Complications of Hickman-Broviac catheters in children with malignancies

The aim of this study was to explore the complications related to Hickman-Broviac central venous catheters (Hickman-Broviac CVCs) in children with cancer, their incidence, and possible associations of complications and premature removal of CVCs with a number of risk factors. During the study period (1 Jan 2000-31 Dec 2003), 223 CVCs were inserted in 198 children (117 boys, 81 girls) at a mean age of 5.73 years (95% CI 5.19-6.27, SE 0.275). In total, 76 (38.4%) children suffered from solid tumors and 122 (61.6%) from leukemia. The mean follow-up after CVC insertion was 232.5 days (95% CI 214.9-250.2, SE 8.94) for a total of 51,839 catheter-days. A complication occurred in 20.8% of them and in 9.6% the complication led to the removal of the catheter. The most frequent complications were infection (63.9%), obstruction (26.2%), accidental failure (8.2%), and rupture (1.6%). An overall incidence of 1.17 (0.38 and 0.79 for mechanical complication and infection, respectively) per 1000 catheter days for the development of a complication was recorded. Additionally, the study revealed more nonelective removals in cases of leukemia compared to those of solid tumors. Systemic use of CVC does not appear to increase significantly the number of complications, and thus CVC remains an effective and safe tool for the management of childhood malignancies. Copyright © Informa Healthcare USA, Inc

Psychosocial functioning of young adolescent and adult survivors of childhood cancer

Goals of work: The present study aimed to assess the psychosocial well-being of Greek adolescent and young adult survivors of childhood cancer and, in particular, self-esteem, anxiety, coping strategies, and social functioning. Patients and methods: The sample comprised 103 Greek childhood cancer survivors and 135 healthy controls. The Battle Culture-free Self-esteem Inventory (BCSEI), the Spielberger State-Trait Anxiety Inventory (STAI), the Lazarus and Folkman Ways of Coping, and 36-item short-form instruments were used along with The Questionnaire for the Quality of Life. Main results: Survivors scored higher than controls on all STAI subscales, but on State, the difference was statistically significant only for female adults, while on the Trait subscale, for the entire group. Survivors scored lower on Personal and higher on Lie subscale of BCSEI, by comparison to controls. When coping with stressful events, the use of self-blame strategies and wishful thinking were more frequent among controls, while distancing strategies more common among survivors. Conclusions: The long-term psychological functioning of Greek survivors of childhood cancer is satisfactory, with emotional difficulties, such as increased anxiety and lower self-esteem, receding over time. Survivors experience personal growth and mature through trauma as they develop a positive view of the impact that the cancer experience has upon their life. © 2007 Springer-Verlag

Quality of Life of Adolescent and Young Adult Survivors of Childhood Cancer

The purpose of this study was to assess the quality of life of Greek survivors of childhood cancer by addressing the physical, psychological, spiritual, and social dimensions of their functioning. The SF-36 Health Survey and the Quality of Life Questionnaire, which was designed for this study, were used. Survivors' scores on most subscales of SF-36 were similar to those of controls, despite some difficulties in their daily activities. They perceived self as more susceptible to health problems, but also more mature and grounded. Generally, they seem to adapt well and focus on the positive aspects of their cancer experience, which enhances the meaning and quality of their life. © 2009 Elsevier Inc. All rights reserved

Psychological problems in children with cancer in the initial period of treatment

Background: The increasing survival rate of children with cancer because of more refined treatments makes necessary the investigation of psychological burden for the young patients. Objective: The aim of the study was to evaluate the development of psychological problems in children with cancer during the initial 6-month period of intensive treatment. Methods: This prospective, comparative study was conducted at one of the largest Greek pediatric oncology units in Athens. The sample comprised 132 children with cancer treated during a 30-month period and 100 children with no cancer as control group. Data were collected using the Rutter instruments for parents and teachers. For patients, it was completed by their parents at 1 (T1), 3 (T2), and 6 months (T3) from diagnosis and by teachers at T3. In the control group, the questionnaire was completed by teachers and parents once. Results: The comparison of total Rutter scores for patients at T1, T2, and T3, according to parents' responses, showed statistically significant difference (P < .001). The difference in scores for patients (at T3) and control subjects was also significant according to both parents' (P < .00001) and teachers' (P < .001) responses. Children with leukemia had higher score reduction during treatment (P = .009) compared with the rest. Only age had a marginal impact on score of patients at T1 (R = 0.04). Conclusions: Based on parental reports, children treated for cancer develop psychological problems during the period of intensive treatment. The development and evolution of these problems depend on their age and type of cancer. Implications for Practice: This information can be used for relevant interventions in specific groups. Copyright © 2011 Lippincott Williams & Wilkins

Changes in children's fatigue during the course of treatment for paediatric cancer

Background: Fatigue is described as one of the most distressing symptoms of cancer therapy; yet it has received limited clinical attention. Children are suffering from a symptom that is under-diagnosed during their treatment. Aim: The aim of this study is: (a) to assess the change in fatigue scores during cancer treatment according to children's perspectives, and (b) to describe the possible causes of fatigue from children's points of view. Sample and methods: The present study is part of an ongoing prospective study. The research group consisted of 40 (n = 40) children aged 7-12 years with cancer who are being followed up in the oncology clinic of a Greek children's hospital. After parental consent was obtained, data were collected using the Child Fatigue Scale and a sociodemographic data form. Results: The children with cancer reported a statistically significant increase in fatigue scores during their treatment (F = 6.846, P = 0.003). Gender was the only demographic factor associated with a significant increase in the fatigue scores (F = 4.857, P = 0.034). Conclusions: Cancer treatment was found significantly to increase children's fatigue levels. Medical procedures and the hospital environment seemed to be major causative factors of the fatigue experienced by children with cancer during their treatment. © 2008 The Authors