Effects of Mobile Application for Enhancing Oral Care Self-Efficacy on Preventive Behavior and Occurrence of Oral Mucositis in School-aged Children with Cancer Receiving Chemotherapy
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Abstract
The purpose of this quasi-experimental study was to examine the effects of a mobile application for enhancing oral care self-efficacy on preventive behavior and the occurrence of oral mucositis in school-aged children with cancer receiving chemotherapy. The sample were 52 school-aged children with cancer aged 7 to 12 years. The research instruments consisted of the following: 1) mobile application for enhancing oral care self-efficacy 2) the preventive mucositis skills assessment form 3) demographic data questionnaire 4) the mucositis preventive behavior form and 5) the mucositis assessment form. All instruments were tested for content validity by experts. The preventive mucositis skills assessment form and the mucositis preventive behavior form were tested for reliability using test-retest, yielding the Pearson’s correlation coefficient of .94 and .90 respectively. The mucositis assessment form was tested for inter-rater reliability, yielding a value of 1. Data were analyzed using descriptive statistics, chi-square, t-test, Mann-Whitney U test, Wilcoxon signed ranks test, and Friedman’s test. The results revealed that the mean score of mucositis preventive behaviors in the experimental group after the intervention was significantly higher than that before the intervention (p < .001). The mean score of mucositis preventive behaviors after the intervention in the experimental group was significantly higher than that of the control group (p < .001). The mean rank of mucositis occurrence in the experimental group was significantly lower than that of the control group at day 7, 14, and 21 (p < .001). Thus, nurses should incorporate this mobile application in preventing complication of oral health for coucer children in the future.
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References
Nation Cancer Institute. Information Technology Division. Hospital-based cancer registry annual report 2017. Bangkok: NCI; 2018.
American Cancer Society. Cancer in children [Internet]. Atlanta (GA): American Cancer Society; 2016 [cited 2017 Feb 01]. Available from: https://www.cancer.org/cancer/cancerin-children/how-are-childhood-cancerstreated.html#references.
Cheng KKF, Lee V, Li CH, et al. Impact of oral mucositis on short-term clinical outcomes in pediatric and adolescent patients undergoing chemotherapy. Supportive Care in Cancer. 2013; 21(8): 2145-52. doi: 10.1007/s00520-013-1772-0.
Rodriguez-Caballero A, Robles-Garcia M, Torres-Lagares D, et al. Cancer treatmentinduced oral mucositis: A critical review. Int J Oral Maxillofac Surg. 2012; 41(2): 225-38. doi: 10.1016/j.ijom.2011.10.011.
Sonis ST. Mucositis: The impact, biology and therapeutic opportunities of oral mucositis. Oral Oncol. 2009; 45(12): 1015-20. doi: 10.1016/j.oraloncology.2009.08.006.
Allen G, Richard BD, Sam BD. Oral manifestations of cancer treatment in children: A review of the literature. Clin J Oncol Nurs. 2010; 14(4): 481-90. doi: 10.1188/10.CJON. 481-90.
Cheng KKF, Leung SF, Liang RHS, et al. Severe oral mucositis associated with cancer therapy: Impact on oral functional status and quality of life. Support Care Cancer. 2010; 18(11): 1477-85. doi: 10.1007/s00520-009-0771-7.
Cheng KKF, Lee V, Li CH, et al. Oral mucositis in pediatric and adolescent patients undergoing chemotherapy: The impact of symptoms on quality of life. Supportive Care in Cancer. 2012; 20(10): 2335-42. doi: 10.1007/s00520-011-1343-1.
Ethier MC, Regier DA, Tomlinson D, et al. Perspective toward oral mucositis prevention from parents and health care professionals in pediatric cancer. Support Care Cancer. 2012; 20(8): 1771-77. doi: 10.1007/s00520-011-1274-x.
Cheng KK. Oral mucositis: A phenomenological study of pediatric patients’ and their parents’ perspectives and experiences. Support Care Cancer. 2009; 17(7): 829-37. doi: 10.1007/s00520-009-0618-2.
