Fatigue in children and adolescents with cancer from the perspective of health professionals

Silva, Michele Cristina Miyauti da; Lopes-Júnior, Luí­s Carlos; Nascimento, Lucila Castanheira; Lima, Regina Aparecida Garcia de

doi:10.1590/1518-8345.1159.2784

Cited by 20 publications

(24 citation statements)

References 27 publications

(63 reference statements)

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“…Additionally, a nationwide survey of clowns, parents and support staff in hospitals in Germany concluded that hospital clowns boost morale and reduce stress in patients without any side effects 108. Moreover, some evidence have indicated the effects of hospital clowns on reducing distress in parents and health professionals as well 108109110. By offering moments of recreation, most researchers perceived hospital clowns as additional opportunities to restore energies 3069109…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials

Lopes-Júnior

Bomfim

Olson

et al. 2020

BMJ

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Objective To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions. Design Systematic review of randomised and non-randomised controlled trials. Data sources Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American Psychological Association PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature. Study selection Randomised and non-randomised controlled trials were peer reviewed using the following eligibility criteria: children and adolescents who were admitted to hospital for acute conditions or chronic disorders, studies comparing use of hospital clowns with standard care, and studies evaluating the effect of hospital clowns on symptom management of inpatient children and adolescents as a primary outcome. Data extraction and synthesis Two investigators independently screened studies, extracted data, and appraised the risk of bias. Methodological appraisal was assessed by two investigators independently using the Jadad scale, the revised Cochrane risk-of-bias tool for randomised controlled trials (RoB 2), and the risk of bias in non-randomised studies (ROBINS-I) tool for non-randomised controlled trials. Results 24 studies (n=1612) met the inclusion criteria for data extraction and analysis. Most studies were randomised controlled trials (n=13). Anxiety was the most frequently analysed symptom (n=13), followed by pain (n=9), psychological and emotional responses and perceived wellbeing (n=4), stress (n=4), cancer related fatigue (n=3), and crying (n=2). Five studies used biomarkers, mainly cortisol, to assess stress or fatigue outcome following hospital clowns. Most of the randomised controlled trials (n=11; 85%) were rated as showing some concerns, and two trials were rated with a high risk of bias. Most non-randomised controlled trials (n=6; 55%) were rated with a moderate risk of bias according to ROBINS-I tool. Studies showed that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological adjustment (P<0.05). Three studies that evaluated chronic conditions showed favourable results for the intervention of hospital clowns with significant reduction in stress, fatigue, pain, and distress (P<0.05). Conclusions These findings suggest that the presence of hospital clowns during medical procedures, induction of anaesthesia in the preoperative room, and as part of routine care for chronic conditions might be a beneficial strategy to manage some symptom clusters. Furthermore, hospital clowns might help improve psychological wellbeing in admitted children and adolescents with acute and chronic disorders, compared with those who received only standard care. Systematic review registration PROSPERO CRD42018107099.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials

Lopes-Júnior

Bomfim

Olson

et al. 2020

BMJ

Self Cite

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“…Furthermore, many TYAs with cancer do not access help for their fatigue. Some do not mention it because they see it as inevitable (Tomlinson et al, 2016), and others ask for help, but professionals do not know what to recommend (Silva et al, 2016). Thus, there is potentially a gap between symptom burden and access to help.…”

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confidence: 99%

Cancer‐related fatigue in teenage and young adult cancer patients: Clinicians' perspectives, practice and challenges

et al. 2020

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CRF causes significant impairments to TYAs' quality of life (Bower, 2014; Poort et al., 2017) and may predict shorter survival (Quinten et al., 2011). TYAs have to navigate a number of developmental tasks towards establishing adulthood, including completing education, beginning employment, establishing and maintaining social and romantic relationships, increasing independence and transitioning away from family homes, greater financial self-sufficiency and increased responsibility (Warner et al., 2016; Zebrack, 2011).

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“…These assessment findings include: fatigue, hair loss, depression, nausea, confusion, pain, anger, bleeding, diarrhoea and mouth sores/mucositis. Other findings were insomnia, neuropathy, neutropenia night sweats, weight loss and sensory changes that are found in patients who are on chemotherapy treatment (Linder & Wawrzynski, 2018; Silva et al., 2016; Ward et al., 2020). These participants' stories revealed that they played with the children and regularly watched the children to monitor their progress.…”

Section: Discussionmentioning

confidence: 99%

Striving to reduce suffering: A Phenomenological Study of nurses experience in caring for children with cancer in Ghana

et al. 2020

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Aim To provide insights into nurses lived experiences in caring for children with cancer. Background Little is known about the paediatric oncology nurses shared practices of caring for children with cancer in Ghana. Design A hermeneutic phenomenological qualitative study. Methods A semi‐structured interview with 14 purposely sampled Ghanaian paediatric oncology nurses. Findings were analysed using Diekelman, Allen and Tanner's approach. Results The theme "Striving to reduce suffering" and three relational subthemes: "knowing children's needs," “Rendering a hopeful fight” and “Ensuring continuity and coordination of care” emerged. Increased awareness of this phenomenon for the nurses who care for these children is vital to ensure quality and holistic care that is meaningful and satisfying by nurses for children with cancer. Paediatric oncology nurses can use the result of the study to evaluate their caring practice and as an avenue to develop better caring practice.

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Fatigue in children and adolescents with cancer from the perspective of health professionals

Cited by 20 publications

References 27 publications

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials

Cancer‐related fatigue in teenage and young adult cancer patients: Clinicians' perspectives, practice and challenges

Striving to reduce suffering: A Phenomenological Study of nurses experience in caring for children with cancer in Ghana

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