Sau Ying Chiu

The impact of cancer on children's physical, emotional, and psychosocial well-being.

The diagnosis and treatment of cancer are a stressful and threatening experience, which can be emotionally devastating to children. Despite the improved prognosis, the course of cancer treatment has tremendous impact on children. This article aims to examine the impact of cancer on physical, emotional, and psychosocial well-being of Hong Kong Chinese children, an area of research that has been underrepresented in the literature. Ninety-eight Hong Kong Chinese children aged 7 to 15 years, admitted for treatment of cancer in 2 pediatric oncology units of 2 different hospitals, were invited to participate in the study. Findings from this study indicated that the children scored considerably high state anxiety on admission, and more than half of the participants presented some depressive symptoms during their stay in the hospital. Moreover, semistructured interviews indicated that nearly all children expressed different degrees of sadness and worry. The findings suggested that there is a room for improvement in existing nursing intervention regarding preparing children for hospitalization and treatment of cancer. There is an imperative need for nurses to evaluate appropriate nursing interventions that can help children resume their normal growth and development, in particular, to help them ease the physical, emotional, and psychological burden of life-threatening disease.

Effectiveness of an integrated adventure-based training and health education program in promoting regular physical activity among childhood cancer survivors

There is growing concern about declining levels of physical activity in childhood cancer survivors. This study aimed to examine the effectiveness of an integrated adventure‐based training and health education program in promoting changes in exercise behavior and enhancing the physical activity levels, self‐efficacy, and quality of life of Hong Kong Chinese childhood cancer survivors.

Coping strategies used by children hospitalized with cancer: an exploratory study

Objectives: The treatment of cancer is a stressful and threatening experience, particularly for children. Knowing how children cope with cancer is a crucial step toward designing appropriate psychological interventions that help them ease the burden of cancer treatment. The purpose of this study was to examine the coping strategies used by Chinese children hospitalized with cancer, an area of research that is under‐represented in the existing literature.

The impact of cancer on the physical, psychological and social well-being of childhood cancer survivors

PURPOSE Notwithstanding the advances in medical treatment, childhood cancer survivors are at risk of adverse physical, psychological and social effects of the cancer treatment. The purpose of this study was to examine the impact of cancer and its treatments on the physical, psychological and social well-being of Hong Kong Chinese childhood cancer survivors. METHOD A total of 137 childhood cancer survivors (aged 9-16 years), who had their medical follow-up in an oncology out-patient clinic were invited to participate in the study. Participants were asked to respond to the standardized measures of depressive symptoms and self-esteem. Additionally, 15 participants from the group were selected for a semi-structured interview. RESULTS The results revealed that more than half of the participants presented depressive symptoms. Results also found that the mean depressive symptom scores for childhood cancer survivors were statistically significant higher than those of school children without cancer (p = 0.01), while the mean self-esteem scores for the survivors were statistically significant lower (p < 0.01). Additionally, qualitative interviews indicated that cancer and its treatments have great impact on the daily life of childhood cancer survivors. CONCLUSION The study reveals that cancer and its treatments have a great impact on the physical, psychological and social well-being of survivors. It is essential for healthcare professionals to develop appropriate interventions with the aim of promoting physical, psychological and social well-being for these children. Most importantly, it is crucial to help them develop a positive view of the impact that the cancer experience has upon their lives.

Relationships Among Therapy-Related Symptoms, Depressive Symptoms, and Quality of Life in Chinese Children Hospitalized With Cancer: An Exploratory Study

Background: Recent advances in cancer screening and treatment have resulted in a decrease in mortality rates in children and adolescents. However, despite the improved prognosis, the course of cancer treatment continues to be a very stressful experience in the life of a child. Objectives: The objectives of the study were to assess the occurrence and severity of treatment-related symptoms manifested by children and adolescents undergoing active cancer treatment and to examine the relationships between therapy-related symptoms, depressive symptoms, and quality of life of these pediatric patients. Methods: A cross-sectional study design was used, and 135 Hong Kong Chinese children (9- to 16-year-olds) who were admitted for treatment of cancer in a pediatric oncology unit were invited to participate in the study. Results: Results indicated that children and adolescents receiving combined cancer treatment generally experienced greater symptom occurrence and severity. In addition, children reporting greater symptom occurrence and severity experienced higher levels of depression and a lower level of quality of life. The study revealed that therapy-related symptoms are a strong predictor of quality of life of children and adolescents hospitalized for cancer treatment. Conclusions: Cancer and its treatments significantly affect the psychosocial well-being and quality of life of children and adolescent hospitalized for cancer care. Therapy-related symptoms can be a useful indicator for screening those pediatric patients who are likely to exhibit psychosocial distress or are at high risk of depression. Implications for Practice: It is essential for nurses to be sensitive and knowledgeable about the therapy-related symptoms of cancer treatment and their effects on children and adolescents to promote the psychosocial well-being of these patients and enhance their quality of life.

