The Symptom Experience in Pediatric Cancer: Current Conceptualizations and Future Directions

Jibb, Lindsay; Ameringer, Suzanne; Macpherson, Catherine Fiona; Sivaratnam, Surabhi

doi:10.1007/s11912-022-01222-2

Cited by 9 publications

(5 citation statements)

References 96 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While evidence‐based guidelines offer a general framework, they may not fully account for the unique needs and preferences of individual patients, particularly those experiencing multiple co‐occurring painful complications associated with HSCT therapy. Personalized symptom management, tailored to individual children's needs, is vital in conjunction with evidence‐based guidelines to optimize pain management and overall treatment outcomes 40 . Future research should prioritize the development of supportive care guidelines for multimodal pain management, guided by comprehensive systematic reviews of available evidence 41,42 …”

Section: Discussionmentioning

confidence: 99%

“…Personalized symptom management, tailored to individual children's needs, is vital in conjunction with evidence-based guidelines to optimize pain management and overall treatment outcomes. 40 Future research should prioritize the development of supportive care guidelines for multimodal pain management, guided by comprehensive systematic reviews of available evidence. 41,42 Overall nonpharmacological interventions were highly valued yet underutilized in this study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The management of pain during pediatric hematopoietic stem cell transplantation: A qualitative study of contextual factors that influenced pain management practices

Plummer,

McCarthy,

Newall

et al. 2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

BackgroundChildren hospitalized following hematopoietic stem cell transplantation (HSCT) experience complex and prolonged pain in response to the intensity of this treatment.ObjectivesTo describe how pain was managed for children during HSCT therapy and how contextual factors related to the clinical environment influenced healthcare providers' and parents' pain management practices.MethodsA qualitative case study was conducted and involved semi‐structured interviews at two time points following transplantation (30 and 90 days) with parents (n = 10) and naturalistic observations of pain‐related care provided to children (n = 29) during HSCT therapy by their healthcare providers (n = 10). Semi‐structured interviews were also conducted with healthcare providers (n = 14).ResultsThe effectiveness of pain management interventions was hindered by the multifactorial nature of pain children experienced, a gap in the provision of psychosocial interventions for pain and a lack of evidence‐based guidelines for the sustained, and often long‐term, administration of opioids and adjuvant medications. Misconceptions were demonstrated by healthcare providers about escalating pain management according to pain severity and differentiating between opioid tolerance and addiction. Parents were active in the management of pain for children, especially the provision of nonpharmacological interventions. Collaboration with external pain services and the impact of caring for children in protective isolation delayed timely management of pain.ConclusionsThere is a pressing need to create evidence‐based supportive care guidelines for managing pain post transplantation to optimize children's relief from pain. If parents and children are to be involved in managing pain, greater efforts must be directed toward building their capacity to make informed decisions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The management of pain during pediatric hematopoietic stem cell transplantation: A qualitative study of contextual factors that influenced pain management practices

Plummer,

McCarthy,

Newall

et al. 2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…Given that PRO disclosure-and particularly disagreement in perspectives-may be surprising for family members, sensitivity to family dynamics and psychosocial preferences are crucial in accompanying families through realization of such disagreement. 16 Pediatric oncology patients may downplay their symptom burden to protect their loved ones or out of a self-protective desire to not acknowledge the extent of their own illness. 17 The interprofessional psychosocial team, including but not limited to social work, child life, psychology, nursing, and chaplaincy, has extensive knowledge about particular families' dynamics, ecosystem, and communication styles and preferences that is crucial in supporting the care team and family in these discussions.…”

