Adolescents Receiving Cancer Treatment Research Articles

A picture of hope: From the perspective of adolescents with cancer-A phenomenological-visual qualitative study.

This study aims to investigate the phenomenon of hope in adolescents diagnosed with cancer and examine adolescents' lived experiences of hope. The study was conducted between November 2022 and March 2023. The study used a phenomenological-visual qualitative research design with 20 adolescents in the pediatric oncology ward. The purposive sampling method was used in the study. Data were collected using "Descriptive Characteristic Form," "Semi-structured Interview Form," "Drawing Technique," and "Mutual Storytelling Technique". The adolescents were instructed, "Let us draw our hopes," and asked to draw pictures. Each adolescent was interviewed about the drawings and asked four semi-structured questions. Audio recordings of the interviews were made and transcribed. A hermeneutic phenomenological approach was used in the analysis of the data. Two main themes and four subthemes were identified in the study. Metaphorical and conceptual context was included in the theme of symbolizing and linking hope. Two subthemes, facilitators and barriers, were identified in the main theme of rooting hope. The study sheds light on hope experiences in adolescents receiving cancer treatment and guides healthcare professionals.

The Relationship Between Digital Game Addiction and Levels of Anxiety and Depression in Adolescents Receiving Cancer Treatment.

Adolescents diagnosed with cancer are vulnerable to symptoms of anxiety, depression, and posttraumatic stress. To examine the relationship between digital game addiction and levels of anxiety and depression in adolescents receiving cancer treatment. This analytical cross-sectional study was carried out with 120 adolescents aged 12-17 years who were receiving cancer treatment. Data were collected using the Digital Game Addiction Scale (DGAS-7) and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using independent-samples t test, 1-way analysis of variance, Pearson correlation analysis, and simple linear regression. The mean age of the adolescents participating in the study was 15.21 ± 1.64 years. The mean DGAS-7 score was 15.19 ± 5.58, whereas the mean HADS Anxiety subscale score was 8.54 ± 4.33, and the mean HADS Depression subscale score was 7.72 ± 3.96. A positive, statistically significant relationship was found between the DGAS-7 mean score and the HADS Anxiety and Depression subscale mean scores (P < .001). As the addiction levels increased in adolescents diagnosed with cancer, their anxiety and depression levels also increased. Health professionals should be mindful that in adolescents diagnosed and treated for cancer, digital game addiction and levels of anxiety and depression may mutually reinforce each other.

Effectiveness of Virtual Reality in Anxiety and Pain Management in Children and Adolescents Receiving Cancer Treatment: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

The study aimed to investigate the effect of virtual reality interventions on relieving pain and anxiety in children and adolescents receiving cancer treatment. A search that involved Cochrane Library (comprising Cochrane Central Register of Controlled Trials (CENTRAL)), PubMed, ProQuest, MEDLINE, Web of Sciences, Science Direct, and Scopus electronic databases covering the records from January 1, 2000 up to May, 2023 was conducted to determine randomized controlled trials that could be included in our study. The results of the search were limited to "anxiety and pain, adolescents, children, virtual reality, cancer." Of the 160 articles that were reached during the search, seven were found eligible based on inclusion criteria. Hedges' g effect size was calculated for each article. Random effects model was used to test effect sizes and moderator variables. The registration number of this meta-analysis on PROSPERO is CRD42022304737. The outcomes were pain and anxiety. Compared with standard care, virtual reality had a medium and significant effect on anxiety (g = 0.60, 95% CI: [- 1.05 - 0.15]) and pain (g = - 0.667, 95% CI: [- 1.08- -0.24]). In addition, age has been identified as an important moderator in the use of virtual reality in pain management. This meta-analysis shows that virtual reality applications are effective interventions for reducing pain and anxiety in the field of pediatric oncology. However, it is necessary to carry out randomized controlled trials that have large samples for evidence-based virtual reality applications in pediatric oncology.

Factors associated with walking performance among adolescents undergoing cancer treatment: A correlational study.

