Evaluation of a nurse-led management program to complement the treatment of adolescent acute lymphoblastic leukemia patients |
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| Institution: | 1. Department of Pediatrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China;2. Department of Hematology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China;1. Pediatric Blood and Marrow Transplantation Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland;2. Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Blood and Marrow Transplantation Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland;1. Department of Pediatric Surgery, McGovern Medical School, Houston, TX;2. Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School, Houston, TX;3. Division of Pediatrics, Children''s Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, TX;4. Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX;1. Department of Pediatric Surgery, McGovern Medical School, Houston, TX;2. Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School, Houston, TX;3. Division of Pediatrics, Children''s Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, TX;4. Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX |
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| Abstract: | PurposeTo evaluate a nurse-led management model of adolescent acute lymphoblastic leukemia (ALL) patients and improve their psychological care and quality of life.MethodsSeventy-three adolescent ALL patients participated in an open, controlled clinical trial and were randomized into a nurse-led management model group (n = 36) and a doctor-led management model group (n = 37). Two assessment questionnaires were administered to assess and compare the 2 models during a 1.5-year follow-up period: the hospital anxiety and depression scale (HADS) questionnaire was administered at 6 different time points, and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) at 3 different time points.ResultsThere were no differences in anxiety and depression between the groups according to the first-administered questionnaire (the mean anxiety and depression scores of the nurse-led group were 14.2 ± 4.1 and 10.8 ± 2.7, respectively; those of the doctor-led group were 13.8 ± 3.8 and 10.6 ± 2.2, respectively). However, repeated measures analysis of variance detected differences in subsequent HADS-based scores as a function of time between the 2 groups (p < 0.05). Moreover, the Holm–Sidak's multiple comparisons tests showed that patients of the nurse-led group had significantly decreased mean anxiety scores compared to those in the doctor-led group at the third and subsequent sessions, as well as in mean depression scores from the second session onwards (all p < 0.05). According to the last-administered EORTC QLQ-C30 questionnaire, there were statistical differences in cognitive, emotional, social, and quality of life scales between the 2 groups (all p < 0.05), but not in role and physical scales (all p > 0.05).ConclusionsIt is necessary to offer unique cognitive, psychological, and behavioral management models to adolescent ALL patients that are tailored toward their age group. Strengthening such management is more conducive to alleviating or even reversing psychological problems, and to improving patients' quality of life while ensuring complication-free follow-up periods. |
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