64
comprehensiveness. This evaluation by experts, as well as support from the theoretical framework and
review of literature underlying the study, supported the content validity of the instruments developed for 9- to 18-year-old children and adolescents with cancer and their parents. Data describing the informational needs of child and adolescent cancer patients and their parents were collected either during the patients’ scheduled clinic visits or during pre-arranged home visits.
Analysis ’
Results of the study indicated that both children and adolescents with cancer and their parents information in relation to disease concerns. Major informational needs expressed by the children and adolescents included those related to disease and social concerns. For parents, the majority of informational needs expressed also related to disease concerns. In relation to the importance of information needed, most children and adolescents identified informational needs related to personal (bodily) concerns as most important, whereas most parents identified informational needs related to disease concerns (prognosis) as most important.
sought
°
Discussion
. .
Because this study consisted of a small convenience sample of children and adolescents with and their parents, there.can be minimal generalization. Since the purpose of this study was to identify and describe the informational needs of children and adolescents with cancer and their parents by using semistructured interviews, the results do provide a beginning framework for further exploration by other researchers. cancer
-
Adaptation
to Illness in Adolescents
With Cancer Pamela Hinds, RN, PhD Susan Scholes, RN, BSN, Jami Gattuso, RN, MSN, Melinda Riggins, RN, BSN, and Brenda Heffner, RN, BSN Adaptation to illness is theorized to be a process through which individuals constructively cope with threatening conditions in order to meet their health needs. For adolescents with cancer, adaptation to illness is believed to be a continuous process through which adolescents attempt to deal in a positive way with the demands of the disease and its treatment. Remarkably little is known about the adolescents’ process of adaptation, including its exact form, sequence, and temporal_ nature. The purpose of this study was to describe major components and characteristics of the adaptational _ process as it was experienced by adolescents during their first 6 months of chemotherapy. The conceptual framework for this study was derived from the works of Lazarus and Folkman’ and Murray and Zentner. 2 The process of adaptation to illness in adolescents with cancer was delineated into three major components: physiological adaptation, social adaptation, and’adaptation in morale. The setting for the study was a pediatric comprehensive cancer center that includes a 48-bed inpatient setting and an ambulatory care setting. The study design was a descriptive-correlational, new or
From St. Jude Children’s Research
Hospital, Memphis. TN.
© 1990
by
Association of Pediatric
Oncology Nurses.
Downloaded from jpo.sagepub.com at NORTH CAROLINA STATE UNIV on May 16, 2015
65
longitudinal design, with four data collection points: 2 weeks, 4 weeks, 3 months, and 6 months after beginning chemotherapy. The data collection points corresponded with theoretical adaptation points. Physiological adaptation was indexed by selected indicators of hematologic status. Social adaptation was indexed by a 13-item Likert scale that measured intrapersonal and interpersonal activities. Adaptation in morale was indexed by the Piers-Harris Self-Concept Scale, the Symptom Distress Scale, the Hopefulness Scale for Adolescents, three open-ended interview questions, and a symptom ranking ’
exercise. The study sample consisted of 15 adolescents (eight males and seven females) who ranged in age from 9 years 8 months to 20 years 2 months (mean, 14 years 7 months). A variety of diagnoses were represented in the sample with the more common being acute lymphocytic leukemia and acute myelocytic leukemia. Other diagnoses included non-Hodgkin’s lymphoma, Ewing’s sarcoma, and osteosarcoma.
Descriptive study findings indicate that the majority of adaptation indicators were lowest at 4 weeks highest at 6 months after starting chemotherapy. Self-concept was the only indicator that did not vary over time. The most significant change (using a sign rank test) in indicators occurred between the final two data collection points with the direction of change being positive. Relationships among the indicators as assessed by Spearman’s correlation coefficient were statistically significant at the first two data collection points but not at the final two points. Interview data indicate that adolescents were not able to identify adaptation strategies until the final two data collection points. Stability and internal consistency measures were used to assess reliability. Construct validity was estimated through testing of theoretical relationships between study indicators. Findings indicate that adolescents do experience a process of adaptation during the first 6 months of treatment for cancer, with the least signs of adaptation visible during the first month of treatment and the most signs visible during the sixth month of treatment. Findings also indicate that adolescents’ physiological adaptation is not consistently correlated with their social or morale adaptation. Findings can be used to assess adolescents’ adaptational efforts and to sensitize caregivers to the existence of and
&dquo;
’
this process.
-
~
..
-
References 1. Lazarus
2.
R, Folkman S: Stress, appraisal, and coping. New York, NY, Springer, 1984 J (eds): Nursing Concepts for Health Promotion (ed 3). Englewood Cliffs, NJ, Prentice-Hall,
Murray R, Zentner
1985
Nurses: Workhorses or Wonderworkers? Anne E. Belcher,
RN, PhD
Pediatric oncology nurses often respond to changes in health care in general, and in cancer care in particular, with the attitudes and behaviors of workhorses; however, there are strategies that can be used to enhance their image as wonderworkers. Specific changes in health care delivery that are impacting pediatric oncology nursing include: shortened length of stay, variable accessibility to health From the School of Nursing, Pediatric Oncology Nurses.
