Thesis (M.A.)--Northern Kentucky University, 2006. / Made available through ProQuest. Publication number: AAT 1435196. ProQuest document ID: 1136092731. Includes bibliographical references (p. 55-60)

Thesis (M. Nurs.)--University of Hong Kong, 2006.

Source: Dissertation Abstracts International, Volume: 70-03, Section: B, page: 1627. Adviser: Sally W. Vernon. Includes bibliographical references.

Acute lymphocytic leukemia (ALL) is one of the most common types of pediatric cancers. Improvements in treatment within the last 20 years have resulted in reduced mortality and a greater focus upon quality of life. Several researchers have documented neuropsychological impairments in children following treatment for ALL; however, there have not been any comparative studies documenting differences in neuropsychological functioning based upon treatment modality despite the documented effects of radiation therapy and combined radiation/chemotherapy upon the developing brain. In addition, past studies have focused on unitary measures, ignoring the hierarchical relationship between basic cognitive functions and more abstract skills. This study examined the neuropsychological functioning of 81 children who were treated for ALL at a metropolitan children's hospital. All children were tested a minimum of two years after the final treatment session and were administered the NEPSY. Results do not support any interactions or main effects with the exception of the age of the child at diagnosis. Children diagnosed prior to the age of 5 showed greater impairments on tasks measuring attention, memory, and visuospatial reasoning in comparison to peers diagnosed after age 6.

With the increase in survival for children with cancer, part of the focus of current research is aimed towards evaluating how these children are adapting psychosocially. Neurocognitive deficits have been well established. However, there are multiple facets encompassing quality of life, including general mental health, lifestyles and health behaviors, and academic and cognitive functioning. The relationship between neurocognitive and psychosocial functioning has yet to be thoroughly evaluated. The purpose of this study was to investigate the relationship between neurocognitive and psychosocial functioning in survivors of brain tumors and acute lymphoblastic leukemia. Data was collected from existing archival database comprised of patients of the at Cook Children's Medical Center in Texas. The sample consisted of 177 patients between the ages of 3 and 12 who were at least two years post-diagnosis. Measures used included the NEPSY and the Behavioral Assessment for Children. Statistical analyses included a several one-way analysis of variances, an independent samples t-test, a univariate analysis of variance, a hierarchical multiple regression, and odds ratio analyses. Results indicated survivors treated with neurosurgery alone appear to be less at risk for developing behavior problems than other treatment modalities. Also, brain tumor survivors demonstrate more problematic behaviors than survivors of acute lymphoblastic leukemia. Visuospatial functioning, diagnosis, and type of treatment were found to be predictive variables of behavior problems. Attention, and perhaps language, deficits may predispose children to more problems in their behavior. It is concluded that there are other factors affecting behavior in this population that were not accounted for in this analysis. It is recommended for future studies to research the individual clinical scales of the Behavior Assessment System for Children, obtain information from multiple informants, study this relationship longitudinally, and research additional factors that may be influencing the relationship between neurocognitive and psychosocial functioning. This provides evidence of risk factors that should be monitored as the child returns home and to school.

SAMMANFATTNING Bakgrund. I Sverige insjuknar årligen drygt 300 barn i cancer. Det saknas empiriska studier som beskriver de små barnens upplevelser av barnsjuksköterskans bemötande vid insjuknandet av cancer. Föräldrar till små barn med cancer har en avgörande roll i barnets liv och det är därför viktigt att belysa även deras upplevelser för att utveckla den barnonkologiska verksamheten samt öka familjens välbefinnande vid insjuknandet. Syfte. Syftet med studien var att beskriva barn och föräldrars upplevelse av barnsjuksköterskans bemötande inom barnonkologisk verksamhet. Metod. Studiens design var kvalitativ där data inhämtades 3-9 veckor efter diagnostillfället. Deltagarna som inkluderades var barn i åldern 1-5 år. Totalt deltog 13 barn samt 23 föräldrar i studien. Intervjuerna analyserades genom en deduktiv innehållsanalys utifrån Swansons caringteori. Resultat. I resultatet framkom vikten av att barnsjuksköterskan visade tilltro till barnet och föräldrarnas förmågor vid insjuknandet. Föräldrarna önskade att barnsjuksköterskan bibehöll en hoppfull attityd i bemötandet. Föräldrarna ville inge trygghet och inte hålla fast sitt sjuka barn vid svåra omvårdnadshandlingar. När familjerna upplevde barnsjuksköterskans närvaro och fokus på individen ökade välbefinnandet hos barnet och föräldrarna. Konklusion. Barnsjuksköterskans bemötande kan både främja eller hindra hälsa och välbefinnande. Barnsjuksköterskor måste visa tilltro till barnet och föräldrars förmåga genom att tillämpa barnets perspektiv samt ett barnperspektiv. Inom den barnonkologiska verksamheten krävs det vidareutbildade barnsjuksköterskor för att säkerställa god omvårdnad då ett litet barn insjuknat i cancer. / ABSTRACT Background. Each year approximately 300 children fall ill with cancer in Sweden. There is a lack of empirical studies describing the younger children's experiences of the pediatric nurse approach during cancer diagnosis. Parents of young children with cancer have a crucial role in the child's life and it is important to shed light on their experiences to develop the pediatric oncology and increase family well-being during the time of diagnosis. Aim. The aim of the study was to describe children and parents' perception of the pediatric nurse approach in pediatric oncology. Method. The study design was qualitative and the data were collected 3-9 weeks after diagnosis. Included participants were children aged 1-5. A total of 13 children and 23 parents took part in the study. The interviews were analyzed through a deductive content analysis based on Swanson’s caring theory. Results. The importance of the pediatric nurse believing the child and the parents' abilities during diagnosis. Parents of the children wished for the pediatric nurse to maintain a hopeful attitude in her approach. The parents felt a need to contribute the child with security and not hold the child during difficult caring actions. When families experienced the pediatric nurse’s presence and focus on the individual, it increased the well-being of the child and the parents. Conclusion. The pediatric nurse’s approach can either promote or prevent health and well-being. Pediatric nurses must maintain belief in the child and the parents' ability by applying the child's perspective as well as a children's perspective. Within the pediatric oncology, further trained pediatric nurses are required to ensure high quality care for a young child newly diagnosed with cancer.

