemia. DESIGN: A phenomenological study. SETTING: A paediatric haematology oncology department of a regional tertiary children's hospital in Shanghai, China. PARTICIPANTS: A total of 14 children and adolescents with leukaemia, aged 7-18 years old, without known psychiatric or developmental disorders, was selected by purposive sampling. METHODS: Four focus group interviews were conducted with nine open-ended, semi-structured questions. FINDINGS: Cancer-related fatigue is a common and distressing issue for Chinese children and adolescents with leukaemia. Three themes were finally generated: 'fatigue is an open interpretation among children and adolescents', 'fatigue is not a single-dimensional aspect', and 'struggles with fatigue and balancing life suffering'. Fatigue, which is closely related to physical, psychological and situational factors, has negative affects on the participants physically, psychologically and on their cognitive well-being, and can impact the family, school and social interaction of children with leukaemia. CONCLUSIONS: Children and adolescents could easily distinguish cancer-related fatigue from normal fatigue. The participants' message to health professionals is that fatigue is a multidimensional and multifactorial symptom that should be comprehensively understood and managed. The findings provide insight and direction for clinical practice and research regarding intervention development and education plans for cancer-related fatigue for paediatric oncology patients.


Assuntos
Fadiga/fisiopatologia , Leucemia/fisiopatologia , Adolescente , Criança , China , Humanos , Leucemia/psicologia
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