BackgroundChildren with special health care needs (CSHCN) are children with medical or behavioral diagnoses that require services beyond those generally needed by pediatric populations. They account for a significant portion of pediatric health care expenditures and often have complicated treatment regiments. Health literacy has recently been recognized as a key indicator of quality chronic disease self-management and parental/caregiver health literacy of CSHCN is an understudied area. The purpose of this systematic review was to assess the available evidence of studies investigating parent/caregiver health literacy of CSHCN.MethodsDatabases were searched to retrieve relevant articles for inclusion (dating from 1998 to 2014). Only studies that assessed the relationship between parent/caregiver health literacy on outcomes pertinent to CSHCN were included. Because of the limited number of studies, there were no restrictions placed on type of outcome.ResultsThirteen studies were included in the final review with a range of health literacy assessments and outcome ascertainment. The majority of studies; (1) focused on the relationship between parental/caregiver health literacy and asthma outcomes, (2) were cross-sectional study designs, and (3) included samples recruited from pediatric clinics in academic medical settings.ConclusionsThere were several gaps in the literature where future research is needed including; (1) direct assessment of child/adolescent health literacy, (2) inclusion of children with co-morbid conditions, (3) further assessment of the relationship between health literacy and health care utilization and cost, and (4) assessment of parental/caregiver health literacy in the inpatient care setting.
Little is known about the physical activity (PA) of young adults (YAs) during cancer therapy. In this feasibility study, 14 YAs (20-34 years old) completed a six-minute walk test, recorded their steps per day for one week, and answered weekly self-reports about physical activity, fatigue, sleep-wake disturbances, and depression during one cycle of chemotherapy. Findings suggest YAs are willing to complete a PA study during chemotherapy and have variable sleep and activity schedules. Their symptoms varied in severity, with highest scores for fatigue. Studies to improve PA in YAs during chemotherapy are warranted to manage short-and long-term treatment effects.Keywords: cancer care continuum, chemotherapy, exercise, physical activity, supportive care P hysical activity (PA) during treatment for cancer is an evidence-based intervention recommended to relieve disease-and treatment-related symptoms such as fatigue and sleep disturbances.1-3 Maintaining PA during cancer treatment may also mitigate the long-term negative effects of inactivity, such as deconditioning and weight gain, that often occur during and after the cancer treatment period.4,5 Staying physically active may also promote better disease outcomes for patients at high risk for developing second cancers.6 Many young adults (YAs) with cancer, however, become sedentary during their months of chemotherapy due to common physical and psychosocial symptoms, such as fatigue and depressed mood. Frequent clinic and hospital visits disrupt daily activity and sleep routines, making it difficult to maintain previously established habits and schedules.PA research to date has focused mainly on outcomes in adults with common cancers, especially following the completion of therapy, and little is known about PA in YAs with cancer. Emerging evidence suggests that adolescent cancer survivors experience significant declines in PA during treatment that may last past completion of treatment. [7][8][9] Studies are needed to describe PA in YAs during active treatment and to test PA interventions for YAs receiving chemotherapy.The aims of this study were to: (1) test the feasibility of procedures to measure four symptoms (fatigue, sleep disturbance, wake disturbance, and emotional disturbancedepression) and PA in YAs; and (2) gather feasibility data related to functional status, symptom severity, and PA over the course of one cycle of chemotherapy. These data will inform the design of a trial to test an age-specific intervention to improve symptom management, PA, and quality of life outcomes for YAs who may become long-term cancer survivors. MethodsData collection began on the first day of a chemotherapy cycle and lasted 2 weeks. This feasibility study was conducted at the University of Virginia Medical Center between November 2010 and May 2012. ParticipantsInclusion criteria included patients who: (1) were diagnosed with any cancer between the ages of 18 and 39; (2) were receiving chemotherapy on a cycle every 3-4 weeks; (3) were in their first through sixth month of chemothera...
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