Effectiveness of Pediatric Palliative Care Education on Pediatric Clinicians.

A lack of knowledge and skills in pediatric palliative care may create hesitation in caring for children with serious life-threatening conditions and their families. Our research examined the effectiveness of pediatric palliative care training for pediatric clinicians. A pretest-posttest study provided educational training in pediatric palliative care to pediatric clinicians and used a pretest and a posttest to assess outcomes. Fifty pediatric clinicians attended this research with 83.3% response rate. After training, participants reported significantly increased confidence in a variety of areas, including providing emotional support to clinicians, personal knowledge, skills, and communication; ethical and legal concerns; and providing emotional support to dying children and their families. Results showed a significant main effect of training on confidence levels ( p < .000). This suggests that education can effectively boost pediatric clinicians' confidence regarding providing pediatric palliative care and therefore should regularly be provided to clinicians.

Infections and association with different intensity of chemotherapy in children with acute myeloid leukemia.

BACKGROUND: The objectives were to compare infections during different intensities of therapy in children with acute myeloid leukemia (AML). METHODS: Subjects were children enrolled in Children's Cancer Group 2891 with AML. In phase 1 (induction), patients were randomized to intensive or standard timing. In phase 2 (consolidation), those with a family donor were allocated allogeneic stem cell transplantation (SCT); the remainder were randomized to autologous SCT or chemotherapy. This report compares infections between different treatments on an intent-to-treat basis. RESULTS: During phase 1, intensive timing was associated with more bacterial (57.7% vs 39.4%; P < .001), fungal (27.4% vs 9.9%; P < .001), and viral (14.0% vs 3.9%; P < .001) infections compared with standard timing. During phase 2, chemotherapy was associated with more bacterial (56.5% vs 40.1%; P = .005), but similar fungal (9.5% vs 6.1%; P = 1.000) and viral (4.2% vs 12.9%; P = .728) infections compared with allogeneic SCT. No differences between chemotherapy and autologous SCT infections were seen. Fatal infections were more common during intensive compared with standard timing induction (5.5% vs 0.9%; P = .004). Infectious deaths were similar between chemotherapy, autologous SCT, and allogeneic SCT. CONCLUSIONS: Prevalence of infection varies depending on the intensity and type of treatment. This information sheds insight into the mechanisms behind susceptibility and outcome of infections in pediatric AML.

Online exclusive: functional integration of nursing research into a pediatric oncology cooperative group: finding common ground.

PURPOSE/OBJECTIVES: To provide a brief description of the historic role of nursing and nursing research in the culture of previous pediatric oncology cooperative groups and compare the research language used in cooperative groups with the language used in nursing research. DATA SOURCES: Published empirical, clinical, and methodologic reports. DATA SYNTHESIS: The culture and language of nursing research differ from those of medical research and the pediatric oncology cooperative group, the Children's Oncology Group (COG). Different approaches exist to integrate nursing research priorities into the priorities of COG, including freestanding protocols, companion protocols, and research objectives included in therapeutic protocols. CONCLUSIONS: Full integration of nursing research into COG is feasible but dependent on recognition of cultural and language differences among researchers. Integration will be demonstrated by the number of concepts and protocols contributed to or developed by active nurses in COG. IMPLICATIONS FOR NURSING: Significant advances exist for nurses conducting research in COG. These research efforts are facilitated by a familiarity with the science language used by other disciplines in COG and an understanding of COG's research processes. Increased interdisciplinary scientific collaborations involving nurses in COG particularly benefit pediatric patients with cancer.