Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses
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When a child is diagnosed with a life-threatening illness, such as cancer, there is much disruption to the family. It is a struggle for parents to divide their time between the hospital, home, and other healthy siblings. Nurses strive to provide family-centered care, which involves siblings in many stages of the treatment process. ⋯ Siblings are often left to stay with extended family members or friends so that they are protected from the reality of death. However, previous research has shown that even young children understand death, and some of the protective measures parents take actually hamper the siblings'bereavement process. Nurses are in a position to guide families through the emotional time of a child's death while advocating for sibling involvement at a level appropriate for their developmental stage.
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J Pediatr Oncol Nurs · Jan 2005
Parents' refusal of medical treatment for cultural or religious beliefs: an ethnographic study of health care professionals' experiences.
Pediatric nurses working in acute care settings serving religious and culturally diverse families may encounter parents whose beliefs influence treatment decisions. Previous literature describes how these complex situations lead to emotional distress and strained relationships between health care provider and family members. An ethnographic study was conducted to investigate the impact of parental treatment refusal on the bedside interactions between pediatric nurses and parents. ⋯ Emotional feelings associated with possible loss of guardianship and subsequent mandated treatment, the impact of the situation on the nurses' health and stress levels, and functional status were all explored. Three themes were identified following interpretive narrative analysis of transcriptions and field notes: weathering the storm of moral conflict, closeness and involvement versus distance and retreat, and battles between the supportive and oppositional groups. The findings of the study lead to a deeper understanding of the complexities of the ethical dilemma surrounding treatment refusal in pediatrics.
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Different mechanisms of cancer pain may involve somatic, visceral, and neural tissues. Pain that involves the neural tissues is classified as neuropathic pain and is less responsive to analgesics than pain that involves somatic and visceral tissues. ⋯ Future research is needed to characterize the intensity, location, quality, and duration of neuropathic pain in children. In addition, research that would determine the efficacy of opioids, nonsteroidal anti-inflammatory drugs, and adjuvant analgesics (antidepressants, anticonvulsants) is needed to increase the nurses' ability to assess and manage neuropathic pain in children with cancer.
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J Pediatr Oncol Nurs · Nov 2004
ReviewNurses' perceptions of phase I clinical trials in pediatric oncology: a review of the literature.
A review of literature was conducted to explore nurses' perceptions of phase I clinical trials in pediatric oncology. Specifically, nurses' perceptions of the goals and outcomes, the nurse's role, and the informed consent process in pediatric oncology phase I clinical trials were investigated. ⋯ However, despite an extensive review of published works, no studies on nurses' perceptions of phase I trials in pediatric oncology were found. Therefore, this literature review consists of findings in similar or related studies such as nurses' perceptions of experimental therapies in the adult setting, adult patients' perceptions, parents' perceptions, or oncologists'perceptions of phase I clinical trials.
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J Pediatr Oncol Nurs · Sep 2004
Review Case ReportsFacilitating care for childhood cancer survivors: integrating children's oncology group long-term follow-up guidelines and health links in clinical practice.
Childhood cancer survivors are a growing, vulnerable group with health care needs unique to their cancer treatments. They may experience many late physical and psychological complications (late effects) of treatment including organ dysfunction, infertility, second neoplasms, chronic hepatitis, musculoskeletal problems, alterations in cognitive function, and myriad psychosocial problems. ⋯ This article will use a case-study approach to demonstrate how the newly developed Children's Oncology Group Long-term Follow-up Guidelines and Health Links can be used in clinical practice to improve awareness about late effects and the importance of follow-up care for childhood cancer survivors. The Children's Oncology Group Guidelines and Health Links were created by a multidisciplinary team of health care experts and patient advocates to provide a systematic plan for pediatric cancer survivor follow-up care and health education across the cancer continuum.