ABSTRACT
High-dose methotrexate (MTX) given in four hospitalizations during interim maintenance for high-risk pediatric B-lineage acute lymphocytic leukemia significantly improves survival but increases resource utilization. Children remain hospitalized for intravenous hydration and blood or urine monitoring until MTX clearance parameters are reached. Improved supportive care, extended infusion center hours, and pediatric home health expertise afford alternatives to prolonged hospital admissions, potentially offering quality, cost-effective approaches that positively impact the delivery of care.
ABSTRACT
Therapy combining dinutuximab with granulocyte macrophage colony stimulating factor, interleukin 2, and isotretinoin has significant side effects; however, these complications are generally predictable and can be managed proactively.
ABSTRACT
PURPOSE: The increased use of oral chemotherapy for the treatment of cancer introduces new challenges for patients and caregivers. Among them are the ability to swallow oral solid dosage forms, the proper administration of the agents and the safe-handling of chemotherapeutic drugs in the home. Since these drugs are hazardous, proper preparation, administration, and disposition introduces a variety of safety issues. The increased toxicity of these drugs coupled with complicated dosing regimens and the occasional need to dilute the drug or measure a liquid dosage form require careful instruction of the patient and/or caregivers. The purpose of this project was to create templates for writing patient instruction brochures. METHODS: A group of clinicians specializing in oncology from several institutions in the United States and Canada met through a series of conference calls. The group included pharmacists with a specialty in pediatric oncology, investigational drug pharmacists, and an oncology nurse practitioner. National guidelines and practices at each institution were used for the creation of templates to be used in developing templates for medication and formulation-specific instruction brochures. RESULTS: The group developed six templates. The templates ranged in scope from instructions on the administration of intact tablets or capsules to directions on opening capsules or crushing tablets and mixing the content with foods or liquids. Thirty-three drug-specific brochures were developed using the templates. CONCLUSION: Templates of patient brochures and drug-specific brochures on the safe handling of chemotherapy in the home can be created using a collaborative, multi-institutional approach.
Subject(s)
Antineoplastic Agents/administration & dosage , Pamphlets , Patient Education as Topic , Self Administration/methods , Adult , Antineoplastic Agents/therapeutic use , Child , Dosage Forms , Humans , Patient SafetyABSTRACT
The purpose of this study is to enable adolescents with cancer to self-evaluate their quality of life (QoL). Data were collected using a newly developed Likertscaled QoL instrument. In addition, each participant could comment on how the variable impacted his or her QoL. Demographic data were self-disclosed to describe the sample population of 75 adolescents (41 males and 34 females). Overall QoL scores ranged from 27 to 48 (mean = 41.27, SD = 4.31) of a possible 48. Quality of life scores were lowest among those who were female and presently receiving therapy. Overall reliability for the instrument is acceptable ( r = .77). These data reveal that adolescents are aware that their QoL is affected by cancer and its treatment. This instrument demonstrates scores that are statistically different (P = .000) between those presently receiving treatment compared with those not receiving treatment. Although not statistically significant, mean scores for females were lower than for males (P = .030), regardless of other variables. Further administration and psychometric testing of the instrument is planned.
Subject(s)
Attitude to Health , Neoplasms/psychology , Psychology, Adolescent , Quality of Life/psychology , Self-Assessment , Surveys and Questionnaires/standards , Activities of Daily Living/psychology , Adaptation, Psychological , Adolescent , Affect , Factor Analysis, Statistical , Female , Health Status , Humans , Male , Neoplasms/therapy , Nursing Assessment , Nursing Evaluation Research , Nursing Methodology Research , Psychometrics , Social BehaviorABSTRACT
The purpose of this qualitative descriptive study was to allow childhood leukemia patients to describe their quality of life (QoL) in their own words. These personal accounts provide an opportunity for health care personnel to understand the impact that leukemia has on these children. A total of 13 children in three focus group interviews participated. They ranged in age from 5 to 9 years and were either off therapy or had completed at least 6 months of treatment. Four semistructured interview questions were used to guide the interviews. Each question related to a domain identified in previous research as having an effect on QoL. Thus, the areas explored in this study were (a) physical well-being and symptoms, (b) psychological well-being, (c) social well-being, and (d) spiritual well-being. Five themes were identified: (a) fatigue, (b) the effect on activities, (c) medication and treatment effects, (d) relationship changes, and (e) hair loss.