published_or_final_version / Social Work and Social Administration / Master / Master of Philosophy

Differences in self-reported depression, anxiety, self-esteem, and coping were evaluated in two groups of pediatric oncology patients: newly diagnosed (less than six months post-diagnosis) (n=5) and patients on cancer treatment for seven months or longer (n=5). Participants (6 males, 4 females, ages 7-17 years) completed the Children's Depression Inventory (CDI), the State-Trait Anxiety Inventory for Children (STAIC), and the Culture-Free Self-Esteem Inventory (CFSEI-2); nine of the ten participants discussed in a semi-structured interview their personal experiences and feelings about having cancer. Although the newly diagnosed group had a higher mean score on the CDI than the 7 months or greater group, the difference was not significant (p = .054). The newly diagnosed group also had higher mean state and trait anxiety scores on the STAIC, indicating higher anxiety levels, and a slightly lower CFSEI-2 mean score, indicating slightly lower self-esteem than the 7 months or greater group, but differences were not at a statistically significant level (p>.05).

Recent medical advances in cancer screening and treatments have led to dramatically decreasing mortality rates from cancer among children and adolescents. However, the cancer itself and the adverse effects of treatments remain severely devastating to their physical and psychological well-being, both during and after treatments. Numerous studies have demonstrated that regular physical activity is related to various physiological and psychological benefits for children and adolescents under cancer treatments. Nevertheless, a review of the literature reveals that children and adolescents commonly present declining levels of physical activity throughout their cancer treatments. There is so far no study has investigated the physical activity level and behaviour in particular, the influencing factors affecting the physical activity level among Hong Kong Chinese children and adolescents with cancer. Therefore, this study aimed (1) to assess and compare the physical activity levels and behaviour of healthy children and adolescents with those of children and adolescents undergoing cancer treatments and (2) to explore the various factors that influence the physical activity levels of children and adolescents with cancer in Hong Kong. A cross-sectional study, using both quantitative and qualitative approaches, was conducted. A total of 76 children and adolescents (9-to 18-year-olds) who were admitted for treatment of cancer in a paediatric oncology unit and 148 healthy counterparts who were participated in two health carnivals in Hong Kong were invited to participate in the study. Their physical activity levels, stages of change for exercise, self-efficacy for physical activity and quality of life were assessed and compared. A total of 25 participants with cancer were purposively selected for semi-structured interviews. The results of this study indicated that children and adolescents with cancer in current situation had significantly decreased levels of physical activity when compared with the premorbid situation or the healthy counterparts. The study also showed that children and adolescents with cancer presented significantly lower levels of physical activity, self-efficacy, stage of change for exercise and quality of life than the healthy participants. Furthermore, qualitative interviews revealed that the negative impacts from cancer and its treatments, the discouragement of and misunderstanding concerning physical activity, and the space limitations in Hong Kong were important factors that disengaged these young people from regular physical activity while under treatment. This study has addressed an literature gap by assessing the levels of physical activity, self-efficacy, stage of change, and quality of life among children and adolescents with cancer as compared to their healthy counterparts. The results provide further evidence that cancer and its treatments induce negative impact on the physical, psychological well-being and the quality of life in children and adolescents with cancer. It is essential for healthcare professionals to detect physical inactivity at an early stage so that appropriate interventions can be applied to correct any misunderstandings about physical activity among children and adolescents with cancer and their parents. Most importantly, interventions should be designed to promote the adoption of regular physical activity for these patients, with the aim of enhancing their physical and psychological well-being. / published_or_final_version / Nursing Studies / Master / Master of Philosophy

Thesis (Ph.D.) -- University of Western Sydney, 2002. / "A thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy - Health and Nursing from the University of Western Sydney" Bibliography : leaves 254-265.