1
|
Bekar P, Altuntaş D, Efe E. Home experiences of parents of children undergoing hematopoietic stem cell transplantation: A qualitative study. J Pediatr Nurs 2023; 73:e541-e548. [PMID: 37923613 DOI: 10.1016/j.pedn.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE This study aimed to describe the home experiences of parents of children undergoing hematopoietic stem cell transplantation. DESIGN AND METHODS This study was conducted using a descriptive qualitative research design. The study sample consisted of 12 parents with a child treated with hematopoietic stem cell transplantation (HSCT) at a university hospital in Turkey. Semi-structured individual interviews and researcher observations were used for data collection. The interview transcripts of the study were analyzed using content analysis. RESULTS Five main themes were obtained, each of which had associated sub-themes: difficulties faced in home experiences, changes in family life, feelings about home experiences, parents' ways of coping with difficulties, and parents' suggestions. CONCLUSIONS Parents faced various difficulties in their own home experiences, and they felt fear, anxiety and stress during this period. Following the child's HSCT, there were changes in health, physical, psychological and social aspects of family life. Some parents used distraction techniques, and the support of their spouses and health professionals to cope with difficulties. PRACTICE IMPLICATIONS For pediatric nurses to comprehensively assess and support the home care needs of the child and parents, they should understand the difficulties parents face in home experiences, as well as their feelings, changes in their lives, suggestions regarding home experiences, and ways of coping. Regular health screening and psychosocial support can be provided for parents of children after HSCT, and regular training can be given for parents' management of care-related problems and increasing their self-efficacy for this management.
Collapse
Affiliation(s)
- Pınar Bekar
- Burdur Mehmet Akif Ersoy University, Bucak School of Health, Department of Child Development, Bucak/Burdur, Turkey.
| | - Duygu Altuntaş
- Akdeniz University, Nursing Faculty, Department of Child Health Nursing, 07058, Campus, Antalya, Turkey.
| | - Emine Efe
- Akdeniz University, Nursing Faculty, Department of Child Health Nursing, 07058, Campus, Antalya, Turkey.
| |
Collapse
|
2
|
Ward J, Smith J, Powers K, Hellsten M, Murray P. Parent Psychological Distress is Associated with Symptom Burden and Health-Related Quality of Life in Children and Adolescents Undergoing Stem Cell Transplantation or Chimeric Antigen Receptor-T Therapy. Transplant Cell Ther 2023:S2666-6367(23)01241-1. [PMID: 37086850 DOI: 10.1016/j.jtct.2023.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/09/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor T-cell (CAR-T) therapy are potentially curative treatment options for children with life-threatening conditions, but can result in a high symptom burden, poor health-related quality of life (HRQoL), and parent psychological distress. OBJECTIVES The purpose of this study is to describe, over time, the association between parent psychological distress with symptom burden and HRQoL among children undergoing HSCT or CAR-T therapy. STUDY DESIGN This multisite study employed a longitudinal, repeated measures design. English and Spanish-speaking parents and their children ages 2-18 years with planned HSCT or CAR-T therapy were eligible. Parents completed self-report measures of psychological distress (Beck Anxiety and Depression Inventories, Perceived Stress Scale) at 4 timepoints: pre-cell infusion, and days +30, +60, +90 after the child's cell infusion. The Memorial Symptom Assessment Scale and PedsQL Cancer Module were administered to children (parent-proxy for younger children) at corresponding timepoints. A symptom cluster called parent distress was created from each parent outcome using exploratory factor analysis. Longitudinal parallel process modeling was used to study the relationship between parent distress and child symptoms and HRQoL over time. RESULTS In total, 140 child/parent dyads (280 participants) were enrolled across 4 sites. Child mean age was 8.4 years/SD=5, 56.4% were male, primarily with an underlying diagnosis of malignancy (72.9%). Most parents were mothers (80.7%), mean age of 39 years/SD=8.1. Parent distress was consistently higher than normative means generated from non-clinical samples of adults. High frequency of suicidal ideation was reported by parents (38.5% at baseline, 37% at day +30, 27.4% at day +60. 33.6% at day +90). A significant relationship between parent distress, child HRQoL and child symptoms was observed at baseline and through day +90. CONCLUSION Findings suggest that parents experience clinically relevant psychological distress throughout their child's HSCT or CAR-T therapy and this parent distress is associated with child HRQoL and symptom scores. Increased psychoeducational support tailored to address parental psychological distress is needed and has potential to positively impact the child's HRQoL and symptoms.
