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Pediatric Education Discharge Support Strategies for Newly Diagnosed Children With Cancer
Marilyn Hockenberry1, Maureen Haugen, Abigail Slaven
1Author Affiliations: Duke University School of Nursing, Durham, North Carolina (Drs Hockenberry and Hatch and Ms Arthur); Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois (Ms Haugen and Ms Coyne); Cohen Children's Medical Center, New Hyde Park, New York (Ms Slaven); Nationwide Children's Hospital, Columbus, Ohio (Dr Skeens); Children's Health System of Texas Children's Medical Center, Dallas, Texas (Ms Patton); American Family Children's Hospital, University of Wisconsin Health, Madison (Dr Montgomery); Northwestern Medicine Central DuPage Hospital, Chicago, Illinois (Ms Trimble); St Jude Children's Hospital, Memphis, Tennessee (Ms Hancock); King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (Mr Ahmad); St Louis Children's Hospital, Washington University School of Medicine, Missouri (Ms Daut and Ms Glover); Levine Children's Hospital, Charlotte, North Carolina (Ms Brown); The Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine (Ms St Pierre); West Virginia University Medicine, Morgantown (Ms Shay); St Peter's University Hospital, New Brunswick, New Jersey (Ms Maloney); Nicklaus Children's Hospital, Miami, Florida (Ms Burke).
Insights
Standardized discharge education for pediatric cancer patients improves outcomes. Nurse-led Parent Education Discharge Support Strategies (PEDSS) were feasible and effective, with symptom management showing greater parent satisfaction.
Area of Science:
- Pediatric Oncology Nursing
- Clinical Trial Research
- Health Services Research
Background:
- Discharge education for pediatric oncology patients lacks standardization across institutions.
- Inconsistent practices pose challenges for newly diagnosed children and their families.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of two nurse-led Parent Education Discharge Support Strategies (PEDSS).
- To compare symptom management PEDSS with parent support and coping PEDSS in pediatric cancer care.
Main Methods:
- Cluster randomized clinical trial involving 16 Magnet-designated sites.
- 283 newly diagnosed pediatric cancer patients and their parents participated.
- Outcome measures included symptom experiences, care perceptions, service utilization, and intervention evaluation at baseline, 1, and 2 months post-diagnosis.
Main Results:
- The symptom management PEDSS group showed a greater decrease in pain over time.
- Fatigue and sleep disturbances significantly decreased in both groups.
- Older children experienced greater nausea and appetite disturbances; the symptom management group reported higher satisfaction.
Conclusions:
- Evidence supports a standardized discharge education strategy for pediatric cancer patients.
- Nurse-led PEDSS interventions are feasible and can be implemented across healthcare institutions.
Background:
Discharge education practices vary among institutions and lack a standardized approach for newly diagnosed pediatric oncology patients and their parents.
Objective:
The purpose of this American Nurses Credentialing Center-supported pediatric multisite trial was to determine the feasibility and effectiveness of 2 nurse-led Parent Education Discharge Support Strategies (PEDSS) for families with a child who is newly diagnosed with cancer.
Interventions/Methods:
A cluster randomized clinical trial design assigned 16 Magnet-designated sites to a symptom management PEDSS intervention or parent support and coping PEDSS intervention. Outcome measures evaluated at baseline, 1, and 2 months after diagnosis include symptom experiences, parent perceptions of care, unplanned service utilization, and parent evaluation of the PEDSS interventions.
Results:
There were 283 newly diagnosed children and their parent participating in this study. Linear mixed models revealed pain differed over time by the intervention; children in the symptom management group had a greater decrease in pain. Greater nausea and appetite disturbances were experienced by older children in both groups. Fatigue and sleep disturbance showed a significant decrease over time in both groups. The symptom management group reported significantly greater satisfaction with the PEDSS intervention.
Conclusions:
This study is among the first to examine the effects of 2 different early-discharge planning strategies for families of a newly diagnosed child with cancer. The evidence supports a standardized discharge education strategy that can be successfully implemented across institutions.
Implications For Practice:
Nurses play a major role in the educational preparation and discharge of newly diagnosed pediatric cancer patients and their families.
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