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Fatigue in children with cancer: Clinical considerations for Nursing
178
Proceedings
of
19th Annual
visits as punishment. They may react with regression in behavior or aggression. Older children may react with anger or passivity. They may withdraw and suffer loneliness and depression. Care givers must have an understanding of developmental stages and a knowledge of appropriate intervention strategies to interact effectively with children at different developmental levels. Unfortunately, although instructed in growth and development principles during school, they often are not taught how to translate the knowledge into effective interventions. This poster presented a tool that can be used by nurses to identify developmental tasks of children at different age levels, possible reactions to the diagnosis and treatment of cancer, and age-appropriate interventions. The tool can also be used to monitor for appropriate attainment of developmental milestones or identify areas of regression and to assess the level of adaptation to the diagnosis and treatment of childhood cancer. The tool will be evaluated by nurses and child life specialists for content, ease of application, and usefulness to practice.
Fatigue in Children With Cancer: Clinical Considerations for Nursing Sarah Bottomley, RN, MN, CPNP, Pediatric Nurse Practitioner, Houston, TX, Christina Teegarden, RN, MSN,
PNP, and Marilyn Hockenberry-Eaton, RN, PhD, PNP, FAAN Childhood cancer treatment is intense and extremely stressful for both the patient and the family. Chemotherapy and irradiation therapy cause numerous side effects for children. Fatigue, a commonly reported side effect experienced by adults with cancer, has been for the most part overlooked in children with cancer. The purpose of this abstract was to discuss fatigue in children with cancer and to provide clinical nursing considerations to help minimize the symptom. No studies were found on fatigue in children with cancer. We recently completed a multi-institutional study
Conference
evaluating the effects of treatment on 75 school-age children with cancer, and fatigue was a common symptom. More than 50% of these children reported being tired, not sleeping well, and not being able to do the things they wanted to do. More than half of the children were not as active as before the illness, and reported playing less. These findings have specific clinical implications for nursing practice. Nurses must be knowledgeable regarding the signs and symptoms of fatigue in children. Common signs of fatigue in children with cancer include the inability to participate in normal play activities, disinterest in food or other events that usually bring pleasure, and falling asleep during normal activities (eg, watching TV). It is important for nurses to understand that fatigue can manifest itself both physically and mentally. Mental fatigue may be exhibited by a poor attention span at school or home, decrease in grades, increased irritability, and clinginess in young children. Reassurance that fatigue is a symptom of cancer treatment is important to discuss with parents and children. Nurses play an important role in teaching interventions that may decrease fatigue. Specific interventions to minimize fatigue in children with cancer include developing schedules to provide rest periods throughout the day, educating parents not to push the child beyond his/her physical limitations, coordinating half-day school attendance or home bound instruction when necessary, and decreasing environmental stimulation to optimize periods of rest and sleep. Relaxation and guided imagery techniques may be taught to help the child rest more easily. Nursing research studies are needed to explore the symptoms of fatigue in children with cancer. Research questions for the future include defining fatigue in children, describing the influence of disease stage on the intensity of fatigue, examining the influence of age on fatigue, and developing ways to measure fatigue in children. The differences in symptoms of fatigue in relation to various treatment modalities should also be examined.
Proceedings
of
19th Annual
visits as punishment. They may react with regression in behavior or aggression. Older children may react with anger or passivity. They may withdraw and suffer loneliness and depression. Care givers must have an understanding of developmental stages and a knowledge of appropriate intervention strategies to interact effectively with children at different developmental levels. Unfortunately, although instructed in growth and development principles during school, they often are not taught how to translate the knowledge into effective interventions. This poster presented a tool that can be used by nurses to identify developmental tasks of children at different age levels, possible reactions to the diagnosis and treatment of cancer, and age-appropriate interventions. The tool can also be used to monitor for appropriate attainment of developmental milestones or identify areas of regression and to assess the level of adaptation to the diagnosis and treatment of childhood cancer. The tool will be evaluated by nurses and child life specialists for content, ease of application, and usefulness to practice.
Fatigue in Children With Cancer: Clinical Considerations for Nursing Sarah Bottomley, RN, MN, CPNP, Pediatric Nurse Practitioner, Houston, TX, Christina Teegarden, RN, MSN,
PNP, and Marilyn Hockenberry-Eaton, RN, PhD, PNP, FAAN Childhood cancer treatment is intense and extremely stressful for both the patient and the family. Chemotherapy and irradiation therapy cause numerous side effects for children. Fatigue, a commonly reported side effect experienced by adults with cancer, has been for the most part overlooked in children with cancer. The purpose of this abstract was to discuss fatigue in children with cancer and to provide clinical nursing considerations to help minimize the symptom. No studies were found on fatigue in children with cancer. We recently completed a multi-institutional study
Conference
evaluating the effects of treatment on 75 school-age children with cancer, and fatigue was a common symptom. More than 50% of these children reported being tired, not sleeping well, and not being able to do the things they wanted to do. More than half of the children were not as active as before the illness, and reported playing less. These findings have specific clinical implications for nursing practice. Nurses must be knowledgeable regarding the signs and symptoms of fatigue in children. Common signs of fatigue in children with cancer include the inability to participate in normal play activities, disinterest in food or other events that usually bring pleasure, and falling asleep during normal activities (eg, watching TV). It is important for nurses to understand that fatigue can manifest itself both physically and mentally. Mental fatigue may be exhibited by a poor attention span at school or home, decrease in grades, increased irritability, and clinginess in young children. Reassurance that fatigue is a symptom of cancer treatment is important to discuss with parents and children. Nurses play an important role in teaching interventions that may decrease fatigue. Specific interventions to minimize fatigue in children with cancer include developing schedules to provide rest periods throughout the day, educating parents not to push the child beyond his/her physical limitations, coordinating half-day school attendance or home bound instruction when necessary, and decreasing environmental stimulation to optimize periods of rest and sleep. Relaxation and guided imagery techniques may be taught to help the child rest more easily. Nursing research studies are needed to explore the symptoms of fatigue in children with cancer. Research questions for the future include defining fatigue in children, describing the influence of disease stage on the intensity of fatigue, examining the influence of age on fatigue, and developing ways to measure fatigue in children. The differences in symptoms of fatigue in relation to various treatment modalities should also be examined.