以质量求发展，以服务铸品牌

Journal of Nursing ›› 2022, Vol. 29 ›› Issue (15): 59-64.doi: 10.16460/j.issn1008-9969.2022.15.059

Previous Articles     Next Articles

Symptom Clusters and Sentinel Symptoms of Children with Acute Lymphoblastic Leukemia during Maintenance Chemotherapy

SHEN Xin-yi1,2a, LI Rong-rong2b, CHAN Yu-ying2c, ZHANG Guan-xun1, YANG Qi2a, ZHANG Lin1   

  1. 1. School of Nursing, Suzhou Medical College of Soochow University, Suzhou 215006, China;
    2a. Dept. of Hematology;2b. Dept. of Nursing Administration;2c. Trade Union, Children's Hospital of Soochow University, Suzhou 215002, China
  • Received:2022-03-21 Online:2022-08-10 Published:2022-09-07

PDF (PC)

263

Like

Abstract: Objective To explore the symptom clusters and their sentinel symptoms in children with acute lymphoblastic leukemia during maintenance chemotherapy. Methods With convenience sampling, children with acute lymphoblastic leukemia who received maintenance chemotherapy in department of hematology of Children's Hospital of Soochow University from June 2020 to August 2021 were selected and assessed by Memorial Symptom Assessment Scale 10-18. The formation of symptom clusters was determined by exploratory factor analysis with Spearman rank correlation analysis, and the sentinel symptoms of clusters were determined by Apriori algorithm association analysis. Results Five symptom clusters in children with acute lymphoblastic leukemia during maintenance chemotherapy were identified, including emotional-psychological cluster, gastrointestinal cluster, somatic cluster, neurosystem cluster, and self-image disorder cluster, and the Cronbach ɑ coefficient was 0.943, 0.906, 0.874, 0.891 and 0.900, respectively; insomnia, vomiting, cough, headache, and hair loss were the sentinel symptoms of the clusters respectively. Conclusion Children with acute lymphoblastic leukemia experience a variety of symptom clusters during maintenance chemotherapy. The identification of symptom clusters and sentinel symptoms is helpful to simplify the evaluation and management of symptoms, improve the efficiency of symptom management, and reduce the disease burden of children and their families.

Key words: acute lymphoblastic leukemia, children, maintenance chemotherapy, symptom clusters, sentinel symptoms

CLC Number: 

