Krista L. Wilkins

A review of qualitative research on the childhood cancer experience from the perspective of siblings: a need to give them a voice.

Researchers are increasingly adopting the qualitative research paradigm to study the world of siblings of children with cancer. The purpose of this review article is to identify the contributions of qualitative research in advancing the understanding of the childhood cancer experience from the perspective of siblings. Articles were selected for inclusion if (1) written in English; (2) published in a peer-reviewed journal between 1979 and present or, if a doctoral dissertation, easily accessible to the authors; (4) cited a specific qualitative research design or some type of qualitative research method of data collection and analysis; and (4) involved siblings of children with cancer as sole research participants or as research participants within the context of the family. Twenty-seven qualitative research studies were reviewed. Three themes emerged from an analysis of the primary findings: (1) changing lives, (2) intense feelings, and (3) unmet needs. Limitations in the conceptualization, research design, and research methods of the qualitative studies are discussed. Suggestions that will help researchers in conducting qualitative research with siblings are also presented.

Designing a Mixed Methods Study in Pediatric Oncology Nursing Research

Despite the appeal of discovering the different strengths of various research methods, mixed methods research remains elusive in pediatric oncology nursing research. If pediatric oncology nurses are to succeed in mixing quantitative and qualitative methods, they need practical guidelines for managing the complex data and analyses of mixed methods research. This article discusses mixed methods terminology, designs, and key design features. Specific areas addressed include the myths about mixed methods research, types of mixed method research designs, steps involved in developing a mixed method research study, and the benefits and challenges of using mixed methods designs in pediatric oncology research. Examples of recent research studies that have combined quantitative and qualitative research methods are provided. The term mixed methods research is used throughout this article to reflect the use of both quantitative and qualitative methods within one study rather than the use of these methods in separate studies concerning the same research problem.

Prospective diary study of nonpainful and painful phantom sensations in a preselected sample of child and adolescent amputees reporting phantom limbs

Objective:To prospectively study factors associated with the occurrence of phantom sensations and pains in a pre-selected sample of child and adolescent amputees reporting phantom limbs. Design:Prospective diary study over 1 month. Participants:Fourteen child and adolescent amputees from 10–18 years of age who were missing a limb due to trauma (n = 12) or congenital limb deficiency (n = 2), and who had previously reported having phantom sensations and pain. Main Outcome Measure:Diary used to assess the occurrence of non-painful and painful phantom sensations. Items included age, sex, location and cause of amputation, past experience with stump pain and pre-amputation pain, and intensity, quality, duration, and triggers of the sensations and pains. Results:Thirteen amputees reported having 104 incidents of non-painful phantom sensations with an average intensity of 4.17 (SD = 2.14) on a 0–10 rating scale. Fifty-three incidents of phantom pain with an average intensity of 6.43 (SD = 1.76) were recorded by 8 amputees. Both amputees with a congenital limb deficiency reported phantom phenomena. Girls reported more psychosocial triggers than did boys whereas boys were more likely than girls to report that they could not identify a trigger (P = 0.0001). Boys also reported a higher proportion of physical triggers than psychosocial triggers while there were no differences for girls (P = 0.0001). Discussion:Child and adolescent amputees experience phantom sensations and pains on a regular basis over a 1-month period. Differences in triggers of phantom phenomena between boys and girls may be due to differences in activities, awareness, attribution, and willingness to report psychosocial triggers.

Supporting adolescents and young adults with cancer through transitions: position statement from the Canadian Task Force on Adolescents and Young Adults with cancer.

Objective: This position statement from the Canadian Task Force on Adolescents and Young Adults with cancer aims to (1) conceptualize the numerous transition experiences encountered by adolescents and young adults (AYA) with cancer; and (2) provide recommendations on how to help the AYA regain a sense of control over their lives as they adjust to these transition experiences. Methods: We reviewed and synthesized a heterogeneous sample of studies and recommendations, ranging from well-designed case-controlled investigations to opinions of respected authorities based on clinical experience, and reports of expert committees. Results: We describe the key factors that have an impact on different transitions during the cancer journey, and the need for developmentally appropriate services for AYA with cancer that consider both the system issues and individual transition issues. Our recommendations are not intended to be prescriptive, but they are broad enough to be applicable in different types of settings (eg, family doctor, cancer center, specialty service) and systems beyond health care (eg, school system, social system). Conclusions: The Task Force urges health care providers, parents, and AYA with cancer to work together in planning and implementing strategies that will enable individuals to navigate the transitions they encounter along the cancer journey successfully, and strive for meaningful participation in life situations, achieving their potential as fully functional members of society.

Taking care of second cancer risk.

Background:Cancer survivors are living longer and are at greater risk of developing cancer than the general population. Promotion of healthy lifestyle behaviors and provision of regular follow-up care may modify the evolution of a second cancer diagnosis. Little is known, however, about cancer survivors’ decision making and actions related to modifying second cancer risk. Objective:Part of a larger mixed-method study of second cancer risk, qualitative interview data were collected to arrive at an interpretive description of how cancer survivors modify their second cancer risk, and how nurses and other healthcare professionals can best support survivors throughout the cancer survival trajectory. Interventions/Methods:Semistructured interviews were conducted with 22 cancer survivors (16 women and 6 men) drawn from a provincial cancer registry. The cancer survivors ranged in age from 19 to 87 years. The cancer history of the participants varied. Data were analyzed using the constant comparative method. Results:Two themes that emerged from the interviews that speak to how cancer survivors modified their second cancer risk were (1) how I take care of my second cancer risk and (2) support I need to take care of my second cancer risk. Conclusions:For many cancer survivors, awareness of the benefits of taking care of second cancer risk does not translate into action. Implications for Practice:Study findings reinforce that more needs to be done in supporting cancer survivors in taking care of second cancer risk.