Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the agrressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Shere's Self-Efficacy Scale (17 item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist(34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation coefficient. Results of this study are summerized as follows 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as lack of clarity (2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured iron 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be Influenced signiicantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high (Mn 2.78). The degree of coping related to be influnced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001) From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.
Byun, Byung Hyun;Lee, Guk Haeng;Kim, Dong Ho;Lim, Jung Sub;Lim, Ilhan;Lim, Sang Moo;Lee, Byeong Cheol;Lee, Jun Ah
Korean Journal of Head & Neck Oncology
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v.36
no.2
/
pp.9-15
/
2020
Background/Objectives: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) in children and adolescents. Materials & Methods: Medical records of 31 DTC cases that were diagnosed and treated at Korea Cancer Center Hospital between 2002 and 2018 were retrospectively reviewed. Results: Most cases were papillary carcinoma (n=26), with female predominance (n=25). Median age was 16.4 years (range, 11.9-18.6 years). Extrathyroidal extension was present in 24 cases. Twenty cases had tumor involvement at cervical lymph nodes and three had lung metastasis. Twenty-two patients received radioactive iodide treatment with a median cumulative dose of 300 mCi (range, 100-920 mCi). During a median follow-up of 68.2 months (range, 2.3-191.4 months), serum thyroglobulin level was elevated in 15 patients. Among them, two cases had remnant thyroid tissue, 4 had recurrence at cervical lymph nodes, and the remaining 9 did not have any detectable lesion. All were alive, and 5-year event-free survival (EFS) was 45.2±10.1%. Age £15 years, tumor size, lymph node status (N1b), and distant metastasis had negative effects on EFS. On multivariate analysis, age and tumor size had prognostic significance. Conclusion: For DTC of children and adolescents (£18 years old), age ≤15 years and tumor size were prognostic factor. Therefore, patients in this age group need meticulous follow-up. Further studies are necessary to answer the potential influence of age on the incidence and behavior of DTC.
The main purpose of this methodological study was to develop an assessment tool and intervention protocol for child and family with childhood cancer at early diagnosis stage. The assessment tool and intervention protocol was developed by extensive literature review and consultation with experts. Review of nine domestic and sixty-six international journal articles were done to identify stress, interventions, coping strategies and adjustment of children with cancer and their family. Results were as follows; First, assessment at the early diagnosis stage need to include information on patient, family, and patient/family attitude toward diagnosis and treatment. Second, intervention protocol for children with cancer includes control physical symptoms, manage the side effects of chemotherapy and diagnostic or therapeutic procedures, control emotional responses, provide support and information, assist decision-making and adjust to environment. Third, intervention protocol for family includes controlling emotional responses, provision of informations, inducing family support to patient, improving family cohesion, supporting siblings and supporting spiritual growth. In conclusion, the early diagnosis stage in cancer treatment is important for child and family since this stage greatly affects the overall adjustment of child and family to live with cancer. Therefore, pediatric nurses need to be sensitive to the need of patient/family and systematically manage their needs at this stage.
Bone pain in a child could be associated with cancer as an initial manifestation of the disease. The childhood malignancies that frequently present bone pain are leukemia, neuroblastoma, and primary bone tumors such as osteosarcoma and Ewing sarcoma. Persistent bone or joint pain associated with swelling, mass, or limitation of motion implies underlying serious causes. Systemic manifestations such as lymphadenopathy, hepatosplenomegaly, fever, fatigue, night sweat, and laboratory abnormalities are also suggestive of malignancy. The index of suspicion tends to be low since less than 1% of children who complain of bone pain are diagnosed as cancer. Nonetheless, pediatricians should be alert to the possibilities of cancer since early detection and prompt treatment might reduce mortality.
Kim, Dong Hwan;Song, Bong Sup;Lee, Jun Ah;Kim, Dong Ho
Pediatric Infection and Vaccine
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v.19
no.1
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pp.1-11
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2012
Purpose : Although influenza is regarded as one of the major causes of morbidity and mortality in children with cancer, the actual vaccine coverage remains poor. We conducted evaluation of immunogenicity and safety of influenza vaccine in children with cancer. Methods : In this study, 25 children with cancer who received influenza vaccine (SK influenza IX vaccine$^{(R)}$) at the Korea Cancer Center Hospital between October and December 2009 were analyzed. Blood samples of patients were collected twice (at the beginning of this study and at 30th day after vaccination) and their antibody titers were measured using the hemagglutination-inhibition (HI) assay. Immunogenicity of the influenza vaccine was assessed by seroprotection rate on days 0 and 30, seroconversion rate on day 30, and mean fold increase (MFI) of geometric mean titer (GMT) of HI between days 0 and 30. Results : Any of the subjects in our study did not experienced serious adverse events after influenza vaccination. Seroprotection rates were 68% for H1N1, 40% for H3N2, and 36% for B. Seroconversion rates were 12% for H1N1, 16% for H3N2, and 20% for B. MFIs were 0.9 for H1N1, 1.2 for H3N2, and 1.8 for B. Conclusion : In the study, we found a limited protective immune response to influenza vaccine, among subjects with cancer. However, some subjects showed seroconversion, and there were no severe adverse events among all subjects, supporting the recommendation of annual influenza vaccination in children with cancer.