This study aimed to describe and compare the differences in walking performance between adolescent patients in inpatient wards and outpatient units, and to identify factors that influence walking performance among adolescents receiving cancer treatment. The cross-sectional study with correlational research design recruited 32 adolescents with cancer between February 2015 and March 2017 in two teaching hospitals in Taiwan. Descriptive, bivariate, and multivariate regression analyses were used. Participants' age, treatment setting, and symptom distress were significantly associated with number of walking steps. All independent variables in the model together accounted for 82.1% of variance. This study addresses a gap in the existing literature to identify associated factors that affected walking performance among adolescents undergoing cancer treatment. Our findings represent a pathway toward generating knowledge to enhance well-being for this unique population.

A Pilot Study of Nutrition Management in the Department of Pediatric Oncology Department of a Hospital in Kazakhstan

Maintaining optimal nutritional status is important for children with cancer because it can affect clinical outcomes. This study aimed to prospectively study clinical practices in children's cancer departments to improve the nutritional health of children and adolescents receiving cancer treatment. Currently, there are no unified and harmonized protocols for assessing the nutritional status and nutritional support of children in pediatric wards in Kazakhstan. According to WHO research, most of the children admitted to hospitals already have significant nutritional status disorders, such as exhaustion and malnutrition, lipid metabolism disorders, hypovitaminosis and anemia. 200 children with cancer aged 6 months to 17 years (n=200) were recruited. Dietary data and other relevant anthropometric and biochemical data were collected using a data collection form validated and developed by the researchers. Data processing is still in progress. They were randomly allocated either to a treatment group or a control group (age-matched and gender matched). The treatment group received nutritional advice and support and the control group received the standard treatment. A significant decrease in the intake of protein and energy with the consumed diets, which are prescribed by doctors in daily practice, was revealed, which is a risk factor for the development of severe nutritional disorders (p&gt;0.5). Patients who were assigned nutritional support in addition to the General diets during the study had higher nutrient intake. Comparing week zero with subsequent weeks of nutritional support, children in the main group showed significant improvements in the thickness of the triceps skin fold (P&lt;0.001), the circumference of the middle shoulder (P&lt;0.001), and the circumference of the arm muscles (P&lt;0.001), showing that performing nutritional support is better for the evolution of nutrition (P&lt;0.01). Proper use of nutritional support in children with cancer can prevent the development of nutritional deficiencies and associated risks. To improve nutrition management, attention should be paid to nutrition education and assessment tools for doctors and nurses.

A Person-Centered Approach to Symptom Assessment and Management for Children and Adolescents Receiving Cancer Treatment.

Discuss the clinical assessment and management of symptoms for children and adolescents receiving treatment for cancer with attention to a person-centered approach to care. Review of currently published literature and guidelines pertaining to symptom assessment and management for children and adolescents receiving treatment for cancer. Symptoms such as pain, nausea, and fatigue are commonly reported by children and adolescents receiving cancer treatment and are associated with greater symptom burden. Symptom assessment should be tailored to the child or adolescent and include the child's or adolescent's preference for reporting symptoms and attention to the symptoms that are of greatest priority. Evidence-based guidelines for the management of symptoms, including pain and nausea, are available to guide symptom management interventions and should be tailored to provide person-centered care. Nurses can lead efforts through clinical practice and research initiatives to advance person-centered symptom care for children and adolescents with cancer on a global level. Priorities for future work to advance person-centered symptom assessment and management include (1) identification of best practices for symptom assessment, (2) attention to social determinants of health and their subsequent influence on symptom outcomes, (3) compilation of evidence for management of less commonly reported symptoms, and (4) implementation of published clinical guidelines for symptom management in practice settings.

The prevention and treatment of chemotherapy-induced nausea and vomiting in children and adolescents receiving cancer treatment: the current status and possibilities for improvement

Even though chemotherapy-induced nausea and vomiting (CINV) rarely become life-threatening, they are regarded by patients as one of the most unbearable complications and can often cause great suffering. CINV may also be an aggravating factor for other complications and pathological conditions. The currently available antiemetic prophylaxis can greatly reduce the incidence of CINV in children and adolescents receiving cancer treatment. However, inadequate management of CINV is still much more common in children than in adults, and the integration of new antiemetic drugs into pediatric care is delayed because of specific regulatory requirements for drug studies in children. The aim of this article is to present current standards for prevention and treatment of CINV in children and adolescents as well as to suggest ways to improve them.

