Effectiveness of a Discharge Planning Protocol for Pediatric Patients with Cancer Receiving Chemotherapy, Maharaj Nakorn Chiang Mai Hospital
Keywords:
Discharge planning, Pediatric oncology patient, ChemotherapyAbstract
Discharge planning for pediatric cancer patients is an essential process to reduce treatment-related complications and unplanned hospital admissions. This quasi-experimental research aimed to study the effects of discharge planning protocol on pediatric cancer patients receiving chemotherapy at Maharaj Nakorn Chiang Mai Hospital on chemotherapy-related complication occurrence and unplanned hospital admissions. Forty caregivers and pediatric cancer patients receiving first-time chemotherapy were recruited by purposive sampling, matched by diagnosis and age, and divided into a control group and an experimental group of 20 each. The research instruments included: 1) the discharge planning protocol for pediatric cancer patients undergoing chemotherapy, Maharaj Nakorn Chiang Mai Hospital; quality was evaluated using the AGREE II instrument, and the protocol met the evaluation criteria across all six domains, with scores ranging from 88.89% to 98.03%; 2) a care manual for pediatric cancer patients undergoing chemotherapy; and 3) educational multimedia on the prevention of infection. Data collection instruments included: 1) a personal information questionnaire for caregivers and pediatric cancer patients; 2) a record form for hospital infection, Maharaj Nakorn Chiang Mai Hospital; and 3) the World Health Organization oral mucositis assessment form. Content validity and reliability of all research instruments were approved. Data were analyzed using descriptive statistics and chi-square test.
The findings showed that the experimental group had statistically significantly lower rates of infection, oral mucositis, and unplanned hospital admission than the control group (p < .01).
This study indicates that the discharge planning protocol for pediatric cancer patients receiving chemotherapy effectively reduces the rate of infection, oral mucositis, and unplanned hospital admission. Thus, nurses can utilize or apply this guideline in pediatric oncologic wards to routinely care for pediatric cancer patients receiving chemotherapy.
References
American Cancer Society. (2024). Key statistics for childhood cancers. https://www.cancer.org/cancer/types/cancer-in-children/key-statistics.html
Amjad, M. T., Chidharla, A., & Kasi, A. (2023). Cancer chemotherapy. StatPearls Publishing. https://europepmc.org/article/MED/33232037#free-full-text
Braguês, R., Marvão, M. F., Correia, P., & Silva, R. M. (2024). Oral mucositis management in children under cancer treatment: A systematic review. Cancers, 16(8), 1548. https://www.mdpi.com/2072-6694/16/8/1548
Brouwers, M. C., Kho, M. E., Browman, G. P., Burgers, J. S., Cluzeau, F., Feder, G., Fervers, B., Graham, I. D., Grimshaw, J., Hanna, S. E., Littlejohns, P., Makarski, J., & Zitzelsberger, L. (2010). AGREE II: Advancing guideline development, reporting and evaluation in health care. Canadian Medical Association Journal, 182(18), E839–E842. https://doi.org/10.1503/cmaj.090449
Chumjamras, K., & Singchungchai, P. (2018). The effects of discharge planning program with a family participation on caregiver’s capacity of knowledge in caring for patients with tracheostomy and caregiver’s satisfaction at the eye, ear, nose, throat ward of Songkhla Hospital. The Southern College Network Journal of Nursing and Public Health, 5(1), 124-134. https://shorturl.asia/6Dda9
de Oliveira Silva, S., da Silva Duarte, F. H., de Souza Costa, T. M., de Araújo, N. M., Barros Leal, N. T., Medeiros, K. S., Neves Dantas, R. A., & Dantas, D. V. (2023). Effectiveness of multimedia education for reducing anxiety among caregivers of children and adolescents undergoing chemotherapy: Randomized controlled trial protocol. PLOS ONE, 18(5), e0285250. https://doi.org/10.1371/journal.pone.0285250
Deribe, L., Girma, E., Lindström, N. B., Gidey, A., Teferra, S., & Addissie, A. (2024). Family-centered care for child cancer treatment in Ethiopia-A qualitative descriptive study. Journal of Pediatric Nursing, 78, e389–e397. https://doi.org/10.1016/j.pedn.2024.07.030
Eckford, R. D., Hernandez-Villafuerte, K. V., Hirschberg, L., & Schlander, M. (2020). Pcn307 The social and socioeconomic impact of cancer on patients and their families: A systematic review. Value in Health, 23(Suppl. 1), S78. https://doi.org/10.1016/j.jval.2020.04.1770
Gray, J., Grove, S. K., & Sutherland, S. (2017). Burns and Grove's the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Elsevier.