Bardellini E, Amadori F, Majorana A. Oral hygiene grade and quality of life in children with chemotherapy related oral mucositis: A randomized study on the impact of a fluoride toothpaste with salivary enzymes, essential oils, proteins and colostrum extract versus a fluoride toothpaste without menthol. Int J Dent Hyg. 2016; 14(4): 314-9. doi: 10.1111/idh.12226.
Choi S, Kim H. Sodium bicarbonate solution versus chlorhexidine mouthwash in oral care of acute leukemia patients undergoing induction chemotherapy: A randomized controlled trial. Asian Nurs Res. 2012; 6(2): 60-6. doi: 10.1016/j.anr.2012.05.004.
Ahmed KM. The effect of olive leaf extract in decreasing the expression of two proinflammatory cytokines in patients receiving chemotherapy for cancer. A randomized clinical trial. The Saudi Dental Journal. 2013; 25(4): 141-7. doi: 10.1016/j.sdentj.2013.09.001.
Darwish AM, Salama MA, Basiouny NS, et al. Effect of chlorhexidine in prevention of oral lesions in leukemic children receiving chemotherapy. J Am Sci. 2011; 7(6): 985-96.
Bulut HK, Tüfekci FG. Honey prevents oral mucositis in children undergoing chemotherapy: A quasi-experimental study with a control group. 2016; 29: 132-40. doi: 10.1016/j.ctim.2016.09.018.
Vetcho S. Effect of an oral care program on oral mucositis in school-aged children with cancer receiving chemotherapy [master thesis]. [Songkla]: Print of Songkla University; 2013. 131 p. Thai.
Chiamchiraporn A. The effects of an oral selfcare program on self-care behavior and mucositis of school-age children with cancer receiving chemotherapy [master thesis]. [Bangkok]: Mahidol University; 2009. 172 p.
Thai.
Hashemi A, Bahrololoumi Z, Khaksar Y, et al. Mouth-rinses for the prevention of chemotherapy induced oral mucositis in children: A systematic review. Iran J Ped Hematol Oncol. 2015; 5(2): 106-12.
Mori T, Hasegawa K, Okabe A, et al. Efficacy of mouth rinse in preventing oral mucositis in patients receiving high-dose cytarabine for allogeneic hematopoietic stem cell transplantation. Int J Hematol. 2008; 88(5): 583-7. doi: 10.1007/s12185-008-0181-5.
Lilleby K, Garcia P, Gooley T, et al. A prospective, randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Bone Marrow Transplant. 2006; 37(11): 1031-5. doi: 10.1038/sj.bmt.1705384.
Amadori F, Bardellini E, Conti G, et al. Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: A randomized double-blind controlled study. Lasers Med Sci. 2016; 31(6): 1231-6. doi: 10.1007/s10103-016-1975-y.
Ward E, Smith M, Henderson M, et al. The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients. Eur J Clin Nutr. 2009; 63(1): 134-40. doi: 10.1038/sj.ejcn.1602894.
Alvariño-Martín C, Sarrión-Pérez MG. Prevention and treatment of oral mucositis in patients receiving chemotherapy. J Clin Exp Dent. 2014; 6(1): 74-80. doi: 10.4317/jced.51313.
Gholizadeh N, Mehdipoor M, Sajadi H, et al. Palifermin and chlorhexidine mouthwashes in prevention of chemotherapy-induced mucositis in children with acute lymphocytic leukemia: A randomized controlled trial. Med Sci. 2016; 17(4): 343-7.
Peterson DE, Jones JB, Petit RG. Randomized, placebo-controlled trial of saforis for prevention and treatment of oral mucositis in breast cancer patients receiving anthracyclinebased chemotherapy. Cancer. 2007; 109(2): 322-31. doi: 10.1002/cncr.22384.
El–Housseiny A, Saleh S, El–Masry A, et al. The effectiveness of vitamin E in the treatment of oral mucositis in children receiving chemotherapy. J Clin Pediatr Dent. 2007; 31(3): 167-70. doi: https://doi.org/10.17796/jcpd.31.3.r8371x45m42l10j7.
Nomura M, Kamata M, Kojima H, et al. Irsogladine maleate reduces the incidence of fluorouracil-based chemotherapy-induced oral mucositis. Ann Oncol. 2013; 24(4): 1062-66. doi: 10.1093/annonc/mds584.