The experiences of adolescents receiving cancer treatment in Turkey: A qualitative study.

The adolescents with cancer usually receive intensive chemotherapy in the hospital. Their experiences of the process can affect their lives. This study aimed to describe the experiences of hospitalised adolescents receiving cancer treatment. This study was conducted using a descriptive qualitative research design. Data were collected from 12 adolescents receiving cancer treatment in the paediatric haematology/oncology clinic at a university hospital in Turkey. Adolescents participated in one session of individual, unstructured mandala drawing. Individual interviews were then conducted using a semi-structured interview guide. The interviews, researcher observations and document analysis methods were used to produce and analyse data. Interview transcripts of the study were analysed using the content analysis method. Two main themes with related sub-themes each were obtained: being an adolescent with cancer, with the sub-themes of changes in health, restriction of freedom and feeling lonely; and coping with cancer with the sub-themes of psychological growth and hope for healing. Adolescents felt lonely and as though their freedom was restricted while they were hospitalised. Participants also noticed changes in their perspective on life and experienced psychological growth. Most of them hoped for healing and prayed to cope with cancer.

Expanding construct validity of established and new PROMIS Pediatric measures for children and adolescents receiving cancer treatment.

The Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric measures were designed to assess symptoms and functioning in children and adolescents. The study goal was to evaluate the validity and responsiveness of the PROMIS Pediatric measures in a diverse cohort of children with cancer. Children (7-18 years) from nine pediatric oncology hospitals completed surveys at 72hours preceding treatment initiation (T1) and at follow-up (T2) approximately 7 to 17 days later for chemotherapy, and 4+ weeks later for radiation. Children completed PROMIS Pediatric measures (Mobility, Pain Interference, Fatigue, Depressive Symptoms, Anxiety, Psychological Stress), Memorial Symptom Assessment Scale (MSAS), and global impressions of change (GIC) questions on their symptoms and functioning at T2 reflecting on T1. Parents completed the Lansky Play-Performance Status (PPS) scale and medication list for their child. The children (n=482) were average age 12.9 years, 46% female, 60% Caucasian, and had diverse cancers and treatments. There were moderate to strong correlations between PROMIS Pediatric and MSAS, supporting convergent validity. In support for known-groups validity, the PROMIS Pediatric average scores were statistically different (P<0.05) for most domains by PPS and if the child was on a medication (or not) for controlling a symptom. The PROMIS Pediatric measures were responsive over time in association with the GIC. In a large, diverse sample of children and adolescents with cancer, there was strong evidence for the construct validity and responsiveness of the PROMIS Pediatric measures. This evidence supports PROMIS Pediatric measure use in pediatric oncology trials.

Symptoms and symptom clusters in adolescents receiving cancer treatment: A review of the literature

ObjectivesThe purpose of this literature review is to document what is known about the most common symptoms and symptom clusters in adolescents receiving cancer treatment in order to advance the science of symptom management for this unique group of patients. DesignThis review identified primary research reports focused on cancer-related symptoms in adolescents using methodology that included objective measurement of the symptom(s) or self-report from the adolescents. Data sources: We searched the literature using Medline, PubMed, and CINAHL from 2000 to 2011. Review methodsThe first step of the review was to synthesize evidence to identify the most common symptoms experienced by adolescents during the cancer treatment period. The second step located findings from additional research about these specific symptoms individually or as clusters. ResultsFrom 12 reports, we identified 6 common symptoms in adolescents during the treatment period: fatigue, sleep-wake disturbances, nausea/eating problems, pain, mood disturbances, and appearance changes. Findings from 51 studies provided a foundation of evidence about symptom trajectories, contributing factors, and associations between symptoms. ConclusionsThis review of the literature identified a relatively small body of research related to symptoms in adolescents during the cancer treatment period. Most of the studies were of low quality evidence and described individual symptoms rather than associations or clusters. A few longitudinal studies described symptoms during a cycle of chemotherapy and across months of chemotherapy treatment. With the exception of nausea, no studies tested any interventions to relieve these common symptoms in adolescents. To ensure that adolescents complete the challenging period of cancer treatment and emerge capable of achieving the developmental milestones of young adulthood, important work remains to be done in this field of symptom management.

