A symptom checklist for children with cancer: the Therapy-Related Symptom Checklist-Children.
ABSTRACT Symptom monitoring and alleviation are basic to the care of children and adolescents with cancer. A symptom checklist helps facilitate this process.
The primary objective of this study was to calibrate a child-friendly, clinically usable checklist capturing symptom occurrence and severity; a secondary objective was to examine age group differences: 5 to 11 years (n = 222) and 12 to 17 years (n = 163) and sex differences: males (54%) and females (46%), and correlate symptom severity, functional status, and quality of life.
Three hundred eighty-five children/adolescents at 5 university-affiliated outpatient oncology clinics: central, western, eastern, southeastern United States. Diagnoses were acute lymphoblastic leukemia (45%), solid tumors (14%), nervous system tumors (18%), and others (23%). Principal component factor analysis, confirmatory factor analysis, correlational statistics, t test, Wilcoxon test were performed.
(a) Robust 30-item checklist, 7 factors; (b) 14 of 30 symptoms reported by at least 40% of patients. Top 5 are feeling sluggish (77%), nausea (72%), appetite loss (66%), irritable (61%), and vomiting (54%). (c) Sixteen of 30 symptoms reported at severity 2 or greater: "quite a bit." (d) Therapy-Related Symptom Checklist-Children (TRSC-C) scores are as follows: range, 0 to 89; mean, 25.14 (SD, 18.68). (e) Cronbach α = .9106. (f) Older children reported greater symptom severities: TRSC-C (t = 2.73, P = .003). (g) There were no sex differences on the TRSC-C total score. (h) Lansky correlations with TRSC-C (r = -0.32; P = .02); factors: nutrition related (r = -0.36; P = .05); oropharyngeal (r = -0.51; P = .0002); and respiratory (r = - 0.25; P = .06). (i) Pediatric Quality of Life Inventory correlation with TRSC-C (r = -0.68; P = .0001).
The new TRSC-C has good measurement properties and is ready for use in clinics and research.
Use of the TRSC-C is consistent with guidelines emphasizing self-report of patient symptoms, shared patient decision making, and improved communications among patients, clinicians, and significant others.
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ABSTRACT: Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen.Clinical journal of oncology nursing 10/2014; 18(5):547-54. · 0.95 Impact Factor
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ABSTRACT: A calibrated easy-to-use symptom checklist for children who are under treatment for cancer had been developed and reported in Cancer Nursing. The 30-item Therapy-Related Symptom Checklist for Children (TRSC-C) has good measurement and psychometric properties and uses "kid-friendly" terms to monitor symptom occurrence and severity during oncology treatment. A secondary analysis is reported using participants who self-identified as Hispanic. The objective of this study was to examine among Hispanic pediatric oncology outpatients (a) occurrence and (b) severity of symptoms reported on the TRSC-C, (c) relationships of symptoms to gender and age (<12 vs ≥12), and (d) differences in summated TRSC-C symptom scores between patients with acute lymphoblastic leukemia (ALL) and other diagnoses. This was a cross-sectional analysis using secondary data and descriptive statistics. The sample was composed of 79 children (55% male) aged 5 to 17 years (mean, 10.3 years) with diagnosis of ALL (52%) or other (48%). Instrument used was TRSC-C by patient/parent report (Cronbach'α = .91). (a) Symptom occurrence: 15 symptoms on the TRSC-C were reported by 40% or greater. (b) Severity means on 11 symptoms were greater than "a little bit." (c) No gender or age differences were found on mean TRSC-C summated scores. (d) Mean TRSC-C scores (symptom occurrence and severity) were slightly lower but not significantly different (t = 1.71) between ALL (13.71 [SD, 8.06]) and other diagnoses (15.71 [SD, 7.01]). Symptom occurrence and severity reported on the TRSC-C by this Hispanic subsample are consistent with findings in the calibration study and with those of another Hispanic group and other ethnicities. Use of the TRSC-C is appropriate during pediatric oncology treatment and diagnoses of Hispanic populations.Cancer nursing 07/2013; · 1.88 Impact Factor
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ABSTRACT: Pediatric cancer diagnoses affect the entire family: parents, well siblings, the ill child, and others. The objective of this study was to review nursing studies on parental caregiving of children with cancer, family impact, and costs. The study used inclusion/exclusion criteria and family systems theory, self/dependent-care, and symptom management (monitoring, alleviation) concepts. Regarding "levels of evidence," 3 studies were Level II; 7 were Level IV; 7 were Level VI; 1 review was Level V and the second was Level I. Of 19 studies: 11 were qualitative; 4, quantitative; 2 were mixed methods. Content analysis themes were: Parental caregiving and family impact, economic burden. Conclusions were that (a) qualitative studies are predominant; findings supported quantitative findings; (b) quantitative nursing studies are less common: found one longitudinal, randomized controlled trial (RCT) focused on outcomes of an intervention for well siblings and parents, implemented by Clinical Nurse Specialists, CNSs; (c) few quantitative studies with large samples were found, especially ones with theoretical models of the family system and measures of illness impact on families; and (d) "mixed methods" longitudinal nursing research is illustrated. There is a need for "evidence-based" practice (EBP) nursing studies of interventions focused on parent education/support/assistance; respite care, and increasing family/well sibling knowledge/other information on the child's illness.Issues in Comprehensive Pediatric Nursing 11/2013; 37(1).