Kyung Taek Hong;Yeon Jun Kang;Jung Yoon Choi;Young Ju Yun;Il-Moo Chang;Hee Young Shin;Hyoung Jin Kang;Won-Woo Lee
Journal of Ginseng Research
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v.48
no.1
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pp.68-76
/
2024
Background: Although the survival outcomes of childhood cancer patients have improved, childhood cancer survivors suffer from various degrees of immune dysfunction or delayed immune reconstitution. This study aimed to investigate the effect of Korean Red Ginseng (KRG) on T cell recovery in childhood cancer patients who underwent autologous hematopoietic stem cell transplantation (ASCT) from the perspective of inflammatory and senescent phenotypes. Methods: This was a single-arm exploratory trial. The KRG group (n = 15) received KRG powder from month 1 to month 12 post-ASCT. We compared the results of the KRG group with those of the control group (n = 23). The proportions of T cell populations, senescent phenotypes, and cytokine production profiles were analyzed at 1, 3, 6, and 12 months post-ASCT using peripheral blood samples. Results: All patients in the KRG group completed the treatment without any safety issues and showed a comparable T cell repopulation pattern to that in the control group. In particular, KRG administration influenced the repopulation of CD4+ T cells via T cell expansion and differentiation into effector memory cell re-expressing CD45RA (EMRA) cells. Although the KRG group showed an increase in the number of CD4+ EMRA cells, the expression of senescent and exhausted markers in these cells decreased, and the capacity for senescence-related cytokine production in the senescent CD28- subset was ameliorated. Conclusions: These findings suggest that KRG promotes the repopulation of CD4+ EMRA T cells and regulates phenotypical and functional senescent changes after ASCT in pediatric patients with cancer.
Objective: This descriptive, cross sectional study was conducted to examine the effect of levels of self-efficacy on children's perceptions of pros and cons of smoking. Methodology: The sample was 233 fifth-grade students. Data were collected in September 2010 using the Socio-Demographic Data Collection Form, Self Efficacy Scale Child Form and Child Decision Balance Scale and analyzed via percentage calculations and t test with the SPSS 11.00 statistical package program. Results: Average age of the students participating in the research was $11.1{\pm}0.41$, 49.8 % (n: 116) being female and 50.2 % (n:117) male. The difference between the score averages of the pros of smoking perceptions of children with a high self-efficacy level and of those with a low self efficacy level (t=2.117, p=.042) and the difference between the score averages of the cons of smoking perceptions of children with a high self-efficacy level and of those with a low self-efficacy level (t=2.206, p=.035) were found to be statistically significant. Conclusions: Children's positive perceptions of smoking were low and negative perceptions high when their self efficacy levels were high. Conversely, children's positive perceptions of smoking were high when their self efficacy levels were low.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.22
no.4
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pp.302-306
/
2011
Objectives : To investigate the cognitive functions of pediatric cancer patients and to test the hypotheses that the impairment of processing speed and working memory are more prevalent in children with medulloblastoma (MBL) compared to children with neuroblastoma (NBL). Methods : We gave the Korean version of the Wechsler Intelligent Scale for Children-III to 21 children with MBL and 24 children with NBL during outpatient follow-up after the treatment was completed. Results : Children with MBL showed below average performance across most of the sub-tests. The full scale IQ, verbal IQ, and performance IQ of children with MBL were significantly lower than those of children with NBL. There were significant differences between two groups in coding and Digit Span subtest scores. Children with MBL performed especially poorly in the coding subtest. Conclusion : These findings support previous reports of generally low IQ and the dysfunction of processing speed and working memory among children with MBL, a kind of central nervous system tumor. Further investigation is needed to determine how the deficit of processing speed and working memory affect neurocognitive development and general intelligent functions.
Growth hormone (GH) treatment has been increasingly widely used for children with GH deficiencies as the survival rate of pediatric patients with malignancies has increased. Both GH and insulin-like growth factor-I have mitogenic and antiapoptotic activity, prompting concern that GH treatment may be associated with tumor development. In this review, the authors examined the relationship between GH treatment and cancer risk in terms of de novo malignancy, recurrence, and secondary neoplasm. Although the results from numerous studies were not entirely consistent, this review of various clinical and epidemiological studies demonstrated that there is no clear evidence of a causal relationship between GH treatment and tumor development. Nonetheless, a small number of studies reported that childhood cancer survivors who receive GH treatment have a small increased risk of developing de novo cancer and secondary malignant neoplasm. Therefore, regular follow-ups and careful examination for development of cancer should be required in children who receive GH treatment. Continued surveillance for an extended period is essential for monitoring long-term safety.
Background: This study was planned in an attempt to develop a scale for the quality of life in pediatric oncology patients aged 7-12, with child and parents forms. Materials and Methods: In collecting the study data, we used the Child and Parent Information Form, Visual Quality of Life Scale, Scale for Quality of Life Pediatric Oncology Patients Aged 7-12 and the Scale for the Quality of Life in Pediatric Oncology Patients Aged 7-12 for Parents. We also used Pearson correlation analysis, the Cronbach alpha coefficient, factor analysis and ROC analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent form was 0.96, the total factor load being 0.54-0.90 and the total variance explained was 82.5%. The cutoff point of the parent form was 93 points. The total Cronbach alpha value for the child form was 0.96, with a total factor load of 0.55-0.91 and the total variance being explained was 78.3%. The cutoff point of the child form was 65 points. Conclusions: This study suggests that the Scale for Quality of Life in Pediatric Oncology Patients Aged 7-12 Child and Parents Forms are valid and reliable instruments in assessing the quality of life of children.
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