Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses
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J Pediatr Oncol Nurs · Sep 2007
ReviewCreating a palliative and end-of-life program in a cure-oriented pediatric setting: the zig-zag method.
Children living with and dying of advanced-stage cancer suffer physically, emotionally, and spiritually. Relief of their suffering requires comprehensive, compassionate palliative and end-of-life (EoL) care. However, an EoL care program might appear inconsistent with the mission of a pediatric oncology research center committed to seeking cures. ⋯ They also completed baseline medical record reviews of 145 patient records to identify key EoL characteristics. The authors then crafted a vision statement and a strategic plan, implemented new research protocols,and established publication and funding trajectories. They conclude that establishing a state-of-the-art palliative and EoL program in a cure-oriented pediatric setting is achievable via consensus building and recruitment of diverse institutional resources.
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J Pediatr Oncol Nurs · Jul 2007
ReviewPrevention and management of post-lumbar puncture headache in pediatric oncology patients.
Pediatric oncology patients are at risk for developing a headache after they undergo a lumbar puncture for diagnostic or therapeutic purposes. These headaches are likely due to leakage of cerebrospinal fluid at the puncture site. ⋯ A number of interventions, such as bed rest, hydration, caffeine administration, and epidural blood patching, have been suggested to prevent and relieve the headaches that follow lumbar punctures. This article outlines the pathophysiology and incidence of headaches related to lumbar punctures in the pediatric oncology setting and reviews the evidence from research trials to suggest which interventions clinicians should adopt into their practice to minimize this complication of lumbar punctures.
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J Pediatr Oncol Nurs · Jul 2007
Variations in pain, sleep, and activity during hospitalization in children with cancer.
This study examines the pain experiences of children with cancer during hospitalization. A descriptive design with repeated measures was used to describe the location, intensity, and quality of pain, pain medications, amount of pain relief, and perceptions of sleep and activity during hospitalization. Data were collected once daily from the day of admission for up to a maximum of 5 consecutive days during hospitalization. ⋯ The highest pain intensity ratings occurred on day 1. Overall, most patients reported good relief after pain medications during hospitalization. Consistent assessment and implementation of pain interventions within the 24 hours of admission is recommended, with particular attention to persistent pain after painful procedures.
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J Pediatr Oncol Nurs · Mar 2007
Review Case ReportsJuvenile metachromatic leukodystrophy: understanding the disease and implications for nursing care.
Hematopoietic stem cell transplants are increasingly being performed in attempt to halt the progression of juvenile metachromatic leukodystrophy, which is a rare neurodegenerative disease. Children who are diagnosed with metachromatic leukodystrophy are not commonly cared for by nurses who specialize in pediatric stem cell transplants. ⋯ The article provides information about the pathophysiology of metachromatic leukodystrophy, the natural progression of symptoms, and how hematopoietic stem cell transplant may work to halt the progression of juvenile metachromatic leukodystrophy. It also focuses on the implications of nursing care, including a review of systems, the need for increased patient and family education, and the complexities of caring for a family with multiple affected children.
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J Pediatr Oncol Nurs · Mar 2007
Health-related quality of life following hematopoietic stem cell transplant during childhood.
The purpose of this study is to examine the self-reported and parent-reported health-related quality of life (HRQoL) of children (age<19 years) who received a hematopoietic (bone marrow, cord blood, or peripheral blood) stem cell transplant (SCT) at the University of Nebraska Medical Center (UNMC). A total of 35 families participated: 31 SCT recipients, 35 mothers, and 28 fathers. Mean scores were 73.6 child, 71.2 mothers, and 76.2 fathers (range of 0-100, with high scores indicating better HRQoL). ⋯ Older age at time of transplant was associated with higher procedural anxiety according to child (r=.498, P=.005) and mothers (r=.466, P=.008). Older age at time of transplant was associated with less worry according to fathers (r=-.589, P=.002). Overall, SCT recipients and their parents report moderately high HRQoL.