Collapse
Affiliation(s)
- Jessica Ward
- Research Nurse Scientist, Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Work address: 4650 Sunset Blvd, Los Angeles, CA 90027, Cell phone: 312-405-4393.
| | - Jilayne Smith
- Pediatric Nurse Practitioner, Pediatric Blood and Marrow Transplant and Cellular Therapy, Children's Hospital of Colorado, Work Address: 13123 E. 16th Ave, Aurora, CO 80045.
| | - Kimberly Powers
- Pediatric Nurse Practitioner, Pediatric Stem Cell Transplantation and Cellular Therapy Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Work address: 225 E Chicago Ave, Chicago, IL 60611.
| | - Melody Hellsten
- Associate Director Texas Children's Cancer and Hematology Centers Palliative Care Program, Texas Children's Hospital, Work Address: 6701 Fannin St, Houston, TX 77030.
| | - Paula Murray
- Biostatistician, Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Work address: 4650 Sunset Blvd, Los Angeles, CA 90027
| |
Collapse
|
3
|
Muñeton-Castaño YF, Hull JH, Graham RJ. Tele-mental health intervention for caregivers of children on home ventilation: A randomized control trial. Child Care Health Dev 2022; 48:80-87. [PMID: 34355408 DOI: 10.1111/cch.12905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 06/07/2021] [Accepted: 07/25/2021] [Indexed: 11/27/2022]
Abstract
AIM This study aims to evaluate a Tele-P cognitive behavioural intervention (CBT) to promote the emotional functioning (i.e. reduce anxiety, depression and social isolation) and improve the quality of life (QoL) of caregivers of children who are ventilator dependent at home. BACKGROUND There is an urgent need for support of parents with technology-dependent children. Research shows that the parents of children whose chronic illness require assisted-technology experience significant emotional stress, potential gaps in social isolation, and social isolation leading to lower quaility of life, unhealthy family functioning, and negative psychological consequences. RESULTS Participation in a Tele-P intervention significantly reduced caregivers' anxiety, depression and fatigue, and reduction was sustained in a 4 week follow-up period. There was no significant change in social isolation. CONCLUSION Findings demonstrate preliminary efficacy of an innovative Tele-P intervention on outcomes of anxiety, depression and fatigue in an at-risk group of caregivers. Although the intervention did not improve self-reported social isolation, using technology in combination with established psychological support is an efficient way to better equip our mental health intervention systems to serve vulnerable populations.
Collapse
Affiliation(s)
- Yudy F Muñeton-Castaño
- Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - John H Hull
- Department of Psychology, Bethany College, Bethany, West Virginia, USA
| | - Robert J Graham
- Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Beckmann NB, Dietrich MS, Hooke MC, Gilmer MJ, Akard TF. Parental Posttraumatic Growth After Pediatric Hematopoietic Stem Cell Transplant. J Hosp Palliat Nurs 2021; 23:331-338. [PMID: 34185727 DOI: 10.1097/njh.0000000000000759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Little is known about the development of posttraumatic growth among parents of children with serious advanced disease. The purpose of this study is to describe parental posttraumatic growth 100 days after pediatric stem cell transplant. This is a cross-sectional, descriptive study of 24 parents, approximately 100 days after their children received stem cell transplant. Participants reported environmental, personal, and disease characteristics and completed measures of distress, coping, rumination, and posttraumatic growth. Evidence of parental posttraumatic growth was described in each of 5 dimensions (relating to others, new possibilities, personal strength, spiritual change, and appreciation of life). Posttraumatic growth was positively associated with parental distress, disengagement coping, and rumination measures (r = 0.44-0.47, P < .05). Appreciation of life demonstrated the strongest associations with distress and rumination (r = 0.53-0.61, P < .01). Curvilinear relationships were observed for the association of distress, disengagement coping, and involuntary engagement with posttraumatic growth (P < .05). Study results highlight opportunities for palliative care nurses and clinicians to facilitate opportunities to support parent posttraumatic growth during treatment for children's advanced disease.
