Predicting Factors of Uncertainty in Illness Among Children with Leukemia Undergoing Chemotherapy
Keywords:
Chemotherapy, Children, Illness uncertainty, Information support, Leukemia, Predicting factors, ThailandAbstract
Leukemia in children is a life-threatening disease and chemotherapy is a complex treatment with severe side effects and complications. Furthermore, the treatment results are unpredictable. This leads to uncertainty in illness resulting in psychological distress. This descriptive cross sectional study aims to examine the predicting factors of uncertainty in illness among children with leukemia undergoing chemotherapy. Ninety-six children with leukemia undergoing chemotherapy in four tertiary hospitals in Bangkok participated in this study. The research instruments included the Children’s Uncertainty in Illness Scale, the Symptom Pattern Scale of Children with Cancer, the Information Support from Health Care Provider Scale, the Information Support from Parent Scale, the Information Support from Peer Scale, the Illness Knowledge Scale, and the Parent Perception of Uncertainty Scale. The results of stepwise multiple regression analysis revealed that symptom pattern, information support from health care providers, illness-related knowledge, and parental uncertainty accounted for 34.8% of variance in uncertainty in illness among the participants. This study provides more understanding for predicting factors of child uncertainty. The results of this study can be used for developing a nursing intervention to reduce uncertainty in illness among children with leukemia undergoing chemotherapy if nurses help them to better understand symptoms as having a pattern, provide information support and illness related knowledge, and decrease parental uncertainty.
References
2. World Health Organization [WHO]. Incidence of childhood leukemia fact sheet 4.1. [update 2014 Oct 12; cited 2014 Nov 21]; Available from: http://www.euro.who.int/__data/ assets/pdf_file/ 0005/97016/4.1.-Incidence-of-childhoodleukaemia-EDITED_layouted.pdf
3. National Cancer Institute, SEER Cancer Statistics Review 1975-2011, Childhood cancer by site incidence, survival and mortality; 2011 [update 2014 Oct 12; cited 2014 Nov 21]; Available from; http://seer.cancer.gov/csr/1975_2011/
4. Wiangnon S, Veerakul G, Nuchprayoon I, Seksarn P, Hongeng S, Krutvecho T, et al. Childhood cancer incidence and survival 2003-2005, Thailand: study from the Thai Pediatric Oncology Group. Asian Pac J Cancer Prev APJCP 2011;12(9): 2215-20.
5. Ministry of Public Health and Ministry of Education. Cancer in Thailand, Volume VII 2007-2009. Bangkok; 2013.
6. Firoozi M, Rahmat AG. Behavioral disturbances in children with acute lymphoblastic leukemia. Life Sci J 2013;10(1): 2897-902.
7. Abu-Saad Huijer H, Sagherian K, Tamim H. Quality of life and symptom prevalence as reported by children with cancer in Lebanon. Eur J Oncol Nurs 2013;17: 704-10.
8. Fortier MA, Batista ML, Wahi A, Kain A, Strom S, Sender LS. Illness uncertainty and quality of life in children with cancer. J Pediatr Hematol Oncol 2013; 35(5): 366-70.
9. Silapavitayatorn B, Kantawang S, Leuviiryakit N. Uncertainty in illness and coping strategies among children with cancer. Nurs J 2009;36(1):78-87.
10. Tathong B, Kantawang S, Sripusanapan A. Factors influencing uncertainty in illness among children with cancer receiving chemotherapy. Nurs J 2012; 39(1): 77-90.
11. Lee YL, Gau BS, Hsu WM, Chang HH. A model linking uncertainty, post-traumatic stress, and health behaviors in childhood cancer survivors. Oncol Nurs Forum 2009; 36(1): E20-E30.
12. Stewart JL, Mishel MH, Lynn MR, Terhorst L. Test of a conceptual model of uncertainty in children and adolescents with cancer. Res Nurs Health 2010;33(3):179-91.
13. Mishel MH. Uncertainty in Illness. Image J Nurs Sch 1988;20(4):225-32.
14. Potts NL, Mandleco BL. Pediatric nursing caring for children and their families (3rd ed.). New York: Delmar cengage learning; 2012.
