1Postgraduated in Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2Instructor of Nursing, Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
3Associate professor of Pediatric Hematology and Oncology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4Assistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
5Instructor of Nursing, Department of Medical Emergency, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Inflammation of the oral mucosa is a common and debilitating complication of chemotherapy that is preventable and manageable following health advices. Empowering the primary caregiver can be helpful in management of this condition. Aim: To determine the effect of empowering the caregivers on preventing inflammation of oral mucosa in children with cancer undergoing chemotherapy. Methods: This non-randomized clinical trial was conducted in 60 children's caregivers aged between 3 and 18 years old undergoing chemotherapy in Sheikh Hospital of Mashhad in two groups of intervention and control. In the intervention group, training was based on clinical guide in 5 sessions and according to Gibson empowerment model in 4 steps. Data were gathered based on questionnaire of side effects of chemotherapy and adherence questionnaire of the prevention and treatment of mouth ulcers in three stages: the first, the sixth and the 12th week of intervention. For data analysis, SPSS version 18 and paired and independent t-tests, Spearman correlation coefficient and the Mann-Whitney tests were used. Results: 61.7% of the patients were men and 38.3 were women. The average ages of the children and caregivers were 5/6±3/2 and 32/1±8/1 years, respectively. The average adherence to prevention recommendations for oral ulcers in the empowerment group increased from 53/6±24/3 to 82/2±11/7 (p<0.001). The occurrence rate of mouth ulcers in the empowerment group in the first week of intervention was 1/8±1/1, in the sixth week 1/7±1/0, and in the twelfth week of treatment was 1/1±0/2 (p<0/001). Conclusion: The empowerment program can help the main caregiver to discover and use critical thinking skills, enhance their ability and increase adherence, which results in decrease of mouth ulcers in children undergoing chemotherapy.
Kashani FL, SHahram V, SHervin G, Mosavi M, Hashemeie M. Effectiveness of Spiritual Interventions on Quality of Life of Mothers of Children with Cancer. Feghhe pezashki. 2001; 4(11):125-49. (Persian)
Mosavi-Jarrahi A, Moini M, Mohagheghi MA, Alebouyeh M, Yazdizadeh B, Shahabian A, et al. Clustering of Childhood Cancer in the Inner City of Tehran Metropolitan Area: a GIS-based Analysis. International Journal of Hygiene and Environmental Health. 2007; 210(2):9-113. (Persian)
Willis J. Patient Compliance: Non Compliance with Treatment Regimes and Failure to Follow Health Advise is Widespread. Nurs Times. 2000; 96(35):36-7.
Kondryn H, Edmondso C, Hill J, Eden T. Treatment Non-Adherence in Teenage and Young Adult Patients with Cancer. Lancet Oncol. 2009; 12(1):100-8.
Billan N, GHafari S. The Role of Training and Regular Follow-up to Increase Adherence with Inhaled Corticosteroids in Children with Mild to Moderate Persistent Asthma. Medical Journal of Tabriz University of Medical Sciences. 2008; 30(4):17-20.
Harris D, Eilers J, Harriman A, Cashavelly B, Maxwell C. Evidence-Based Interventions for the Manangment of Oral Mucositis. Clin J oncol Nurs. 2008; 12:141-52.
Stakman M, Spijkeret F, Boezen H, Schouten J, Roodenburg J, Vrise E. Preventive Intervention Possibilities in Radiotherapy and Chemotherapy Induced Oral Mucositis: Results of Meta Analyses. J Dent Res 2006; 85:690-700.
Rahimi SH, Fadakar G, Kazemnejad E. Evaluation of Relationship between Public Health and Quality of Life of Mothers of Children with Cancer. Hayat. 2013; 19(2):93-108. (Persian)
Eimani Z, Rayani M, Borhani F, Dortaj S. Effect of Empowerment on Attitudes Toward the Disease in Patients with Type I Diabetes. Journal of Nursing and Midwifery, Kerman. 2010. 1-8: (10)8. 20-1. (Persian)
Farahani b, Safavi M, Salehi S. Effect of Patient Care, Education, Knowledge, Knowing, Understanding and Application of Caregivers of Cancer Patients Under Chemotherapy Referring to the University Hospitals of Tehran University of Medical Sciences in 1999. Medical Science Journal of Islamic Azad University. 2004; 2(14):99-103. (Persian)
Dalvand H, Rassafiani M, Bagheri H. Family Centered Approach: A Literature Review Scientific Journal Rehabilitation New, Faculty of Rehabilitation, Tehran University 2014; 8(1):1-9. (Persian)
Gibson CH. The Process of Empowerment in Mothers of Chronically Ill Children. J Adv Nurs. 1995; 21:1201-10.
Palapirom R, Prasopkittikun T, Vichitsukon K. Effects of an Empowerment Program on Mothers’ Self Efficacy in the Care of Children with Developmental Delays. J Nurs Sci. 2010; 28(4):68-75.
Vashani HB, Zohoreian Z, Badiei Z, Sarafeshirazi A. Effect of Evidence-Based Care with Ice Therapy on Oral Mucosal Inflammation Children Undergoing Chemotherapy. Journal of Sabzevar University of Medical Sciences. 2011; 18(4):250-9. (Persian)
Office CN. Booklet Series Offers Up-to-Date, Easy-to-Read Information on the Latest Treatments, Managing Side Effects, and Coping with Cancer: http://www.cancercare.org.pdf.
Society AC. Caring for the Patient with Cancer at Home: A Guide for Patients and Families: http://www.cancer.org/treatment/index.
Pereira-Pinto L, Souza L, Gordon-Nunez M, Soares R, Birto-Costa E, Aquino A, et al. Prevention of Oral Lesions in Children with Acute Lymphoblastic Leukemia Int. J Pediatr Otorhinolaryngol 2006;70(11):1847-51.
Bonnaure-Mallet M, Bunetel L, Tricot-Doleux S, Guerin J, Bergeron C, LeGall E. Oral Complications during Treatment of Malignant Diseases in Childhood: Effects of Tooth Brushing. Eur J Cancer Care 1998; 34(10):1588-98.
Djuric M, Hillier-Kolarow V, Belic A, Jankovic L. Mucositis Prevention by Improved Dental Care in Acute Leukemia Patients. Support Care Cancer 2006; 14:137-46.
Wansa S, Nongluk Ch, Pornsri S, Wanida S. The Effects of an Empowerment Program on the Competence of Caregivers in Caring for Preschool Children with Acute Leukemia Undergoing Chemotherapy. J Nurs Sci. 2009; 27(2):17-8.
Kanjana A. The Effects of Empowerment Program on Maternal Caring Behavior for Children with Leukemia Undergoing Chemotherapy: Mahidol University 2006.
Chung Y-C, Hwang H, editors. Education for Homecare Patients with Leukemia Following a Cycle of Chemotherapy: An Exploratory Pilot Study. Oncology nursing Forum; 2008.
Partovi S, Banihashem A, Farshidi F. Prevalence of Gastrointestinal Side Effects of Chemotherapy in Children with Leukemia. Iranian Journal of Pediatrics 2013; 2(14):89-124. (Persian)
Little J, Falace D, Miller C, Rhodus N. Dental Management of Medically Compromised Patients. New York: Elsevier, Mosby; 2008.