  • R473.55
[1] Yi M, Zhou L, Li A, et al.Global Burden and Trend of Acute Lymphoblastic Leukemia from 1990 to 2017[J]. Aging(Albany NY),2020,12(22):22869-22891.DOI:10.18632/aging.103982.
[2] Yang W, Cai J, Shen S, et al.Pulse Therapy with Vincristine and Dexamethasone for Childhood Acute Lymphoblastic Leukaemia (CCCG-ALL-2015): An Open-label, Multicentre, Randomised, Phase 3, Non-inferiority Trial[J]. Lancet Oncol, 2021, 22(9):1322-1332.DOI:10.1016/s1470-2045(21)00328-4.
[3] Kim HJ, McGuire DB, Tulman L, et al. Symptom Clusters: Concept Analysis and Clinical Implications for Cancer Nursing[J]. Cancer Nurs, 2005, 28(4):270-282.DOI:10.1097/00002820-200507000-00005.
[4] 郑渊,刘可,卜秀青,等. 急性白血病患儿化疗期间症状群的调查分析[J]. 中华护理杂志,2016, 51(11):1320-1324.DOI:10.3761/j.issn.0254-1769.2016.11.008.
[5] Li R, Ma J, Chan Y, et al.Symptom Clusters and Influencing Factors in Children with Acute Leukemia During Chemotherapy[J]. Cancer Nurs, 2020, 43(5): 411-418.DOI:10.1097/ncc.0000000000000716.
[6] 李蓉蓉, 马金玲, 阐玉英, 等. 急性淋巴细胞白血病患儿化疗期间症状群的纵向研究[J].护理学杂志,2019, 34(16):5-9.DOI:10.3870/j.issn.1001-4152.2019.16.005.
[7] Kirkova J, Aktas A, Walsh D, et al.Consistency of Symptom Clusters in Advanced Cancer[J]. Am J Hosp Palliat Care, 2010,27(5):342-346.DOI:10.1177/1049909110369869.
[8] Brown JK, Cooley ME, Chernecky C, et al.A Symptom Cluster and Sentinel Symptom Experienced by Women with Lung Cancer[J]. Oncol Nurs Forum, 2011, 38(6): E425-435.DOI:10.1188/11.Onf.E425-e435.
[9] 夏超, 段培蓓, 杨玲, 等. 166例胃癌术后化疗患者症状群内前哨症状的调查[J].护理学报,2021,28(8):44-49.DOI:10.16460/j.issn1008-9969.2021.08.044.
[10] 中华人民共和国国家卫生健康委员会,国家卫生健康委办公厅. 儿童急性淋巴细胞白血病诊疗规范(2018版)[EB/OL].(2018-10-8)[2022-03-21].http://www.nhc.gov.cn/yzygj/s7653/201810/aef82930c1af4fc5bf325938e2fcb075.shtml.
[11] Zheng R, Peng X, Zeng H, et al.Incidence, Mortality and Survival of Childhood Cancer in China during 2000-2010 Period: A Population-based Study[J]. Cancer Lett, 2015, 363(2): 176-180.DOI:10.1016/j.canlet.2015.04.021.
[12] 郑卫军, 何凡. 现况调查的样本量计算方法[J].预防医学, 2020, 32(6):647-648.DOI:10.19485/j.cnki.issn2096-5087.2020.06.028.
[13] Williamson Lewis R, Effinger KE, Wasilewski-Masker K, et al.Self-reported Late Effect Symptom Clusters among Young Pediatric Cancer Survivors[J]. Support Care Cancer, 2021,29(12):8077-8087.DOI:10.1007/s00520-021-06332-4.
[14] Collins JJ, Byrnes ME, Dunkel IJ, et al.The Measurement of Symptoms in Children with Cancer[J]. J Pain Symptom Manage, 2000,19(5):363-377.DOI:10.1016/s0885-3924(00)00127-5.
[15] Drake R, Frost J, Collins JJ.The Symptoms of Dying Children[J]. J Pain Symptom Manage, 2003, 26(1):594-603.DOI: 10.1016/S0885-3924(03)00202-1.
[16] 冯芳茗, 楼建华, 徐红, 等. 癌症患儿症状体验的现况调查[J].中国护理管理, 2012, 12(1):30-34.DOI:10.3969/j.issn.1672-1756.2012.01.010.
[17] 张浩彬. IBM SPSS Modeler 18.0 数据挖掘权威指南[M]. 北京:人民邮电出版社, 2019:356-366.
[18] Tang X, Mo L, Liu Q, et al.Adverse Experiences of Social Adaptation in Children with Leukaemia: A Qualitative Study from China[J]. BMJ Open, 2022, 12(3):e051953.DOI:10.1136/bmjopen-2021-051953.
[19] Rahiman EA, Rajendran A, Sankhyan N, et al.Acute Neurological Complications during Acute Lymphoblastic Leukemia Therapy: A Single-center Experience over 10 Years[J]. Indian J Cancer, 2021, 58(4): 545-552.DOI:10.4103/ijc.IJC_422_19.
[20] Mahon SM, Carr E.Skin Toxicities: Common Side Effect[J]. Clin J Oncol Nurs, 2021, 25(6):32.DOI:10.1188/21.Cjon.S2.32.
[21] Balachandran DD, Miller MA, Faiz SA, et al.Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer[J]. Curr Treat Options Oncol, 2021, 22(9): 81.DOI:10.1007/s11864-021-00872-x.
[22] Steur LMH, Kaspers GJL, van Someren EJW, et al. The Impact of Maintenance Therapy on Sleep-wake Rhythms and Cancer-related Fatigue in Pediatric Acute Lymphoblastic Leukemia[J]. Support Care Cancer, 2020, 28(12): 5983-5993.DOI:10.1007/s00520-020-05444-7.
[23] Paw Cho Sing E, Robinson PD, Flank J, et al. Classification of the Acute Emetogenicity of Chemotherapy in Pediatric Patients: A Clinical Practice Guideline[J]. Pediatr Blood Cancer, 2019, 66(5): e27646.DOI:10.1002/pbc.27646.