A descriptive study of the psychosocial well-being and quality of life of childhood cancer survivors in Hong Kong

Background: Research indicates that increased survival rates are accompanied by an increase in associated psychosocial problems. Whereas much of the attention has focused on the physiological care of childhood cancer survivors, the consequences of cancer and its treatments on psychosocial well-being and quality of life remain relatively underexplored. Objective: The aim of this study was to describe the psychosocial well-being and quality of life of Hong Kong Chinese childhood cancer survivors. Methods: A cross-sectional study was used. A total of 137 childhood cancer survivors (9- to 16-year olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. Results: A significant number of childhood cancer survivors had low self-esteem and experienced high levels of depression. The study also indicated that greater symptoms of depression in childhood cancer survivors were associated with higher state anxiety, lower self-esteem, and poor quality of life. Conclusions: Cancer and its treatments can have adverse effects on the psychosocial well-being and quality of life of survivors. Implications for Practice: It is essential for nurses to develop and evaluate interventions with the aim of promoting psychosocial well-being and quality of life for childhood cancer survivors. Knowing the self-esteem and coping behavior of survivors can help design appropriate and effective psychosocial interventions to promote their psychosocial well-being.

The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors

Background: Research indicates that regular physical activity is associated with numerous physiological and psychological health benefits for childhood cancer survivors. A review of the literature reveals that no study has so far examined the physical activity levels and behavior of Hong Kong Chinese childhood cancer survivors, and how the cancer and its treatment affect the physical activity and other behavior of these children remains unclear. Objective: The aims of this study were to assess the physical activity levels of Hong Kong Chinese childhood cancer survivors and to explore the factors that affect their adherence to and maintenance of regular physical activity. Methods: A cross-sectional study was used. A total of 128 childhood cancer survivors (9–16-year-olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. Results: There was a significant decline in physical activity levels among childhood cancer survivors. Most of them did not take physical exercise regularly. Concern about academic performance, fatigue, and a decrease in physical strength and endurance after remission prevented them from engaging in regular physical activity. Conclusions: This study indicates that many childhood cancer survivors did not engage in regular physical activity and that they overlooked or underestimated its importance. Implications for Practice: It is essential for nurses to correct misconceptions about physical activity among childhood cancer survivors and their parents and, most importantly, to advocate the principle of regular physical activity for these children, with the aim of enhancing their physical and psychological well-being.

Predisposing Factors to the Quality of Life of Childhood Cancer Survivors

The aim of this study was to examine the predisposing factors to the quality of life of Hong Kong Chinese childhood cancer survivors. A cross-sectional study was conducted with 153 survivors (9-16 years of age) during follow-up at the oncology outpatient clinic. The study found that depressive symptoms are a strong predictor of quality of life in childhood cancer survivors and that systematic screening of this population is important. It is essential for health care professionals to develop, plan, and evaluate interventions with the aim of alleviating depressive symptoms for childhood cancer survivors so as to enhance their quality of life.

Effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of Hong Kong Chinese children hospitalized with cancer

PURPOSE. To examine the effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of children hospitalized with cancer. DESIGN AND METHODS. A nonequivalent control group design was employed. Children (8-16 years of age; n= 122) admitted to a pediatric oncology ward during a 14-month period were recruited. RESULTS. The results support the effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of children hospitalized with cancer. PRACTICE IMPLICATIONS. The results heighten the awareness in nurses of the importance of integrating play activities as an essential component of holistic and quality nursing care.

Sustainability of an Integrated Adventure-Based Training and Health Education Program to Enhance Quality of Life Among Chinese Childhood Cancer Survivors: A Randomized Controlled Trial.

Background: Physical activity is of paramount importance to enhance the quality of life of childhood cancer survivors. Objective: The objectives of this study were to examine the sustainability, feasibility, and acceptability of an adventure-based training and health education program in changing the exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors. Methods: A follow-up study (12 and 18 months) of a previous study was conducted. Participants in the experimental group (n = 33) joined a 4-day integrated adventure-based training and health education program. The control group (n = 36) received the standard medical care. Changes in exercise behavior, levels of physical activity, self-efficacy, and quality of life were assessed from the time of recruitment, and at 12 and 18 months after starting the intervention. Process evaluation was conducted to determine whether the program was feasible and acceptable to participants. Results: From baseline to 18 months after the intervention, the experimental group reported statistically significant differences in the stages of change in physical activity and higher levels of physical activity, self-efficacy, and quality of life than did the control group. The results of process evaluation revealed that the program was both feasible and acceptable to participants. Conclusions: The program was found to have substantial effects on enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors over at least 18 months. Implications for Practice: Healthcare professionals should consider adopting such programs to promote the regular physical activity among childhood cancer survivors.