Collapse
|
5
|
Liu YM, Jaing TH, Wen YC, Chen SH, Weng PY, Lin L, Wu CL. Health-related quality of life predicts length of hospital stay and survival rates for pediatric patients receiving allogeneic hematopoietic cell transplantation. Qual Life Res 2021; 30:3421-3430. [PMID: 34018123 DOI: 10.1007/s11136-021-02887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE We examined the association between health-related quality of life (HRQoL) of pediatric patients during hospitalization for allogeneic hematopoietic cell transplantation (HCT) and length of hospital stay, and 1-year survival. METHODS Primary family caregivers were proxy-assessors for the Pediatric Quality of Life (PedsQL) Stem Cell Transplant Module at three time points: 5-days pre-HCT (T0); 14-days post-HCT (engraftment, T1); and 1-week before hospital discharge (T2). Cox regression analyses determined predictors of the overall 1-year survival after allogeneic HCT. RESULTS Thirty-nine eligible caregivers completed all assessments. The mean age of the pediatric patients was 9.07 years (SD = 5.2). PedsQL Stem Cell Transplant Module scores decreased from 71.33 (SD = 13.26) at T0 to 55.41(SD = 13.05) at T1 (p < 0.001) and increased to 68.46 (SD = 13.97) at T2 (p < 0.001). There was no significant difference between scores at T0 and T2. Longer length of hospital stay was associated with children who were younger and had greater relative changes in scores on the caregiver-proxy PedsQL Stem Cell Transplant Module from T0 to T1. PedsQL Stem Cell Transplant Module scores ≥ 58.07 at T2 were associated with higher 1-year survival rates (Hazard Ratio = 0.12, 95% Confidence Interval = 0.02-0.78; p = 0.03). CONCLUSION Our findings suggest that assessment of HRQoL during early HCT can add prognostic value beyond demographic and HCT factors. Understanding the HRQoL status during hospitalization for HCT could help identify pediatric patients with low prospects of 1-year survival in order to provide support interventions to improve HRQoL and survival rates.
Collapse
Affiliation(s)
- Ying-Mei Liu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- , No. 261, Wen-Hwa 1st Road, Guishan District, Taoyuan, Taiwan.
| | - Tang-Her Jaing
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Chuan Wen
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Hsiang Chen
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Pei-Yin Weng
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Lin Lin
- School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Chia-Ling Wu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| |
Collapse
|
6
|
Beckmann NB, Dietrich MS, Hooke MC, Gilmer MJ, Akard TF. Parent Caregiving Experiences and Posttraumatic Growth Following Pediatric Hematopoietic Stem Cell Transplant. J Pediatr Oncol Nurs 2021; 38:242-253. [PMID: 33750237 DOI: 10.1177/1043454221992306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Parents of children recovering from hematopoietic stem cell transplant (HSCT) experience significant distress due to unpredictable and potentially life-threatening complications. Distress is heightened by intensive caregiving parents provide the child during the first 100 days after HSCT. Management of distress and adaptation to caregiving responsibilities may be enhanced if parents find benefit in their experiences through posttraumatic growth (PTG), yet little is known about how parents' experiences after HSCT foster PTG. This study aimed to explore how parents experience caregiving and PTG 100 days after children's HSCT. Methods: Thirty-one parents completed semi-structured interviews ∼100 days after children received HSCT. Results: Four major themes emerged from the data to describe parent experiences after HSCT: (1) psychosocial and healthcare contextual factors; (2) cognitive, affective, and social support reactions to HSCT; (3) problem-based, emotion-based, and cognitive coping strategies; and (4) PTG. Discussion: Results increase the understanding of how parents' experiences and caregiving responsibilities contribute to PTG. These findings may guide future research to understand how these experiences influence PTG. Nurses are integral to the parents' experiences. Future work should focus on nursing interventions that enhance positive reinterpretation of parents' experiences after their children's HSCT.
