The Nurse’s Role in Prognosis-Related Communication in Pediatric Oncology Nursing Practice

The experiences of pediatric oncology nurses with prognosis-related communication (PRC) remain largely unknown. The purpose of this article is to report results of focus groups wherein 15 pediatric oncology nurses from three Midwestern pediatric cancer programs provided descriptions of PRC and how they experience PRC within their daily practice. Data from focus groups were analyzed via an interpretive descriptive approach, which resulted in three themes: (1) nurses’ operational definition of PRC, (2) nurses’ roles in PRC, and (3) nurses’ preparation for engagement in PRC. From discussions within the focus groups, nurses recognized that PRC occurs across a continuum. Nurses distinguished that the definition of PRC expands beyond simply reporting life expectancy to describing the consequences of cancer- and treatment-related toxicities and effects. When nurses are not actively invited by their physician partners to participate in PRC, nurses will often develop workarounds to ensure that they understand what was said to patients and families. This allows them to function more effectively as supporters, advocates, and informants. Nurses described little preparation to participate in such challenging conversations. Pediatric oncology nurses need to acknowledge and embrace that they are an integral part of PRC. Interprofessional communication training is necessary to enhance the comfort and confidence of nurses engaging in PRC

Priority Symptoms, Causes, and Self-Management Strategies Reported by AYAs With Cancer

Context Cancer and symptom experiences of adolescents and young adults (AYAs) with cancer can be highly variable, creating challenges for clinicians and researchers who seek to optimize AYAs\u27 health outcomes. Understanding the heuristics AYAs use to designate priority symptoms can provide insight into the meaning they assign to their symptoms and self-management behaviors. Objectives This study described the frequency and characteristics of priority symptoms. It qualitatively explored reasons for a symptom\u27s designation as a priority symptom, perceived causes of priority symptoms, and strategies AYAs use to manage priority symptoms. Methods Participants in this single-group, longitudinal study reported symptoms using a heuristics-based symptom reporting tool, the Computerized Symptom Capture Tool, at two scheduled visits for chemotherapy. AYAs designated priority symptoms and responded to three short answer questions: What makes this a priority symptom?, What do you think causes it?, and What do you do to make it better? Results Eighty-six AYAs, 15–29 years of age (median 19 years), identified 189 priority symptoms. Priority symptoms were of greater severity (t = 3.43; P \u3c 0.01) and distress (t = 4.02; P \u3c 0.01) compared with nonpriority symptoms. Lack of energy, nausea, difficulty sleeping, and pain comprised 39% of priority symptoms. Reasons for priority designation included the impact of the symptom and the attributes of the symptom. Categories of self-management strategies included “Physical Care Strategies,” “Things I take (or not),” and “Psychosocial Care Strategies.” Conclusion Supporting AYAs to identify their priority symptoms may facilitate a more personalized approach to care. Seeking the patient\u27s perspective regarding priority symptoms could enhance patient-clinician collaboration in symptom management

Children Should Be Seen AND Heard: Children's Perspectives of Their Illness-Related Experiences

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lectures; Illness-Related Experience

Nighttime Sleep Characteristics of Hospitalized Children with Cancer

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lectures; Hospitalized Children; Childhood Cance

Writing Test Items

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lectures; Test Writin

iPads, Adolescents and Menopausal Women

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lectures; iPad

If You Ask a Child a Question: Answers from Children, Adolescents, and Young Adults with Cancer Regarding Their Symptoms and Hospitals Experience

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lectures; Hospital Experienc

MS

thesisThe purpose of this study was to investigate changes in school behaviors of children with cancer as perceived by their parents and school teachers. Subjects included 21 children, aged 6 to 12 years, receiving treatment for cancer. Data were collected through interviews and questionnaires developed for both parents and teachers. The area most impacted was an increased frequency of school absences reported by both parents (p = 0.006) and teachers (p = 0.0001). Other areas impacted included use of specialized interventions with school work, decreased physical energy, teasing, and concern with physical appearance. Parents reported greater changes in these areas than teachers although they did not demonstrate statistical significance. Interview responses, however, suggested that adjustment in these areas may be difficult for some children. Findings of this study draw attention to potential difficulties children may experience during school reentry. A longitudinal study may be helpful to identify the process of school reentry further

PhD

dissertationDisturbed sleep-wake patterns are prevalent in up to 40% of children with cancer; however, sources of sleep-wake pattern disturbances are not well understood. Light and noise disrupt sleep-wake patterns in intensive care settings. Cancer-related symptoms, including fatigue, may impair sleep. Individual temperament characteristics influence symptoms in acutely and chronically ill children. Polymorphisms in the dopamine D4 receptor gene and regulatory region of the serotonin transporter promoter gene are associated with behavioral variation and may influence the child's response to physiologic and environmental stimuli. The purpose of this multiple-case study was to examine sleep-wake patterns and the influences of environmental and biobehavioral factors on sleep-wake patterns among children with cancer. The UCSF Symptom Management Model was the conceptual framework. Participants were 15 school-age children with cancer receiving inpatient chemotherapy. Data were collected during an admission lasting 3 days or longer. Wrist actigraphs and sleep diaries measured sleep. A data logger and sound pressure level meter measured environmental variables. Fatigue was measured using Fatigue Scale: Child and Parent Versions. Temperament was measured using Carey Temperament Scales. Polymerase chain reaction was used to genotype polymorphisms. Data analysis included statistical and visual graphical analyses. Children with cancer slept less and had more fragmented sleep compared with age-related norms. A basic mixed linear model identified a significant main effect for epoch (F = 56.27, g < .01) on sleep minutes within a night shift. Main effects for sound (F = 50.87, p < .01) and light (F = 7.04, p < .01) on sleep minutes were present. A backwards multiple regression model contained five variables (sound, light, number of medications, pain, and nausea) Accounting;; for 57.4% of the variance in sleep minutes within each 2-hour epoch of a 12-hour night shift (F = 62.85, p < .01). Children with less predictable biologic cycles slept longer and had fewer awakenings. Children homozygous for short serotonin polymorphisms, associated with increased anxiety, had poorer sleep efficiency. Clinicians should seek opportunities to minimize nighttime disruptions. Research is warranted to develop and test interventions to promote sleep in the hospital and investigate the role of intraindividual factors on children's cancer-related symptoms