The impact of cancer on children's physical, emotional, and psychosocial well-being

The diagnosis and treatment of cancer are a stressful and threatening experience, which can be emotionally devastating to children. Despite the improved prognosis, the course of cancer treatment has tremendous impact on children. This article aims to examine the impact of cancer on physical, emotional, and psychosocial well-being of Hong Kong Chinese children, an area of research that has been underrepresented in the literature. Ninety-eight Hong Kong Chinese children aged 7 to 15 years, admitted for treatment of cancer in 2 pediatric oncology units of 2 different hospitals, were invited to participate in the study. Findings from this study indicated that the children scored considerably high state anxiety on admission, and more than half of the participants presented some depressive symptoms during their stay in the hospital. Moreover, semistructured interviews indicated that nearly all children expressed different degrees of sadness and worry. The findings suggested that there is a room for improvement in existing nursing intervention regarding preparing children for hospitalization and treatment of cancer. There is an imperative need for nurses to evaluate appropriate nursing interventions that can help children resume their normal growth and development, in particular, to help them ease the physical, emotional, and psychological burden of life-threatening disease. © 2010 Lippincott Williams & Wilkins.postprin

Play interventions to reduce anxiety and negative emotions in hospitalized children

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Factors contributing to the psychological well-being for Hong Kong Chinese children from low-income families: a qualitative study

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The relationship between children's locus of control and their anticipatory anxiety

Objectives: This study investigated the relationship between children's locus of control and their state anxiety scores, and determined whether children's locus of control could predict their state anxiety scores before academic examinations. Design: A test-retest within subjects design was used. Sample: 519 school children were invited to participate in the study. Measurements: Participants were asked to respond to the Chinese version of the Nowicki-Strickland locus of control scale and state anxiety scale for children in stressful and nonstressful situations. The data were collected in 2005. Results: There were significant strong positive correlations between the state anxiety and locus of control scores in the period before academic examinations. Multiple regression analysis showed that the Nowicki-Strickland locus of control score was a good predictor of children's state anxiety in a stressful situation. Conclusions: This study supports the use of the Nowicki-Strickland locus of control scale as a screening tool to identify school children who are most likely to exhibit high levels of anxiety before academic examinations. Understanding children's locus of control in advance is a necessary step toward designing appropriate interventions to reduce their stress and bolster their coping mechanisms. © 2009, Wiley Periodicals, Inc.link_to_subscribed_fulltex

Incorporating experiential learning theory in promoting regular physical activity among childhood cancer survivors

BACKGROUND: There is growing concern about declining levels of physical activity in childhood cancer survivors. There has been an increase in the use of experiential learning to promote the psychological well-being of primary schoolchildren, and to help youth substance abusers and adolescents suffering from chronic illness to change their feelings, patterns of thought, and behavior [1,2]. This study aimed to examine the effectiveness of using experiential learning in promoting changes in exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of Hong Kong Chinese childhood cancer survivors. METHODS: A randomized controlled trial, two-group pretest and repeated post-test, between-subjects design was conducted to 71 childhood cancer survivors (9-16-year olds). Participants in the experimental group joined a four-day integrated adventure-based training guided by Kolb’s experiential learning theory [3]. Control group participants received the same amount of time and attention as the experimental group, but not in such a way as to have any specific effect on the outcome measures. Participants’ exercise behavior changes, levels of physical activity, self-efficacy and quality of life were assessed at the time of recruitment, 3, 6, and 9 months after starting the intervention. RESULTS: Participants in the experimental group reported statistically significant difference in physical activity stages of change (p < 0.001), higher levels of physical activity (p < 0.001) and self-efficacy (p = 0.04) than those in the control group. Besides, there were statistically significant mean differences (p < 0.001) in physical activity levels (2.6), self-efficacy (2.0) and quality of life (4.3) of participants in the experimental group from baseline to 9 months after starting the intervention. CONCLUSIONS: Experiential learning was found to be effective in promoting regular physical activity among childhood cancer survivors

Potential Implementation of an Adventure-Based Training Intervention in Clinical Practice to Enhance the Self-Efficacy and Quality of Life Among Childhood Cancer Survivors