Collapse
Affiliation(s)
- Nicole B Beckmann
- School of Nursing, 16194Vanderbilt University, Nashville, USA.,Pediatric Blood & Marrow Transplant, 65830University of Minnesota Masonic Children's Hospital, Minneapolis, USA
| | - Mary S Dietrich
- School of Nursing, 16194Vanderbilt University, Nashville, USA
| | - Mary C Hooke
- School of Nursing, University of Minnesota, Minneapolis, USA
| | - Mary J Gilmer
- School of Nursing, 16194Vanderbilt University, Nashville, USA
| | - Terrah F Akard
- School of Nursing, 16194Vanderbilt University, Nashville, USA
| |
Collapse
|
7
|
Chardon ML, Canter KS, Pai ALH, Peugh JL, Madan-Swain A, Vega G, Joffe NE, Kazak AE. The impact of pediatric hematopoietic stem cell transplant timing and psychosocial factors on family and caregiver adjustment. Pediatr Blood Cancer 2020; 67:e28552. [PMID: 32881326 DOI: 10.1002/pbc.28552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The impact of pediatric hematopoietic stem cell transplant (HCT) on family functioning varies, but little is known about how the timing of HCT in children's treatment course contributes to this variability. This study examines how preexisting child, sibling, and family problems, the length of time between diagnosis to HCT, and children's age at HCT are associated with family and caregiver functioning. PROCEDURE Caregivers (n = 140) of children (≤18 years old) scheduled to undergo their first HCT completed the Psychological Assessment Tool-HCT and the Impact on Family Scale. Treatment information was extracted from electronic medical records. A bootstrapped multivariate path analysis was used to test the hypotheses. RESULTS More preexisting family problems related to greater caregiver perceived negative impact of their child's HCT across family and caregiver functioning domains. Less time between diagnosis and HCT was associated with greater caregiver personal strain, particularly for those with younger children undergoing HCT. Younger child age at HCT was also associated with a larger negative impact on family social functioning. CONCLUSIONS Families with preexisting problems are the most at-risk for experiencing negative impacts related to their child's HCT. The timing of a child's HCT within their treatment course and the child's age during HCT may impact families' social functioning and caregiver adjustment. Screening families for preexisting family problems, particularly for families with young children or who are abruptly learning of their child's need for an HCT, may assist providers in identifying families who would benefit from earlier or more intensive psychosocial support.
Collapse
Affiliation(s)
- Marie L Chardon
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kimberly S Canter
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Orlando, Florida.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ahna L H Pai
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - James L Peugh
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Avi Madan-Swain
- Division of Pediatric Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gabriela Vega
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Orlando, Florida
| | - Naomi E Joffe
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Orlando, Florida.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
8
|
Kazak AE, Swain AM, Canter K, Vega G, Joffe N, Deatrick JA, Kolb EA, Chewning J, Pai ALH. A psychosocial clinical care pathway for pediatric hematopoietic stem cell transplantation. Pediatr Blood Cancer 2019; 66:e27889. [PMID: 31276304 DOI: 10.1002/pbc.27889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Currently, no evidence-based psychosocial clinical care pathways (PCCP) exist to triage psychosocial risk levels and guide delivery of psychosocial care to youth receiving a hematopoietic stem cell transplantation (HCT) and their families. The purpose of this paper is to describe the use of qualitative research methodologies to develop PCCP in pediatric HCT consistent with the Standards for Psychosocial Care developed for children with cancer. METHODS We previously used qualitative methodologies to interview parents to identify four principles to inform the development of PCCPs. Then in this study a focus group with parents and multidisciplinary clinicians was conducted to assess the acceptability of the PCCP, suggest modifications, and provide input on its use. RESULTS The PCCP is six-step pathway, starting with a standardized screening assessment with the Psychosocial Assessment Tool (PAT-HCT) that identifies the family's specific care needs. The focus group data support overall assessment with the PAT-HCT and the care principles underlying this approach. CONCLUSIONS This PCCP is a systemic multidisciplinary model for providing psychosocial care that is ready for the next stage of development and evaluation in clinical care.
