Linder Lauri A, Hooke Mary C
1 University of Utah College of Nursing, Salt Lake City, UT, USA.
2 Cancer Transplant Service, Primary Children's Hospital, Salt Lake City, UT, USA.
J Pediatr Oncol Nurs. 2019 Jul/Aug;36(4):262-279. doi: 10.1177/1043454219849578.
Children and adolescents receiving treatment for cancer experience multiple symptoms as a consequence of their disease and its treatment that interfere with the child's quality of life. Understanding of symptom assessment in children with cancer is foundational to the work of the Children's Oncology Group Nursing Discipline, whose research aims are to address knowledge gaps including understanding illness-related distress. This article is the second of a two-part summary of current evidence addressing the assessment of symptoms frequently reported by children and adolescents receiving treatment for cancer. Studies reporting assessment of pain, sadness, and symptom clusters published between January 2008 and May 2018 were included. Forty-three publications addressed pain. Pain was highly prevalent and distressing, varied in its trajectory across a cycle of chemotherapy and across multiple cycles of treatment, and correlated with biomarkers associated with the pain response. Consequences of pain were poorer functional status and emotional health. Twenty publications addressed sadness. Sadness was the most prevalent psychosocial symptom. Its prevalence decreased over the course of treatment and over a cycle of chemotherapy. Persistent sadness was of greater severity and distress. Eight publications addressed symptom clusters. These studies identified both groups of co-occurring symptoms and groups of patients with common symptom profiles. This two-article series provides evidence for the distressing nature of symptoms among children receiving cancer treatment. Efforts to support clinicians in routine symptom assessment are needed. Additional research directed at alleviating symptoms and building resilience among the child experiencing symptoms is needed.
接受癌症治疗的儿童和青少年会因疾病及其治疗而出现多种症状,这些症状会影响孩子的生活质量。了解癌症患儿的症状评估是儿童肿瘤学组护理学科工作的基础,该学科的研究旨在填补知识空白,包括了解与疾病相关的痛苦。本文是关于接受癌症治疗的儿童和青少年经常报告的症状评估的两部分总结的第二篇。纳入了2008年1月至2018年5月间发表的报告疼痛、悲伤和症状群评估的研究。43篇出版物涉及疼痛。疼痛非常普遍且令人痛苦,在化疗周期和多个治疗周期中的轨迹各不相同,并且与与疼痛反应相关的生物标志物相关。疼痛的后果是功能状态和情绪健康较差。20篇出版物涉及悲伤。悲伤是最普遍的社会心理症状。其患病率在治疗过程和化疗周期中有所下降。持续性悲伤的严重程度和痛苦程度更大。8篇出版物涉及症状群。这些研究确定了同时出现的症状组和具有共同症状特征的患者组。这个两篇文章系列为接受癌症治疗的儿童症状的令人痛苦的性质提供了证据。需要努力支持临床医生进行常规症状评估。还需要开展更多研究,以减轻症状并增强经历症状的儿童的恢复力。