Abstracts / European Journal of Oncology Nursing 17 (2013) 892–899 897

FRIENDSHIP FROM THE PERSPECTIVE OF CHILDREN WITH EXPERIENCEOF CANCER: A FOCUS GROUP STUDY

E. Einberg a, P. Svedberg a, K. Enskär b, J. Nygren a

aHalmstad University, School of Social and Health Sciences, Halmstad,Swedenb Jönköping University, School of Health Sciences, Jönköping, Sweden

Purpose/objective

Friendship is a significant contributor to the experience of health.Disease and treatment can end contact with friends and it has beenfound that children treated for cancer often have fewer close friendsand consult less often with their friends compared to healthy children.Children with cancer identify friends as one of the main sources ofsupport but also that friends that do not share experiences of cancerhave less abilities to support them. Support programs for those whoshare similar experiences (peer support) have been recognised as animportant contributor to health and well-being but empirical evidencethat could guide development of peer support programs involvingchildren is limited. The purpose of this study was to explore percep-tions of friendship from the perspective of children with experience ofcancer.

Materials and methods

Fifteen children with experience of treatment of cancer participated infocus groups with 3 children in each group. A mixture of informative andcreative techniques assisted the children in talking and expressing them-selves. The focus group discussions were analysed using qualitative con-tent analysis.

Results

Children described friendship in terms of having common interests andexperiences, to respect and help each other, and to build common trustand understanding. They also described that friendship is a process thatdevelops over time and that interaction takes place both face-to-face anddigitally.

Conclusions

These insights are now used in an iterative and participatory developmentof a digital service for peer support for children with cancer. The knowl-edge based on this study may contribute to interventions designed topromote children's social networks.

EXPERIENCES OF SIBLINGS OF PEDIATRIC CANCER PATIENTS

J. Nonaka a, N. Shirahata b

a kanagawa University of Human Services Faculty of Health & Social WorkSchool of Nursing, Child and family Nursing, Yokosuka, Japanb Iwate Prefectural University, Child and family Nursing, Morioka, Japan

Purpose/objective

The purpose of this study was to clarify the experiences of siblings ofpediatric cancer patients and develop an intervention model.

Materials and methods

Using our method, based on the philosophical method proposed by A.P.Giorgi, a phenomenological psychologist, we analyzed the data throughadopting a qualitative descriptive approach and trajectory equifinality

model (TEM). Siblings of pediatric cancer patients were affected bothphysically and mentally by their brothers' and sisters' lives undermedical treatment and their parents' speech and behavior, causing thesiblings to perform. As our subjects, we conducted a survey of siblingsand parents of pediatric cancer patients.

Results

As our subjects, we conducted a survey of 11 people comprised of 7 siblingsand 4 parents of pediatric cancer patients. As the results, we identified 394phenomena, 66 elements, and 27 essential elements. Siblings of pediatriccancer patients were affected both physically and mentally by theirbrothers' and sisters' lives under medical treatment and their parents'speech and behavior, causing the siblings to perform 'self-restraint andsuppression' and experience abrupt somatic symptoms.

Conclusions

The results suggested the necessity of supporting siblings of pediatriccancer patients and intervening specifically so as to allow the siblings tohave places to express their feelings, establish their identity through newrelationships, and 'live their own lives' by answering the questions andsolving the conflicts regarding their relationships with their deceasedbrothers and sisters.

SURVEILLANCE ON CENTRAL VENOUS CATHETER COMPLICATIONS INPAEDIATRIC HAEMATOLOGY-ONCOLOGY UNIT

C.Y. Hung a, S.Y. Chiu a, S.K. Shum a, H.Y. Chan a, D.K.L. Cheuk a,A.K.S. Chiang a, S.Y. Ha a, G.C.F. Chan a

aQueen Mary Hospital, Department of Paediatrics and Adolescent Medicine,Hong Kong, Hong Kong China

Purpose/objective

To determine the incidence of central venous catheter (CVC) complicationsin haematology-oncology paediatric patients.

Materials and methods

This is a prospective surveillance study of the CVC complications in January2010-June 2012. Rate of catheter-associated infection was calculated baseon the Centers for Disease Control and Prevention guidelines.

Results

There were 151 CVC for a total of 36634 catheter days were monitoredduring the study. Patients belonged to 4 major disease groups: leukaemia/lymphoma (57%), solid tumor (27%), other hematological diseases (13%),and primary immunodeficiencies (2%). Median age of the patients was 4.5years (range 1month -18 years). Twenty-eight catheter-associated in-fections were detected, with 18 CVC associated bloodstream infection(CLABSI) and 10 exit site infection (ESI). Overall infection rate was 0.76 per1000 CVC days (0.49 for CLABSI and 0.27 for ESI). Organisms responsible forCLABSI included Escherichia coli (22%), Bacillus (22%), Coagulase negativeStaphylococcus (CNS) 22%, Pneumococcus (11%), and others (22%). Organ-isms cultured in ESI included Methicillin sensitive Staphylococcus aureus(MSSA) (n¼5), CNS (n¼4), and MSSA and CNS (n¼1). Fifty-one non-infec-tive CVC complications (0.14 per 1000 CVC days) were detected whichincludedblockage (56.9%), slipped out (15.7%), leakage (9.8%), cuff exposure(7.8%), malposition (7.8%), and others (2.0%). Twenty-nine CVC removedbefore end of treatment due to infection (24%), slipped out (24%), malpo-sition of CVC (14%), blockage (10%), leakage (10%), and others (11%).