Collapse
Affiliation(s)
- Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Avi Madan Swain
- University of Alabama-Birmingham, Birmingham, Alabama.,Children's of Alabama, Birmingham, Alabama
| | - Kimberly Canter
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Gabriela Vega
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware
| | - Naomi Joffe
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,The University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Janet A Deatrick
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - E Anders Kolb
- Nemours Center for Healthcare Delivery Science, Wilmington, Delaware.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Joseph Chewning
- University of Alabama-Birmingham, Birmingham, Alabama.,Children's of Alabama, Birmingham, Alabama
| | - Ahna L H Pai
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,The University of Cincinnati College of Medicine, Cincinnati, Ohio
| |
Collapse
|
9
|
Pai ALH, Swain AM, Chen FF, Hwang WT, Vega G, Carlson O, Ortiz FA, Canter K, Joffe N, Kolb EA, Davies SM, Chewning JH, Deatrick J, Kazak AE. Screening for Family Psychosocial Risk in Pediatric Hematopoietic Stem Cell Transplantation with the Psychosocial Assessment Tool. Biol Blood Marrow Transplant 2019; 25:1374-1381. [PMID: 30878608 DOI: 10.1016/j.bbmt.2019.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 03/08/2019] [Indexed: 12/29/2022]
Abstract
Family psychosocial risk screening is an important initial step in delivering evidence-based care in hematopoietic stem cell transplantation (HCT). Establishing an evidence-based screening approach that is acceptable, reliable, and valid is an essential step in psychosocial care delivery. This is a 3-institution multimethod study. In part 1, caregivers of children about to undergo HCT (n = 140) completed the Psychosocial Assessment Tool-Hematopoietic Cell Transplantation (PAT-HCT), a brief parent report screener adapted for HCT, and validating questionnaires. Families received feedback on their risks identified on the PAT-HCT. In part 2, 12 caregivers completed a semistructured interview about their perceptions of the PAT and the feedback process. The reliability and validity of the PAT-HCT total and subscale scores were tested using Kuder-Richardson-20 (KR-20) and Pearson correlations. Thematic content analysis was used to analyze the qualitative interview data. Internal consistency for the total score (KR-20 = .88) and the Child Problems, Sibling Problems, Family Problems, and Stress Reactions subscales were strong (KR-20 >.70). Family Structure, Social Support, and Family Beliefs subscales were adequate (KR-20 = .55 to .63). Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. Feedback was provided to 97.14% of the families who completed the PAT-HCT, and the mean rating of acceptability was >4.00 (on a 5-point scale). The qualitative data indicate that families appreciate the effort to provide screening and feedback. The PAT-HCT is a psychometrically sound screener for use in HCT. Feedback can be given to families. Both the screener and the feedback process are acceptable to caregivers.
