Kara Vickers, University of Utah
Nursing
Symptoms related to cancer and its treatments are a significant source of distress for children and adolescents with cancer. Although children and adolescents may receive interventions aimed at alleviating symptoms, the hospital care environment itself may be one that adds to the overall symptom burden. The purpose of this study is to investigate relationships between symptoms experienced by hospitalized children and adolescents with cancer and the care environment on an inpatient pediatric oncology unit. This prospective, descriptive study uses use a repeated measure, within-group design to identify relationships between symptoms and the nursing care environment that can be used to guide future interventions. Participants are 50 children and adolescents (7 to 18 years of age) with cancer. Data collection is occurring over a 3-day and 3-night period. Children and adolescents’ symptoms are measured each shift using the Memorial Symptom Assessment Scale for patients aged 7-12 years. Participants also answer two open-ended questions about what has bothered them about the hospital environment and what they perceive could improve the hospital environment. Sound and light levels are measured continuously using a sound pressure level meter and data logger placed approximately 48 inches from the child’s bedside. Nursing care activities are measured through counts of care activities occurring during room entries by nursing staff. Room entries are identified using an Axis pan-tilt-zoom (PTZ) dome camera. A member of the research team reviews the child’s nursing flow sheet, medication administration record, acuity level, laboratory values, and medical orders each day. Data is presently being collected and will be analyzed using hierarchical mixed effects statistical models. Long-term goals of this project include improving symptom management in the inpatient setting, minimizing modifiable factors in the care environment that cause greater symptom burden, and lastly use the findings to inform hypotheses for a larger intervention studies. Hopefully these studies will target structuring the hospital care environment to minimize the symptom burden experienced by hospitalized children and adolescents with cancer and, ultimately, promote their quality of life.