University of Maryland, Baltimore, MD. ©
1990
by
Association of
Downloaded from jpo.sagepub.com at NORTH CAROLINA STATE UNIV on May 16, 2015
comprehensiveness. This evaluation by experts, as well as support from the theoretical framework and
review of literature underlying the study, supported the content validity of the instruments developed for 9- to 18-year-old children and adolescents with cancer and their parents. Data describing the informational needs of child and adolescent cancer patients and their parents were collected either during the patients’ scheduled clinic visits or during pre-arranged home visits.
Analysis ’
Results of the study indicated that both children and adolescents with cancer and their parents information in relation to disease concerns. Major informational needs expressed by the children and adolescents included those related to disease and social concerns. For parents, the majority of informational needs expressed also related to disease concerns. In relation to the importance of information needed, most children and adolescents identified informational needs related to personal (bodily) concerns as most important, whereas most parents identified informational needs related to disease concerns (prognosis) as most important.
sought
°
Discussion
. .
Because this study consisted of a small convenience sample of children and adolescents with and their parents, there.can be minimal generalization. Since the purpose of this study was to identify and describe the informational needs of children and adolescents with cancer and their parents by using semistructured interviews, the results do provide a beginning framework for further exploration by other researchers. cancer
-
Adaptation
to Illness in Adolescents
With Cancer Pamela Hinds, RN, PhD Susan Scholes, RN, BSN, Jami Gattuso, RN, MSN, Melinda Riggins, RN, BSN, and Brenda Heffner, RN, BSN Adaptation to illness is theorized to be a process through which individuals constructively cope with threatening conditions in order to meet their health needs. For adolescents with cancer, adaptation to illness is believed to be a continuous process through which adolescents attempt to deal in a positive way with the demands of the disease and its treatment. Remarkably little is known about the adolescents’ process of adaptation, including its exact form, sequence, and temporal_ nature. The purpose of this study was to describe major components and characteristics of the adaptational _ process as it was experienced by adolescents during their first 6 months of chemotherapy. The conceptual framework for this study was derived from the works of Lazarus and Folkman’ and Murray and Zentner. 2 The process of adaptation to illness in adolescents with cancer was delineated into three major components: physiological adaptation, social adaptation, and’adaptation in morale. The setting for the study was a pediatric comprehensive cancer center that includes a 48-bed inpatient setting and an ambulatory care setting. The study design was a descriptive-correlational, new or
From St. Jude Children’s Research
Hospital, Memphis. TN.
© 1990
by
Association of Pediatric
Oncology Nurses.
Downloaded from jpo.sagepub.com at NORTH CAROLINA STATE UNIV on May 16, 2015
65
longitudinal design, with four data collection points: 2 weeks, 4 weeks, 3 months, and 6 months after beginning chemotherapy. The data collection points corresponded with theoretical adaptation points. Physiological adaptation was indexed by selected indicators of hematologic status. Social adaptation was indexed by a 13-item Likert scale that measured intrapersonal and interpersonal activities. Adaptation in morale was indexed by the Piers-Harris Self-Concept Scale, the Symptom Distress Scale, the Hopefulness Scale for Adolescents, three open-ended interview questions, and a symptom ranking ’
exercise. The study sample consisted of 15 adolescents (eight males and seven females) who ranged in age from 9 years 8 months to 20 years 2 months (mean, 14 years 7 months). A variety of diagnoses were represented in the sample with the more common being acute lymphocytic leukemia and acute myelocytic leukemia. Other diagnoses included non-Hodgkin’s lymphoma, Ewing’s sarcoma, and osteosarcoma.
Descriptive study findings indicate that the majority of adaptation indicators were lowest at 4 weeks highest at 6 months after starting chemotherapy. Self-concept was the only indicator that did not vary over time. The most significant change (using a sign rank test) in indicators occurred between the final two data collection points with the direction of change being positive. Relationships among the indicators as assessed by Spearman’s correlation coefficient were statistically significant at the first two data collection points but not at the final two points. Interview data indicate that adolescents were not able to identify adaptation strategies until the final two data collection points. Stability and internal consistency measures were used to assess reliability. Construct validity was estimated through testing of theoretical relationships between study indicators. Findings indicate that adolescents do experience a process of adaptation during the first 6 months of treatment for cancer, with the least signs of adaptation visible during the first month of treatment and the most signs visible during the sixth month of treatment. Findings also indicate that adolescents’ physiological adaptation is not consistently correlated with their social or morale adaptation. Findings can be used to assess adolescents’ adaptational efforts and to sensitize caregivers to the existence of and
&dquo;
’
this process.
-
~
..
-
References 1. Lazarus
2.
R, Folkman S: Stress, appraisal, and coping. New York, NY, Springer, 1984 J (eds): Nursing Concepts for Health Promotion (ed 3). Englewood Cliffs, NJ, Prentice-Hall,
Murray R, Zentner
1985
Nurses: Workhorses or Wonderworkers? Anne E. Belcher,
RN, PhD
Pediatric oncology nurses often respond to changes in health care in general, and in cancer care in particular, with the attitudes and behaviors of workhorses; however, there are strategies that can be used to enhance their image as wonderworkers. Specific changes in health care delivery that are impacting pediatric oncology nursing include: shortened length of stay, variable accessibility to health From the School of Nursing, Pediatric Oncology Nurses.
University of Maryland, Baltimore, MD. ©
1990
by
Association of
Downloaded from jpo.sagepub.com at NORTH CAROLINA STATE UNIV on May 16, 2015