Abstracts / European Journal of Oncology Nursing 17 (2013) 892–899898

Conclusions

Catheter-associated infections and catheter blockage were the mostfrequent complications in our paediatric patients with CVC. Despite of thelow CLABSI rate when compared with pooled mean CLABSI rate (1.7 per1000 CVC days) for all paediatric haematology-oncology units reported in2010 National Healthcare Safety Network, staff training and patient edu-cation on CVC care should be reinforced to minimize infection. Moreover,continuous surveillance of the CVC complications is essential to improveinfection control and quality of patient care.

THE STATE OF DENTAL VISIT AND ORAL HEALTH CARE IN CHILDHOODCANCER SURVIVORS

N. Ito a, E. Suzuki a, C. Kawakami b, F. Inoue c

a Shukuutoku University, School of Nursing & Nutrition, Chiba, Japanb Toho University, School of Nursing, Tokyo, JapancMillefeuille Child Cancer Frontiers, Chairperson, Chiba, Japan

Purpose/objective

To research the state of dental visits * dentists' attitude/response whenthey are reported patients' cancer experience, their knowledge in child-hood cancer/ treatments and late effects, and managing skills for cancersurvivors, how survivors manage their dental health care as well.

Materials and methods

Mailed questionnaires to 204 survivors who live in a district (Chiba pre-fecture) in Japan. The questionnaire was prepared drawing on some lit-eratures about the state of dental visits, late effects related to mouth fromchildhood cancer treatments, and pediatric dental health.

Results

79 respondents including hematological malignancy. Age; 29 school chil-dren, 16 in 20's, 11 in 30's, 18 in adolescence. Time from completion oftreatment; 29 are �11 years and 28 are 3 years - 10 years.50 visit dental clinics (46 for dental check, 44 for tooth decay, 9 forhypotrophy of dental root, 9 for missing teeth and 2 for enamel hypopla-sia). They reported some troubles including ‘being easy to have a decay’,‘hypotrophy of dental root’ ‘poor secretion of saliva’ and ‘irregular teeth’. A30 years old survivor reported he had milk teeth still now. 54 reported todentists that they were cancer survivors and most of them receivedtreatment without any uncomfortable response and uneasiness, althoughsome were rejected treatment from the dentists or were referred to othermedical institutions.78 keep brushing teeth every day including 20 who have been carefuldental health care after childhood cancer experience.

Conclusions

Need for education of dental health care to patients and their familiesduring hospitalization. Need to give information about childhood cancertreatments and late effects to dentists because more than 60% visit den-tist's office. They visit a dentist whom they used to visit before diagnosis ofcancer and keep good communication with the dentist. It is important toconfirm if patients have trustworthy dentist at the time of dischargingfrom the hospital.

A GLOBAL WEB-BASED PROGRAMME ABOUT CANCER IN LANGUAGESPECIFIC FOR STAFF, A SICK CHILD AND THEIR FAMILY

M. Jenholt Nolbris a, B. Wee Sævig b, J. Challinor c, I. Skärsäter d,L.Z. Abramovitz e

aCentrum for Children's Right, Queen Silvia's Children's Hospital SahlgrenskaUniversity, Gothenburg, Swedenb The Norwegian Cancer Society, The Norwegian Cancer Society, Bergen,NorwaycDepartment of Physiological Nursing, University of California, San Francisco,USAd School of Health and Social Sciences Halmstad University, SahlgrenskaAcademy Gothenburg University, Gothenburg Halmstad, SwedeneUCSF Medical Center, University of California, San Francisco, USA

Purpose/objective

To have expert paediatric oncology nurses to inform and explain childhoodcancer diagnoses, treatments, side effects, situations and feelings, bydeveloping a web-based programme.

Materials and methods

The programme will be developed and tested in three steps. Step 1 is todevelop a web portal with animated pictures of cancer themes based onthe ‘See Hear Do’ programme in Sweden and Norway. Step 2 is to add textand audio in several languages for each theme (such as Arabic, English,Spanish). Step 3 is to develop two informational sections on the webportal: one section for staff and for the patient and family. The staff,children and families will evaluate each section as appropriate before theprogramme is published on the web portal. A participatory design methodis going to be used. The programme will also be offered to nurses in theInternational Society of Paediatric Oncology and nursing working group ofthe Pediatric Oncology in Developing Countries committee for translationinto their native languages.

Results

Expected result is that the web portal can easily be downloaded viacomputer, iPad or mobile and can be used twofold. Staff can use thisprogramme for self-education and for working with the child andfamily. The child and family can use the web programme in varioussituations during the child's cancer treatment, e.g., explaining thediagnosis to family members, schoolmates, families' networks, duringphone calls using an interpreter or for persons with a visual or auditorydisability.

Conclusions

Goal of the project is to globalize childhood cancer education and infor-mation with a web-based programme including pictures, text and audio invarious languages. Theprogramme isdesigned toconsider theprofessional'sinformation and the child and family's needs and participation. The activerole of all stakeholders to ensure cultural relevance is key to this project.

SEARCH FOR A GOOD FIT BETWEEN NURSING PRACTICE ANDELECTRONIC NURSING RECORDS: BENEFITS AND LIMITATIONS OFNURSING RECORDS ON A PEDIATRIC HEMATO-ONCOLOGY WARD

E. Willems a, V. Van de Velde a, K. Goethals a, Y. Benoit a, G. Laureys a

a Paediatric Hemato-oncology and SCT, University Hospital Ghent, Ghent,Belgium

Purpose/objective

Nowadays, electronic charting is widely used in healthcare. The electronicpatient file has been introduced on our ward since May 2011 to improveworkflow and quality of documentation.Two years after implementation, the benefits and limitations of electronicnursing records are identified. This will contribute to the accurate selectionof a future electronic system in our hospital.