[24] Patel P, Robinson PD, Devine KA, et al.Prevention and Treatment of Anticipatory Chemotherapy-induced Nausea and Vomiting in Pediatric Cancer Patients and Hematopoietic Stem Cell Recipients: Clinical Practice Guideline Update[J]. Pediatr Blood Cancer, 2021, 68(5): e28947.DOI:10.1002/pbc.28947.
[25] 汪燕, 王宁玲, 谢志伟.甲氨蝶呤所致急性淋巴细胞白血病患儿相关药源性咳嗽诊治体会[J]. 安徽医学, 2014, 35(8):1111-1112.DOI:10.3969/j.issn.1000-0399.2014.08.031.
[26] Cho PSP, Turner RD.Cough and Pain: More Similar Than at First Glance[J]. Chest, 2021, 159(3):904-905.DOI:10.1016/j.chest.2020.10.001.
[27] Sadighi ZS, Ness KK, Hudson MM, et al.Headache Types, Related Morbidity, and Quality of Life in Survivors of Childhood Acute Lymphoblastic Leukemia: A Prospective Cross Sectional Study[J]. Eur J Paediatr Neurol, 2014, 18(6):722-729.DOI:10.1016/j.ejpn.2014.06.006.
[28] Rastogi RG, Arnold TL, Borrero-Mejias C, et al.Non-pharmacologic and Mindful-based Approaches for Pediatric Headache Disorders: A Review[J]. Curr Pain Headache Rep, 2021, 25(12):78.DOI:10.1007/s11916-021-00993-w.
[1] WANG Rui, LI Zhi, YANG Qin, WANG Chun-li, LI Feng-ting, WANG Xu-mei. Best Evidence Summary of Hypoglycemia Identification and Management in Homebound Children with Type 1 Diabetes Mellitus [J]. Journal of Nursing, 2022, 29(7): 50-56.
[2] YU Xiao-yan, LIU Yu, HUANG Yi. Effects of Clown Care on Children's Anxiety and Pain: A Meta-analysis [J]. Journal of Nursing, 2022, 29(4): 21-26.
[3] WANG Ke, WU Jin, HUANG Hong-yu, LI Xin-yi, ZHOU Ming-ming, WU Xiao-na. Quality Control Circle in Standardized Medical Nutrition Management of Hospitalized Children with Diabetes [J]. Journal of Nursing, 2022, 29(1): 13-16.
[4] REN Li, ZHAO Xiu-fang. Construction of Competency Model and Index System of New Nurses in Maternity and Children’s Hospital Based on Onion Model [J]. Journal of Nursing, 2021, 28(7): 21-25.
[5] YANG Jin-xia, YAO Wen-ying, WANG Xin. Effect of Child Medical Assistance Services on School-age Children with Asthma [J]. Journal of Nursing, 2021, 28(6): 71-75.
[6] CUI Han-fei, QIAO Juan, WEI Jing-wen, DONG Feng-qi. Filial Piety Motivation and Experience among Children of Patients with Advanced Cancer: A Qualitative Study [J]. Journal of Nursing, 2021, 28(24): 57-62.
[7] ZHANG Xiao-tian, QIU Yu, YUE Peng, LIN Jian-yu. Experience of Adult Children in Caring for Dying Patients：A Meta-synthesis of Qualitative Studies [J]. Journal of Nursing, 2021, 28(18): 28-34.
[8] LI E, YAN Qiu-ping. Complications after Epicardial Permanent Pacemaker Implantation and Nursing: A 68-case Study [J]. Journal of Nursing, 2021, 28(10): 72-74.
[9] XIE Xiao-min, LIANG Ya-hong, FENG Bei, WEI Dan, JIANG Xun. Current Status of Dietary Behavior of Preschool Children and Its Influence Factors: A 240-case Study [J]. Journal of Nursing, 2020, 27(9): 33-37.
[10] LV Yun-xia, FENG Shao-juan, LI Dan-feng, WU Xuan-lin, CHEN Yan-qiu, CHEN Liu-mei, LIU Jie, HUANG Jie-ying, LIU Zheng-wei. Best Evidence Summary for Post-tonsillectomy Pain Management in Children [J]. Journal of Nursing, 2020, 27(7): 38-43.
[11] KUANG Wan, YANG Yan-dan, GUO Yue, ZHAO Ti-yu. Effect of Parental Presence during Induction of Anesthesia on Preoperative Anxiety and Compliance of Anesthesia Induction in Preschool Children [J]. Journal of Nursing, 2020, 27(4): 67-71.
[12] WANG Hui-ping, WEI Li-jun, FANG Dong-min, LI Jin-hui, YUAN Qing-li. Self-consciousnesss of Children with Short Stature and Its Influence Factor: A 97-case Study [J]. Journal of Nursing, 2020, 27(2): 53-57.
[13] YANG Bei-bei, TONG Xin-yang, CHEN Fang, WANG Xiao-mei, LI Ling, LI Li-yan, WAN Feng-jing. Consistency of Self-report and Nursing Records of Adverse Reactions in Children with Leukemia: A 60-case Study [J]. Journal of Nursing, 2020, 27(17): 67-72.
[14] LIANG Xin, GAO Zu-mei, ZHANG Hai-yuan, HAI Rong, DENG Wen-fang. Meta-analysis of Effects of Parent Present Anesthesia Induction on Children with General Anesthesia [J]. Journal of Nursing, 2019, 26(6): 32-37.
[15] WANG Fei-jie, ZHAO Tian-yun, WANG Lu, CHU Yin-ping, WANG Zhi-xia. Development and Application of Mobile-based Health Education Platform for Children after Hypospadias Repair [J]. Journal of Nursing, 2019, 26(4): 58-61.
Viewed
Full text


