Pediatric Education Discharge Support Strategies for Newly Diagnosed Children With Cancer

Abstract

Background: Discharge education practices vary among institutions and lack a standardized approach for newly diagnosed pediatric oncology patients and their parents.

Objective: The purpose of this American Nurses Credentialing Center-supported pediatric multisite trial was to determine the feasibility and effectiveness of 2 nurse-led Parent Education Discharge Support Strategies (PEDSS) for families with a child who is newly diagnosed with cancer.

Interventions/methods: A cluster randomized clinical trial design assigned 16 Magnet-designated sites to a symptom management PEDSS intervention or parent support and coping PEDSS intervention. Outcome measures evaluated at baseline, 1, and 2 months after diagnosis include symptom experiences, parent perceptions of care, unplanned service utilization, and parent evaluation of the PEDSS interventions.

Results: There were 283 newly diagnosed children and their parent participating in this study. Linear mixed models revealed pain differed over time by the intervention; children in the symptom management group had a greater decrease in pain. Greater nausea and appetite disturbances were experienced by older children in both groups. Fatigue and sleep disturbance showed a significant decrease over time in both groups. The symptom management group reported significantly greater satisfaction with the PEDSS intervention.

Conclusions: This study is among the first to examine the effects of 2 different early-discharge planning strategies for families of a newly diagnosed child with cancer. The evidence supports a standardized discharge education strategy that can be successfully implemented across institutions.

Implications for practice: Nurses play a major role in the educational preparation and discharge of newly diagnosed pediatric cancer patients and their families.

Figure 1

Symptom management worksheet.

Figure 2

Coping and support worksheet.