Background: Sustainability is an important consideration in the potential implementation of an innovation in clinical practice. There is evidence that adventure-based training intervention can be effective in in enhancing the self-efficacy and quality of life among childhood cancer survivors. Nevertheless, it is uncertain whether such effects could be sustained over time, up to 12 or 18 months.Objective: To examine the sustainability, feasibility and acceptability of an adventure-based training and health education program in changing the exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors. Methods: A randomized controlled trial, two-group pretest and repeated post-test, between-subjects design was conducted to 69 childhood cancer survivors (9- to 16-year-olds). Participants in the experimental group joined a 4-day integrated adventure-based training and health education program. Control group participants received the same amount of time and attention as the experimental group but not in such a way as to have any specific effect on the outcome measures. Participants’ exercise behavior changes, levels of physical activity, self-efficacy, and quality of life were assessed at the time of recruitment, 3, 6, and 9, 12 and 18 months after starting the intervention. Results: From baseline to 18 months after the intervention, the experimental group reported statistically significant differences in the stages of change in physical activity, and higher levels of physical activity, self-efficacy, and quality of life than the control group. The results of process evaluation revealed that the program was both feasible and acceptable to participants. Conclusions: The program was found to have substantial effects on enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors over at least 18 months. Healthcare professionals should consider adopting such programs to promote the regular physical activity among childhood cancer survivors

Center for Epidemiologic Studies Depression Scale for Children: Psychometric testing of the Chinese version

Aim: This paper is a report of psychometric testing of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children. Background: The availability of a valid and reliable instrument that accurately detects depressive symptoms in children is crucial before any psychological intervention can be appropriately planned and evaluated. There is no such an instrument for Chinese children. Methods: A test-retest, within-subjects design was used. A total of 313 primary school students between the ages of 8 and 12 years were invited to participate in the study in 2009. Participants were asked to respond to the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children, short form of the State Anxiety Scale for Children and Rosenberg's Self-Esteem Scale. The internal consistency, content validity and construct validity and test-retest reliability of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children were assessed. Results: The newly-translated scale demonstrated adequate internal consistency, good content validity and appropriate convergent and discriminant validity. Confirmatory factor analysis added further evidence of the construct validity of the scale. Conclusion: Results suggest that the newly-translated scale can be used as a self-report assessment tool in detecting depressive symptoms of Chinese children aged between 8 and 12 years. © 2010 Blackwell Publishing Ltd.link_to_subscribed_fulltex

Coping behaviour checklist for Chinese children: Development and psychometric testing

li h.c.w., chung o.k.j., wong m.l.e. & ho k.y. (2010) Coping behaviour checklist for Chinese children: development and psychometric testing. Journal of Advanced Nursing 66(7), 1633-1643. Title.: Coping behaviour checklist for Chinese children: development and psychometric testing. Aim.: This paper is a report of development and psychometric testing of the coping behaviour checklist for Chinese children. Background.: An understanding of the coping behaviour of children is an essential prerequisite for the design of an appropriate psychological intervention to enhance children's ability to cope with stressful medical procedures and hospitalization. Review of literature reveals that there is lack of child-sensitive measurement tools in the Chinese culture for assessing coping behaviours of children with good psychometric properties. Methods.: An instrument development and validation study was conducted. Phase 1 was designed to develop a checklist of coping behaviour for Chinese children, while in phase 2 the psychometric properties of the new scale were tested. A total of 168 (phase 1) and 236 (phase 2) children between the ages of 7 and 12 years, were invited to participate in this study in 2008 and 2009, respectively; 228 completed both phases of data collection. Results.: On the basis of the results of qualitative interview data, the coping behaviour checklist for Chinese children was developed. The newly developed scale had adequate internal consistency reliability and test-retest reliability, high content validity and appropriate construct validity. Confirmatory factor analysis further added evidence of the construct validity of the scale. Conclusion.: The instrument can be used to identify the coping behaviour of Hong Kong Chinese children aged between 7 and 12 years. Knowing the coping behaviour of children in advance can help nurses to shape and design appropriate psychological interventions that can help children better cope with stressful medical procedures and hospitalization. © 2010 Blackwell Publishing Ltd.link_to_subscribed_fulltex