Journal of Pediatric Hematology/Oncology Nursing

Pleuropulmonary blastoma (PPB) is a dysontogenetic neoplasm of childhood that involves lung and/or pleura. There is an increased incidence of neoplasias and dysplasias among young relatives of children with PPB. Pathophysiologically, PPB evolves from a cystic to solid state over time. It is subclassified as type I (purely cystic), type II (both cystic and solid elements), and type III (completely solid). Type II and type III may be associated with metastasis, with the brain being the most common metastatic site. The absence of epithelial malignancy in PPB is a feature that distinguishes it from the adult-type pulmonary blastoma. The clinical presentation includes signs and symptoms associated with various respiratory disorders. To make a definitive diagnosis of PPB, an examination of the cystic fluid or solid tumor is required. Treatment for PPB consists primarily of surgery and chemotherapy. Nursing care is directed toward maintaining normal respiratory and neurological function, maintaining normal fluid and electrolyte balance, minimizing side effects associated with treatment, and providing education for the family.

The purpose of this article is to describe the results of a national descriptive survey of 509 pediatric oncology nurses' interventions for managing patients'symptoms. The Nurses' Distress and Interventions for Symptoms Survey (NDISS) is used to assess nurses' management of patients' 7 most distressing symptoms. The average number of symptoms reported as being present is 6.0 (SD 1.3; range, 0-7). Pain is the most commonly reported symptom; trouble sleeping is the least common. The mean score for nurses' distress is 2.9 (SD 0.8; range, 0-4); nurses' distress is greatest with trouble sleeping and lowest with hair loss. Nurses use an average of 12.7 interventions to treat each symptom; pain has the greatest number of interventions to treat and hair loss the least. The average perceived effectiveness of interventions across symptoms is 2.5 (SD 0.5; range, 0-4). Pain is perceived as the most effectively treated symptom; fatigue is the least.

The purpose of this article is to describe the results of a study examining the relationship between nurses' management of pediatric oncology patients' symptoms and job satisfaction. Surveys were mailed to a national sample of pediatric oncology nurses to assess the presence of symptoms in their patients, the nurses' distress from the patients' symptoms, the interventions used to manage the symptoms, the perceived effectiveness of the interventions, and the nurses' job satisfaction. Based on the stress response sequence model, study hypotheses proposed that nurses' symptom management affects nurses' distress and, in turn, job satisfaction. Hierarchical regression analyses were used to evaluate the hypotheses and study model. Results demonstrated that both the number of nursing interventions and the perceived effectiveness of nursing interventions were significant as mediators in predicting nurses' distress. The overall study model contributed significantly in predicting overall job satisfaction.

A literature review was performed to explore the experiences of parents during their child's diagnosis of leukemia. The findings revealed that anxiety is a major reaction to the diagnosis. Because of the parents' reactions, communication barriers and parental role changes are established between the parent and child. The lack of communication between the parent and child during diagnosis and treatment and parental role changes produce negative outcomes. Negative outcomes place the parent and child at risk for experiencing anxiety years after the illness is treated. This literature review describes positive outcomes that can be accomplished by decreasing the anxiety of parents, which leads to a decrease in communication barriers and parental role changes during the new diagnosis of leukemia. Interventions are provided to increase the support and resources of parents during this phase of the disease. Future research may focus on interventions to decrease anxiety, which will increase communication, produce positive outcomes for treatment, and decrease stress years after the disease is treated.

Families and children often report a diverse range of academic achievements and challenges after undergoing treatment for a brain tumor. This study explores the experiences of children, youth, and their families as they seek to reintegrate into mainstream educational systems. Despite the variable experiences, there are many common strategies that could positively influence the child's success in school. Strong communication between parents, school, and health professionals is paramount. Preparing parents to advocate for their children's academic and social needs and developing an awareness of the challenges among school staff has potential to improve outcomes for these children. Equipping the children with the social skills needed to manage social situations will strengthen their ability to overcome the challenges that they face. These study findings shed light on the academic experiences of these children and can lead to the development of strategies to support families facing similar challenges.

Although pediatric cancer treatment has been reviewed by several authors, the lived experiences of children undergoing this process have seldom been discussed in the literature. The data for this article were obtained from a larger qualitative study that provided a collective view of the pediatric cancer experience at San Jorge Children's Hospital in Puerto Rico. In this article, findings that are directly related to the hospitalization process of these young patients are described, including the hospital as a safe haven, dealing with pain, taking control, and thriving in adversity. These findings provide a rationale for the development of a biopsychosocial model of health that emphasizes reciprocal interactions among the biological, psychological, social, cultural, and spiritual dimensions that influence health.