Leukemia Children: Chemotherapy-Related Side Effects and Caring Needs

Abstract

The purpose of this study is to understand chemotherapy- related side effects and caring needs for children with ALL under TPOG-882 therapeutic regimens in the induction and consolidation phases. Fifteen children with ALL in a teaching hospital served as the sample for this study. Children were divided into two groups, a standard risk group (SR), and a high risk group (HR), based on the risk factors and placed on the different therapeutic regimens. The data were generated from nurses’ prospective close observation in the natural caring setting for each child, laboratory data and medical record. The collected data were categorized and statistically analyzed. The results show that chemotherapy-related side effects were multifaceted and invasive in nature, including changes in body functions and body appearances. It is also found that under the particular therapeutic regimens, the second and the third weeks were the crucial time for children during the treatment course. During this period WBC, HB, and platelet reached their lowest level, while side effects on body functions gained peak scores. An another important finding is that 50 % of children in the high risk had infection. Infected HR had higher scores of side effects on body functions than uninfected HR and SR groups. The findings stressed the importance of the nurse’s role and function in taking care for children to prevent infection, To relieve symptoms, promote and maintain comfort besides the skills of close observation and emotional support. Team approach is also emphasized. 本研究之目的在於探討 急性淋巴性白血病兒童接受TPOG -882化學治療方案時在誘導期及鞏固期副作用之發 生情形及其護理需求。15位病童當中，有5位是屬標準危險群，10位是屬於高危險群 。資料的收集係在一教學醫院，由病童之主護護士在自然的情況下，一方面照顧病童 ，一方面將每日觀察到的副作用逐日紀錄。並將檢驗結果及與母親之面談作成紀錄。 再根據紀錄加以整理，歸類並分析之。所得結果顯示，化學治療過程中，副作用之發 生是多方面且具侵入性的，包括造血功能的抑制，身體功能之改變及外表的改變。化 學治療後第二週及第三週，白血球、血色素、血小板之數據進入低谷期，副作用之積 分達高峰時，是為治療過程之危險期。另外，高危險群感染組有較高之副作用發生， 這段期間，護理人員極需要密切觀察病童各項副作用之發生，更需採取各項措施以預 防感染之發生，減輕各項不適之症狀，以協助病童順利度過危險期。本研究之結果強 調。越是高度醫療科技之使用，越需要護理人員積極的參與照護及醫院行政與其他醫 事人員之配合，使得病童不但能獲得高科技之好處，亦能受到人性化的關懷與照護。