Hockenberry, M., Haugen, M., Slaven, A., Skeens, M., Patton, L., Montgomery, K., Trimble, K., Coyne, K., Hancock, D., Ahmad, A., Daut, E., Glover, L., Brown, L., St Pierre, S., Shay, A., Maloney, J., Burke, M., Hatch, D., & Arthur, M. (2021). Pediatric education discharge support strategies for newly diagnosed children with cancer. Cancer Nursing, 44(6), E520–E530. https://doi.org/10.1097/NCC.0000000000000947
Introtakun, K., Silaguntsuti, C., Vittaytigonnasak., A., Supawattganaobodee., B., & Parklug, P. (2020). Effect of discharge planning for colorectal cancer patients using METHOD-P on the knowledge of adverse reactions management after receiving chemotherapy. Vajira Nursing Journal, 22(1), 1-14. https://he02.tci-thaijo.org/index.php/vnj/article/view/227474
Landier, W., York, J. M., Wadhwa, A., Adams, K., Henneberg, H. M., Madan-Swain, A., Benton, B., Slater, V., Zupanec, S., Miller, J., Tomlinson, K., Richman, J. S., & Bhatia, S. (2023). A structured discharge education intervention for parents of newly diagnosed pediatric oncology patients. Journal of Pediatric Hematology/ Oncology Nursing, 40(3), 145-157. https://doi.org/10.1177/27527530221140058
Leung, C., Andersen, C. R., Wilson, K., Nortje, N., George, M., Flowers, C., Bruera, E., & Hui, D. (2023). The impact of a multidisciplinary goals-of-care program on unplanned readmission rates at a comprehensive cancer center. Supportive Care in Cancer, 32(1), 66. https://doi.org/10.1007/s00520-023-08265-6
Maharaj Nakorn Chiang Mai Hospital. (1992). Nosocomial infection surveillance. Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University.
Mergenthaler, D., Jordan, K., Powers, K., Hunter, M., & Truman, A. (2023). The effectiveness of video discharge instructions for the newly diagnosed pediatric oncology caregiver [Doctor of Nursing Practice, The University of North Carolina at Charlotte]. ProQuest Nursing & Allied Health Database. https://www.proquest.com/openview/e992c0dfdf672db1fcf23066bda3fd79/1?cbl=18750&diss=y&pq-origsite=gscholar
National Cancer Institute. (2022). Hospital-based cancer registry 2022. https://www.nci.go.th/th/cancer_record/download/Hosbased-2022-1.pdf
National Cancer Institute. (2024). Cancer in children and adolescence. https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet
National Health and Medical Research Council. (1999). A guide to the development, implementation and evaluation of clinical practice guidelines. Canberra.
Niyomkar, S. (2020). Basic knowledge and nursing care for children with cancer. Faculty of Nursing, Chiang Mai University.
Offenbacher, R., Citron, C., Lin, J., Hosgood, H. D., Parsons, S. K., Moerdler, S., & Weiser, D. A. (2024). Preventing infection in pediatric patients receiving chemotherapy: A survey of provider recommendations. JCO Oncology Practice, 21(2), 155-161. https://doi.org/10.1200/op.23.00641
Patong, W., Pomrin, R., Sutumkittikun, S., & Somjit, C. (2020). The effectiveness of discharge planning for pediatric patients with pneumonia in Phrae Hospital. Journal of the Phrae Hospital, 28(2), 36-49. https://thaidj.org/index.php/jpph/article/view/10696/9422
Pediatric Nursing Department. (2022) Annual report: 2022, Maharaj Nakorn Chiang Mai Hospital. Faculty of Medicine, Chiang Mai University.
Peters, S., Adler, M., & Rossoff, J. (2023). Outcomes of children discharged prior to absolute neutrophil count recovery after admission for febrile neutropenia. Journal of Pediatric Hematology/Oncology, 45(8), e948–e952. https://doi.org/10.1097/MPH.0000000000002757
Pires, R. A. F., Santos, M. R., & Pinto, C. da A. S. (2018). Preparing the return home of the children with cancer. Digital Suplemento Revista ROL Enfermeria, 41(11-12), 239-245. https://comum.rcaap.pt/bitstream/10400.26/31744/1/2017_239-245.pdf
Rodaree, Y., Sonkongdang, W., Arunritthidecha, A., Rengrad, P., Wongkom, S., & Sathitsamitphong, L. (2022). Development of discharge planning guidelines for pediatric patients with cancer receiving chemotherapy, Maharaj Nakorn Chiang Mai Hospital. Nursing Journal CMU, 49(1), 302-316. https://he02.tci-thaijo.org/index.php/cmunursing/article/view/254638
Roganovic, J. (2025). Late effects of the treatment of childhood cancer. World Journal of Clinical Cases, 13(7), 98000. https://doi.org/10.12998/wjcc.v13.i7.98000
Wolf, K. M. R. (2019). The transition from health to Illness: Best practices for education of parents with children newly diagnosed with cancer [Master’s thesis, University of North Dagota]. https://commons.und.edu/cgi/viewcontent.cgi?article=1232&context=nurs-capstones
World Health Organization. (1979). WHO handbook for reporting results of cancer treatment. https://iris.who.int/bitstream/handle/10665/37200/WHO_OFFSET_48.pdf?sequence=1&isAllowed=y
Yodkolkij, T., Kanogsunthornrat, N., & Thiengthiantham. R. (2018). Clinical practice guideline implementation in colorectal disease patients undergoing abdominal surgery. Thai Journal of Nursing and Midwifery Practice, 5(1), 94–111. https://he02.tci-thaijo.org/index.php/apnj/article/view/131565
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