Arbabi-kalati F, Arbabi-kalati F, Deghatipour M, et al. Evaluation of the efficacy of zinc sulfate in the prevention of chemotherapyinduced mucositis: A double-blind randomized clinical trial. Arch Iran Med. 2012; 15(7): 413-7.
Clarkson JE, Worthington HV, Furness S, et al. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev. 2010; 2010(8): CD001973. doi: 10.1002/14651858.CD001973.pub4.
Chaveli-López B, Bagán-Sebastián JV. Treatment of oral mucositis due to chemotherapy. J Clin Exp Dent. 2016; 8(2): e201-9. doi: 10.4317/jced.52917.
Harris DJ, Harriman A, Cashavelly BJ, et al. Putting evidence into practice: Evidencebased interventions for the management of oral mucositis. Clin J Oncol Nurs. 2008; 12(1): 141-52. doi: 10.1188/08.CJON.141-152.
Miller MM, Donald DV, Hagemann, TM. Prevention and treatment of oral mucositis in children with cancer. J Pediatr Pharmacol Ther. 2012; 17(4): 340-50. doi: 10.5863/1551-6776-17.4.340.
Eilers J, Million R. Clinical update: Prevention and management of oral mucositis in patients with cancer. Semin Oncol Nurs. 2011; 27(4): 1-16. doi: 10.1016/j.soncn.2011.08.001.
Kim YH, Lee H, Jung MJ, et al. The effects of flash animation facilitated oral self care education on the Incidence of oral mucositis and performance of self-care in pediatric cancer patients undergoing chemotherapy. J Korean Soc Matern Child Health. 2017; 21(2): 130-8. doi: 10.21896/jksmch.2017.21.2.130.
Bender JL, Yue RYK, To MJ, et al. A lot of action, but not in the right direction: Systematic review and content analysis of smartphone applications for the prevention, detection, and management of cancer. J Med Internet Res. 2013; 15(12): e287. doi: 10.2196/jmir.2661.
Oldenmenger WH, Baan MA, Van der Rijt, CC. Development and feasibility of a web application to monitor patients’ cancerrelated pain. Supportive Care in Cancer. 2018; 26(2): 635-42. doi: 10.1007/s00520-017-3877-3.
Weaver A, Young AM, Rowntree J, et al. Application of mobile phone technology for managing chemotherapy-associated sideeffects. Ann Oncol. 2007; 18(11): 1887-92. doi: 10.1093/annonc/mdm354.
Berntsen E, Babic A. Cherry: Mobile application for children with cancer. Stud Health Tech Informat. 2013; 192(1): 1168. doi: 10.3233/978-1-61499-289-9-1168.
Tomlinson D, Hesser T, Maloney AM, et al. Development and initial evaluation of electronic Children’s International Mucositis Evaluation Scale (eChIMES) for children with cancer. Support Care Cancer. 2014; 22(1): 115-9. doi: 10.1007/s00520-013-1953-x.
Bandura A. Self-efficacy. In: VS Ramachaudran, editor. Encyclopedia of human behavior. Vol 4. New York: Academic Press; 1994.
Soper DS. Effect size (Cohen’s d) calculator for a student t-test [Internet]. 2016 [cited 2017 Jan 6]. Available from https://www.danielsoper.com/statcalc/default.aspx.
Lertwongpaopun W. The effects of an oral care program on stomatitis in acute myeloid leukemia patients undergoing chemotherapy [master thesis]. [Bangkok]: Mahidol University; 2003. Thai.
Miller MM, Donald DV, Hagemann TM. Prevention and treatment of oral mucositis in children with cancer. J Pediatr Pharmacol Ther. 2012; 17(4): 340-50. doi: 10.5863/1551-6776-17.4.340.
Figliolia SL, Oliveira DT, Pereira MC, et al. Oral mucositis in acute lymphoblastic leukaemia: analysis of 169 paediatric patients. Oral Dis. 2008; 14(8): 761-6. doi: 10.1111/j.1601-0825.2008.01468.x.
Sonis ST. New thoughts on the initiation of mucositis. J Oral Dis. 2010; 16(7): 597-600. doi: 10.1111/j.1601-0825.2010.01681.x.