Collapse
Affiliation(s)
- Ahna L H Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine
| | - Avi Madan Swain
- Division of Pediatric Hematology-Oncology, Children's of Alabama; Department of Pediatrics, University of Alabama at Birmingham
| | - Fang Fang Chen
- Center for Healthcare Delivery Science, Nemours Children's Health System; Sidney Kimmel Medical School at Thomas Jefferson University
| | - Wei-Ting Hwang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine of the University of Pennsylvania
| | - Gabriela Vega
- Center for Healthcare Delivery Science, Nemours Children's Health System
| | - Olivia Carlson
- Center for Healthcare Delivery Science, Nemours Children's Health System
| | | | - Kimberly Canter
- Center for Healthcare Delivery Science, Nemours Children's Health System; Sidney Kimmel Medical School at Thomas Jefferson University
| | - Naomi Joffe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine
| | - E Anders Kolb
- Sidney Kimmel Medical School at Thomas Jefferson University; Center for Cancer and Blood Disorders, Nemours Children's Health System
| | - Stella M Davies
- Department of Pediatrics, University of Cincinnati College of Medicine; Cancer and Blood Diseases Institute, Cincinnati Children's Hospital
| | - Joseph H Chewning
- Division of Pediatric Hematology-Oncology, Children's of Alabama; Department of Pediatrics, University of Alabama at Birmingham
| | - Janet Deatrick
- Department of Family and Community Health, University of Pennsylvania School of Nursing
| | - Anne E Kazak
- Center for Healthcare Delivery Science, Nemours Children's Health System; Department of Pediatrics, Sidney Kimmel Medical School at Thomas Jefferson University.
| |
Collapse
|
10
|
An Explorative Study of Qualities in Interactive Processes with Children and Their Parents in Music Therapy during and after Pediatric Hematopoietic Stem Cell Transplantation. MEDICINES 2019; 6:medicines6010028. [PMID: 30781617 PMCID: PMC6473402 DOI: 10.3390/medicines6010028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/29/2019] [Accepted: 02/11/2019] [Indexed: 01/16/2023]
Abstract
Background: Hematopoietic stem cell transplantation (HSCT) is an established treatment for severe disorders of the pediatric hematopoietic system. However, there is a need for supportive interventions due to physiological and psychological strain. Music therapy is used in health care to help patients through difficult experiences and enable well-being. Our previous randomized studies showed significantly reduced heart rates four to eight hours after intervention as well as increased health-related quality of life. Methods: The aim of this qualitative study was to explore the participants’ and parents’ own experiences of the interactive processes during the music therapy intervention. Six families were included. The data collection used collaborative research interviews. An independent psychologist facilitated the interviews with the children, the parents, and the music therapist and also performed the analysis. Results: Three main themes emerged: experiences of competency and recognition of self, interactive affect regulation as change potential, and importance of the therapeutic relationship. Conclusions: For the participants, music therapy developed into a significant and helpful experience, an important ingredient in coping with and managing the treatment period at the hospital.
Collapse
|
11
|
Brock KE, Wolfe J, Ullrich C. From the Child's Word to Clinical Intervention: Novel, New, and Innovative Approaches to Symptoms in Pediatric Palliative Care. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E45. [PMID: 29597333 PMCID: PMC5920391 DOI: 10.3390/children5040045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/12/2018] [Accepted: 03/21/2018] [Indexed: 12/13/2022]
Abstract
Despite vast improvements in disease-based treatments, many children live with life-threatening disorders that cause distressing symptoms. These symptoms can be difficult to comprehensively assess and manage. Yet, frequent and accurate symptom reporting and expert treatment is critical to preserving a patient's physical, psychological, emotional, social, and existential heath. We describe emerging methods of symptom and health-related quality-of-life (HRQOL) assessment through patient-reported outcomes (PROs) tools now used in clinical practice and novel research studies. Computer-based and mobile apps can facilitate assessment of symptoms and HRQOL. These technologies can be used alone or combined with therapeutic strategies to improve symptoms and coping skills. We review technological advancements, including mobile apps and toys, that allow improved symptom reporting and management. Lastly, we explore the value of a pediatric palliative care interdisciplinary team and their role in assessing and managing distressing symptoms and minimizing suffering in both the child and family. These methods and tools highlight the way that novel, new, and innovative approaches to symptom assessment and management are changing the way that pediatrics and pediatric palliative care will be practiced in the future.
Collapse
Affiliation(s)
- Katharine E Brock
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.
- Pediatric Palliative Care, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Emory University, Atlanta, GA 30322, USA.
| | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital Cancer and Blood Disorders Center, Boston, MA 02215, USA.
| | - Christina Ullrich
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital Cancer and Blood Disorders Center, Boston, MA 02215, USA.
| |
Collapse
|