Skeens Micah A, Cullen Patsy, Stanek Joe, Hockenberry Marilyn
1 Nationwide Children's Hospital, Columbus, OH, USA.
2 Regis University, Denver, CO, USA.
J Pediatr Oncol Nurs. 2019 Jul/Aug;36(4):287-293. doi: 10.1177/1043454219858608.
Management of symptom-related distress is an important area of pediatric oncology nursing. Participants who attended the Children's Oncology Group (COG) State of the Science Symposium on symptom distress completed an anonymous survey. The purpose was to explore participant perceptions of symptom distress experienced by children receiving cancer treatment on clinical trials, determine how symptom distress is currently assessed at COG institutions, and to identify what interventions are used to reduce symptom distress for these children. Among the 90 symposium attendees, 72% completed the survey, the majority (92%) of whom were nurses. The five most distressing symptoms in children with cancer enrolled on clinical trials identified by survey respondents were nausea/vomiting, fatigue, pain, anxiety, and sleep disturbances. Results from our survey also suggest that symptom distress may differ by disease type. For example, symptoms associated with leukemia/lymphoma included steroid side effects, procedural pain, and neuropathy. The majority of respondents (90%) also reported that symptoms go unrecognized by health care providers. The most commonly described unrecognized symptoms were behavioral (i.e., sadness, anxiety, fear, depression, and emotional needs; 45%) and fatigue (19%). Key focus areas reported by respondents included informal and inconsistent symptom assessment, the need for uniform measurement tools, and improved documentation of symptom-related distress. Management of symptom-related distress is an important aspect of pediatric oncology nursing. Further exploration of symptom distress experienced by children with specific types of cancers, and the development of standardized symptom assessment processes, will provide a foundation for developing future interventions aimed at alleviating symptom-related distress.
症状相关困扰的管理是儿科肿瘤护理的一个重要领域。参加儿童肿瘤学组（COG）症状困扰科学现状研讨会的参与者完成了一项匿名调查。目的是探讨参与者对参加临床试验的癌症患儿所经历的症状困扰的看法，确定COG机构目前如何评估症状困扰，并确定使用了哪些干预措施来减轻这些患儿的症状困扰。在90名研讨会参与者中，72%完成了调查，其中大多数（92%）是护士。调查受访者确定的参加临床试验的癌症患儿中最令人困扰的五种症状是恶心/呕吐、疲劳、疼痛、焦虑和睡眠障碍。我们的调查结果还表明，症状困扰可能因疾病类型而异。例如，与白血病/淋巴瘤相关的症状包括类固醇副作用、程序性疼痛和神经病变。大多数受访者（90%）还报告说，症状未被医疗保健提供者识别。最常被描述为未被识别的症状是行为方面的（即悲伤、焦虑、恐惧、抑郁和情感需求；45%）和疲劳（19%）。受访者报告的关键重点领域包括非正式和不一致的症状评估、对统一测量工具的需求以及改善症状相关困扰的记录。症状相关困扰的管理是儿科肿瘤护理的一个重要方面。进一步探索特定类型癌症患儿所经历的症状困扰，以及制定标准化的症状评估流程，将为制定未来旨在减轻症状相关困扰的干预措施奠定基础。
