Effectiveness of Application of Oral Regimen, Practicing Oral Health, Health Education, Observation (APHO) Nursing Intervention in Preventing and Managing Oral Mucositis in Children Undergoing Chemotherapy: An Interventional Study in Central India

Abstract

Background The incidence of childhood cancer is rising worldwide, with acute lymphoblastic leukemia being the most commonly diagnosed form. These young patients are immunocompromised and susceptible to infections. In addition, chemotherapy and radiation therapy often cause oral mucositis as a side effect. Given these challenges, nurses play a crucial role in delivering special care to these vulnerable children. Material and methods A study design utilizing a one-group pretest-posttest approach was implemented on 45 children, aged one to 12 years, who were undergoing chemotherapy and experiencing oral mucositis. Demographic information, including age, gender, diagnosis, chemotherapy cycle, and length of therapy, was collected. A customized intervention, which involved the application of an oral regimen, oral health practices, health education for caregivers, and observation, was administered by nursing staff using the APHO (Application of an Oral Regimen, Practicing Oral Health, Health Education to Caregivers, and Observation) protocol for a period of seven days. Both pre-intervention and post-intervention assessments were conducted to determine the effectiveness of the APHO nursing intervention. The assessment tool used to assess the effectiveness of APHO intervention was using a standardized scale given by the World Health Organization grading scale for oral mucositis. Result An analysis was conducted utilizing both descriptive and inferential statistics. Before the intervention, those children in grade 2 were in grade 1 after the intervention, and the children in grade 1 before the intervention were in grade 0 after the intervention. The health education provided to the caregivers was significantly effective. Notably, there was a significant decrease in the oral mucositis grade of the children by one level in all instances, indicating that the APHO nursing intervention was remarkably effective. Thus, promoting the use of APHO nursing intervention can lead to positive outcomes in children afflicted with oral mucositis. Conclusion APHO nursing intervention has shown remarkable effectiveness among children with mucositis. As a result, promoting continuous APHO intervention in children with mucositis can help enhance in prevention and management.

The Effect of Oral Care Intervention in Mucositis Management Among Pediatric Cancer Patients: An Updated Systematic Review

“… 13 These issues can impede cancer treatment and lower survival rates, particularly in immunocompromised children. 14 …”