Section: Preview Family's Emotional and Communication Ecosystem Prior Tomentioning

confidence: 99%

How we approach sharing child–caregiver PRO disagreement

Porter,

Hinds,

Wiener

et al. 2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Researchers use patient‐reported outcomes (PRO) to capture the patient experience, and in pediatrics, parent report of symptom and function often accompanies the child's assessment. Children with cancer and their family caregivers frequently evaluate symptom burden and functional status differently. Child–caregiver PRO disagreement often worries pediatric oncology clinicians, who do not know how to best approach sharing it with families. Openly discussing differences in symptom and functional status reporting is a crucial element of supporting families and can improve family harmony throughout the child's illness journey. This paper offers strategies and language for communicating with families about PRO disagreement.

show abstract

“…Some patients experience frequent and severe symptoms while others experience fewer and more tolerable symptoms. Yet, research that provides possible explanations for differences in symptom experiences is scant (Jibb et al, 2022) and has focused primarily on patient demographic or clinical variables. Investigation of the associations between symptoms and a child's cancer diagnosis, demographics, including biological sex, or proximity to treatment have yielded mixed results.…”

Section: Introductionmentioning

confidence: 99%

“…Pediatric oncology researchers have infrequently studied potential biological mechanisms underlying cancer symptoms (Jibb et al, 2022; Mandrell & Withycombe, 2019), despite theoretical support and evidence from adult oncology. The Children's Oncology Group Nursing Discipline identified several biomarkers, including oxidative stress, cytokines, melatonin, and cortisol, for inclusion in pediatric oncology symptom research because of their potential to aid in identifying children at risk for symptom suffering and diminished quality of life (Mandrell & Withycombe, 2019).…”

Section: Introductionmentioning

confidence: 99%

Exploring Inflammation and Stress as Biological Correlates of Symptoms in Children With Advanced Cancer: A Longitudinal Feasibility Study

Montgomery,

Basha,

Nyholm

et al. 2024

Journal of Pediatric Hematology/Oncology Nursing

View full text Add to dashboard Cite

Background: Few studies have examined biomarkers of stress and inflammation as underlying mechanisms of symptoms in adolescents and young adults with cancer. This study determined the feasibility of collecting blood and saliva samples across time, described the range and distribution of biomarkers, and explored the association of biomarkers with symptom adverse events (AEs). Method: This longitudinal, prospective repeated-measures single-site feasibility study recruited N = 10 children ( M = 12.5 years) receiving treatment for advanced cancer. Symptom AE data and inflammation (cytokines and C-reactive protein) and physiologic response to stress (salivary cortisol and salivary alpha-amylase) biomarker levels were collected at three time points. Descriptive statistics were used to examine feasibility and acceptability and to summarize symptom AE, stress, and inflammatory biomarker data. A linear regression model was used to determine cortisol diurnal slopes. The relationship between symptom and inflammatory biomarker data was explored and Hedges’s g statistic was used to determine its effect size. Results: Participants provided 83% of saliva samples ( n = 199/240) and 185 samples were sufficient to be analyzed. Nurses collected 97% ( n = 29/30) of blood samples. Participants reported the saliva collection instructions, kits, and reminders were clear and helpful. Insomnia, pain, fatigue, and anxiety demonstrated the most medium and large negative effects with inflammatory markers. Symptom AEs demonstrated the highest number of medium and large negative effects with interleukin-8 and tumor necrosis factor-alpha (−0.53 to −2.00). Discussion: The results indicate longitudinal concurrent collection of symptom and biomarker data is feasible and inflammatory and stress biomarkers merit consideration for inclusion in future studies.

show abstract

The Symptom Experience in Pediatric Cancer: Current Conceptualizations and Future Directions

Cited by 9 publications

References 96 publications

The management of pain during pediatric hematopoietic stem cell transplantation: A qualitative study of contextual factors that influenced pain management practices

The management of pain during pediatric hematopoietic stem cell transplantation: A qualitative study of contextual factors that influenced pain management practices

How we approach sharing child–caregiver PRO disagreement

Exploring Inflammation and Stress as Biological Correlates of Symptoms in Children With Advanced Cancer: A Longitudinal Feasibility Study

Contact Info

Product

Resources

About