Abstract

Session presented on: Tuesday, July 23, 2013:

Purpose: In 2007, a comprehensive nursing program was implemented at the National Pediatric Oncology Unit in Guatemala to improve the quality of nursing care. Twenty-four new nursing positions were created, decreasing nurse patient ratio from 1:7 to 1:5, and a full-time nurse educator was hired to provide pediatric oncology education. In addition, processes were established to improve 20 nursing quality standards. The purpose of this study was to assess the program's impact on treatment abandonment in children with cancer. Treatment abandonment is a critical problem in developing countries and a leading cause of death for children with cancer.

Methods: Pre-program (January 2004-December 2006) cumulative incidence (CIN) of treatment abandonment was compared to post-program CIN (January 2007 to October 2008) at the intervention site (Guatemala) and to a control site in which no new nursing interventions were implemented during the study period. The sample included 1,936 patients diagnosed with cancer during study period.

Results: Pre-program CIN of treatment abandonment for the intervention site (10.2 - 1.2) was significantly higher (p = .045) than post-program CIN (6.5 - 1.3). Post- program CIN of treatment abandonment for the intervention site (6.5 - 1.3) was significantly lower (p = 0.0003) than post-program CIN for the control site (14.7 - 2.7).

Conclusion: Significant improvement in the CIN of treatment abandonment within the intervention site and as compared to the control site was found. Several factors may have contributed to the study's findings. Well educated nurses are better able to provide parents with insight regarding the need to continue therapy, and the improved nurse-patient ratio allowed more time for nurses to provide individualized parent education. In developing countries, abandonment is seen as the primary domain of psychologists and social workers. A combined effort of nursing and psychosocial intervention may be the best option for preventing abandonment.

Author Details

Sara W. Day, PhD, RN; Rita M. Carty, DNSc, RN, FAAN; Leslie McKeon, RN, PhD

Sigma Membership

Unknown

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Clinical Outcomes, Developing Countries, Quality Nursing Care

Conference Name

24th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Prague, Czech Republic

Conference Year

2013

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Impact of the Guatemalan nursing program on treatment abandonment in children with cancer

Prague, Czech Republic

Session presented on: Tuesday, July 23, 2013:

Purpose: In 2007, a comprehensive nursing program was implemented at the National Pediatric Oncology Unit in Guatemala to improve the quality of nursing care. Twenty-four new nursing positions were created, decreasing nurse patient ratio from 1:7 to 1:5, and a full-time nurse educator was hired to provide pediatric oncology education. In addition, processes were established to improve 20 nursing quality standards. The purpose of this study was to assess the program's impact on treatment abandonment in children with cancer. Treatment abandonment is a critical problem in developing countries and a leading cause of death for children with cancer.

Methods: Pre-program (January 2004-December 2006) cumulative incidence (CIN) of treatment abandonment was compared to post-program CIN (January 2007 to October 2008) at the intervention site (Guatemala) and to a control site in which no new nursing interventions were implemented during the study period. The sample included 1,936 patients diagnosed with cancer during study period.

Results: Pre-program CIN of treatment abandonment for the intervention site (10.2 - 1.2) was significantly higher (p = .045) than post-program CIN (6.5 - 1.3). Post- program CIN of treatment abandonment for the intervention site (6.5 - 1.3) was significantly lower (p = 0.0003) than post-program CIN for the control site (14.7 - 2.7).

Conclusion: Significant improvement in the CIN of treatment abandonment within the intervention site and as compared to the control site was found. Several factors may have contributed to the study's findings. Well educated nurses are better able to provide parents with insight regarding the need to continue therapy, and the improved nurse-patient ratio allowed more time for nurses to provide individualized parent education. In developing countries, abandonment is seen as the primary domain of psychologists and social workers. A combined effort of nursing and psychosocial intervention may be the best option for preventing abandonment.