Withycombe Janice S, Haugen Maureen, Zupanec Sue, Macpherson Catherine F, Landier Wendy
1 Emory University, Atlanta, GA, USA.
2 Children's Healthcare of Atlanta, Atlanta, GA, USA.
J Pediatr Oncol Nurs. 2019 Jul/Aug;36(4):294-299. doi: 10.1177/1043454219854983.
Recognizing and addressing illness-related distress has long been a priority for pediatric oncology nurses and the Children's Oncology Group. Although symptoms are known to be highly prevalent during treatment for childhood cancer, there is currently no guidance for how often symptoms should be assessed, which symptoms should be prioritized for assessment, and how the data should be collected. : The Nursing Discipline, within Children's Oncology Group, hosted a one-day Interprofessional seminar titled "Symptom Assessment During Childhood Cancer Treatment: State of the Science Symposium." Following the symposium, an expert panel was assembled to review all available evidence, including information presented and collected during the symposium. Consensus-building discussions were held to identify common themes and to produce recommendations for clinical practice. Four recommendations emerged including (1) the identification of priority "core" symptoms for assessment; (2) inclusion of the child's voice through self-report, when possible; (3) consistent documentation and communication of symptom assessment results; and (4) implementation of patient/family education related to symptoms. Symptom recognition, through appropriate assessment, is the first step in symptom management. The goal for developing and sharing these recommendations is to promote consistent and comparable clinical practice across institutions in regard to symptom assessment during childhood cancer therapy. Integration of these recommendations will set the stage for future studies related to the frequency of symptoms across disease groups, projection of anticipated symptom trajectories, development of evidence-based teaching tools for common symptoms, and evaluation of patient outcomes with enhanced symptom assessment and management.
长期以来,识别并应对与疾病相关的痛苦一直是儿科肿瘤护士和儿童肿瘤研究组的工作重点。尽管已知症状在儿童癌症治疗期间极为普遍,但目前对于症状评估的频率、应优先评估哪些症状以及应如何收集数据尚无指导意见。儿童肿瘤研究组的护理学科主办了一场为期一天的跨专业研讨会,题为“儿童癌症治疗期间的症状评估:科学现状研讨会”。研讨会之后,组建了一个专家小组来审查所有现有证据,包括研讨会期间展示和收集的信息。开展了建立共识的讨论,以确定共同主题并提出临床实践建议。共形成了四项建议,包括:(1)确定优先评估的“核心”症状;(2)尽可能通过儿童自我报告纳入其意见;(3)对症状评估结果进行一致的记录和沟通;(4)开展与症状相关的患者/家庭教育。通过适当评估来识别症状是症状管理的第一步。制定并分享这些建议的目的是促进各机构在儿童癌症治疗期间的症状评估方面形成一致且可比的临床实践。整合这些建议将为未来有关不同疾病组症状发生频率、预期症状轨迹预测、常见症状循证教学工具开发以及通过强化症状评估和管理对患者结局进行评估的研究奠定基础。