15. Mishel MH, Clayton MF. Theories of uncertainty in illness. In Smith MJ, Liehr PR, editor. Middle range theory for nursing. New York: Springer Publishing; 2014. p. 53-86.
16. Kantawang S, Tathong B. Predicting factors of uncertainty in illness among children with cancer receiving chemotherapy. International Nursing Conference on Health, Healing & Harmony: Nursing Values, Phuket, Thailand; 2013, May 1-3.
17. Schapira L. Handing uncertainty. Support Care Cancer 2014; 22:859-61.
18. Gibson F, Aldiss S, Horstman M, Kumpunen S, Richardson A. Children and young people’s experiences of cancer care: a qualitative research study using participatory methods. Int J Nurs Stud 2010 Nov; 47(11): 1397-407. doi: 10.1016/j.ijnurstu.2010.03.019. Epub 2010 Apr 28.
19. Miller LE. Sources of uncertainty in cancer survivorship. J Cancer Surviv 2012; 6: 431-40. doi: 10.1007/s11764012-0229-7
20. House J S, Work stress and social support, Reading MA: Addison-Wesley; 1981.
21. Naruemandecha B. Knowledge regarding illness, social support, and illness uncertainty among adolescents with systemic lupus erythematosus. [Master thesis]. Chiang Mai, Thailand: Chiang Mai Univ.;2008. 85 p. [in Thai].
22. Page MC, Fedele DA, Pai ALH, Anderson J, WolfeChristensen C, Ryan JL, et al. The relationship of maternal and child illness uncertainty to child depressive symptomotology: a mediational model. J Pediatr Psychol 2011;19:1-9.
23. Cohen J. Statistical power analysis for the behavioral sciences. New Jersey, Lawrence Erlbaum Associates; 1988.
24. Mullins LL, Hartman VL. Children’s uncertainty in illness scale. Unpublished manuscript, Norman, Univ of Oklahoma Health Science Center; 1995.
25. Kantawang S. Children’s uncertainty in illness scale. Unpublished instrument, Chiang Mai, Thailand: Chiang Mai Univ; 2007. [in Thai].
26. Suwanna-o-sod S. Uncertainty, social support, and coping strategies among parents of children with cancer. [master’s thesis]. Chiang Mai, Thailand: Chiang Mai Univ; 2004. 102 p. [in Thai].
27. Trevino KM, Fasciano K, Prigerson HG. Patient-Oncologist alliance, psychosocial well-being, and treatment adherence among young adults with advanced cancer. J Clin Oncol 2013 May; 31(13): 1683-9. doi: 10.1200/JCO. 2012.46.7993. Epub 2013 Mar 25.
28. Pui CH, Mullighan CG, Evans WE, Relling MV. Pediatric acute lymphoblastic leukemia: where are we going and how do we get there?. Blood 2012; 120: 1165-74.
29. Decker CL, Haase JE, Bell CJ. Uncertainty in adolescents and young adults with cancer. Oncol Nurs Forum 2007; 31(3): 681-88.
30. Lin L, Yeh CH, Mishel MH. Evaluation of a conceptual model based on Mishel’s theories ofuncertainty in illness in a sample of Taiwanese parents of children withcancer: A cross-sectional questionnaire survey. Int J Nurs Stud 2010; 47: 1510-24.
31. Okado Y, Long AM, Phipps S. Association between parent and child distress and the moderating effects of life events in families with and without a history of pediatric cancer. J Pediatr Psychol 2014;39(9):1049-60.
32. Hinds PS, Kelly KP. Helping parents make and survive end of life decisions for their seriously ill child. Nurs Clin of North Ame 2010;45:465-74.
33. Kelly P, Daniel Kelly D. Childhood cancer-parenting work for British Bangladeshi families during treatment: An ethnographic study. Int J Nurs Stud 2013; 50: 933-44.
34. Cicogna EC, Nascimento LC, de Lima RAG. Children and Adolescents with Cancer: Experiences with Chemotherapy. Latino-Am. Enfermagem 2010 Sep-Oct; 18(5): 864-72.
35. Michell W, Clarke S, Sloper P. Care and support needs of children and young people with cancer and their parents. Psycho-Oncology 2006;15: 805-816.
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