Abstract

Cited
  Shared   
[1] . [J]. Journal of Nursing, 2022, 29(14): 26 -30 .
[2] ZHENG Jun-jun, YU Wei-hua, YAN Ting. Current Status of Sedentary Behavior of the Elderly in Medical-nursing Combined Institutions and Its Influencing Factors[J]. Journal of Nursing, 2022, 29(15): 1 -6 .
[3] LAI Xian-ting, YI Zi-han, LI Qian, Zhang Jie-lan, XU Tie-fei, SHE Cheng-hong, JU Mei. Mediating Effect of Expectations Regarding Aging and Moderating Effect of Self-efficacy on Family Function and Loneliness[J]. Journal of Nursing, 2022, 29(15): 7 -13 .
[4] SHI Hai-ning, CHEN Ling, ZHOU Li-jing, WANG Li. Construction of Nursing Sensitive Quality Index System for Enhanced Recovery after Surgery of Breast Cancer Patients[J]. Journal of Nursing, 2022, 29(15): 14 -18 .
[5] . [J]. Journal of Nursing, 2022, 29(15): 19 -23 .
[6] XU Li-min, Qian Zhi-gang. Construction of Clinical Teachers' Tacit Knowledge Sharing Scale and Its Reliability and Validity[J]. Journal of Nursing, 2022, 29(15): 24 -27 .
[7] JIN Yu-ping, ZHUANG Hong-xia, CHEN Xia, FAN Xiao-ning, MA Wen, WEI Zhi-juan. Construction of Evaluation Index System of Core Competence of Neurocritical Care Nurses[J]. Journal of Nursing, 2022, 29(15): 28 -32 .
[8] CHEN Wen-wen, LIU Xia, HUANG Dong-lan, ZHOU Chun-yan, CHEN Liang. Effect of Information-based Detachable Atlas Library of Endoscopic Instruments in CSSD[J]. Journal of Nursing, 2022, 29(15): 33 -35 .
[9] . [J]. Journal of Nursing, 2022, 29(15): 36 -38 .
[10] . [J]. Journal of Nursing, 2022, 29(15): 39 -43 .