Trailblazers in Adolescent and Young Adult Oncology.

The development of adolescent and young adult (AYA) oncology as a burgeoning discipline that is now into its own adolescence may be best illustrated by the surge in AYA oncology publications in peer-reviewed journals during the past three years. Prior to 2007, the number of articles identified by the search term ‘‘adolescents young adults cancer’’ in the PubMed database ranged from 129 to 381 per year. Since then, the number increased to 598 in 2007, 1971 in 2008, and 4045 in 2009. The dramatic increase is still well short of the 7000–7500 articles per year that the ‘‘children cancer’’ search term identifies, especially when one considers that the number of cancer patients in the AYA age group is four to six times greater, depending on what age range is used for the AYA group. Nonetheless, the change in publication rate of AYA cancer reports and reviews is striking testimony of need and partial success. To understand the history that led to this revolution, several of its pioneers in England, the United States, and Canada were convened for a roundtable discussion to offer their recall. As described below, the original seed appears to have been sowed in England, thanks to Ian Lewis and London’s Teenage Cancer Trust. A root took hold a decade later when national statistics in the United States showed a survival progress gap that was analogized to the famous London Tube gap between the platform and the Underground train. The stems that then broke ground were conferences, organizations, hospital and outpatient programs, scientific reviews, and international collaborations. The participants in this Roundtable undoubtedly neglected many other events along the way, but they are all appreciative of the emerging buds and blossoms of AYA oncology. Most of all, they sense that AYAs around the world will ultimately truly benefit in improved prevention, early detection, and treatment of cancer during the prime of their lives.

Adolescents’ and Parents’ Experiences of Managing the Psychosocial Impact of Appearance Change During Cancer Treatment

Using combined qualitative data from multiple case study interviews and an online survey, this study explored the impact of appearance change on 22 adolescents receiving cancer treatment aged 13 to 18 years and six of their parents. Data were analyzed using template analysis. Appearance changes were a major concern. Adolescents typically struggled to adapt to new experiences and concerns related to this highly sensitive issue. Many felt anxious and self-conscious and were reluctant to reveal appearance changes in public. These feelings were compounded by the negative reactions of others (e.g., staring, teasing, and inappropriate questioning), which sometimes lead to avoidance of social activity and threats of noncompliance. Parents of these children felt ill-prepared to manage appearance-related anxieties. Adolescents wanted support to develop the practical and social skills necessary to maintain a "normal" appearance and manage the negative responses of others. However, some adolescents showed resilience and, with support from friends and family, developed strategies to manage their altered appearance and its social consequences. These strategies are explored, which can inform interventions to support adolescents and parents.

Treatment non‐adherence in teenage and young adult cancer patients: a preliminary study of patient perceptions

Non-adherence (NA) by adolescents receiving cancer treatment is believed to be a major problem. However, adequate measures of NA have not been developed. The purpose of this study was to (1) assess the internal reliability of a new scale reflecting low-risk NA behaviours, (2) examine whether the scores on this scale were associated with high-risk NA behaviours and (3) assess the relationship between NA behaviours and patient attitudes towards stopping treatment. Thirty-three patients (16-24 years) with solid tumours reported on their previous adherence with treatment. Low-risk NA behaviours were assessed on a 0-40 scale derived from the sum of 10 items. High-risk NA behaviours and attitudes towards stopping treatment were assessed by questions with yes/no response options. Internal reliability of the low-risk NA scale was alpha=0.73. Patients not seeking help for pyrexia had higher total low-risk NA scores than those who sought help (mean 7.4, SD 5.3 vs mean 3.5, SD 3.6, t=2.1, p=0.03). There was also a trend for individuals who ignored pyrexia to be more likely to have contemplated stopping treatment than those who sought medical assistance (Fisher's Exact=0.09). A scale reflecting low-risk NA behaviour had good internal reliability and was associated with not seeking help when pyrexic. Ignoring a temperature was also associated with contemplating stopping treatment. We are now conducting a prospective study using the measure to assess validity against a range of information regarding NA.