The Sake Of Growth Nursing Essay

INTRODUCTION

BACKGROUND OF THE STUDY

"Growth for the Sake of Growth is the Ideology of the Cancer Cell.."

-Edward Abbey

Childhood cancer always comes as biggest heartbreaking shock to the family. Childhood cancer is treated uncompromisingly, often with a amalgamation of chemotherapy, radiation, and surgery, at a time of life when bodies are growing and developing. Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death. Cancer is treated with surgery, radiation, chemotherapy, hormone therapy, biological therapy, and targeted therapy.

The World Health Organization reports that the distribution of cases of death among children under 5 years around 150 per100, 000 populations who have died with cancer in the past year. Childhood cancer is the second leading causes of death globally among children under 15 years of age is causing 11.9% of deaths.

The World Health Organization reports that in India the distribution of cases of death among children under 5 around 108 per100, 000 populations are dying with cancer. The below 15 years children may estimate 12,060 in numbers however taking almost care 80% survive by 5 years & above. "Surviving Childhood Cancer" In spite of advanced medical care, is still causing second leading cause of death, it is expected that around 1,340 children to lose their lives in 2012.

The World Health Organization reports that in South-East Asian Region the distribution of cases of death among children under 5 years around 125 per100,000 population are dying with cancer.

The newspaper reports states that one in every 10,000 children in India is affected by cancer. According to statistics, 1.6 to 4.8 of all cancer cases reported in the country is among children below 15 years of age. On the occasion of international childhood cancer day, on February 15, experts from the city speak about childhood cancer and treatments available. In India the reported incidences of childhood cancer have increased over the last 25 years (The Hindu, Feb 2012)

The reports on childhood cancer in India states that around 1.68-1.48% are suffering from the disease. Among them 70% of them lives in villages and they have relatively less. (Arora R.S, 2010)

The Global Survey reports states that the number of childhood cancer exceeds 200,000 and more than 80% are from the developing countries. In United States approximately 10,400 children under age 15 were diagnosed with cancer and about 1,545 children had died due to cancer. which makes cancer the leading cause of death in children 1 to 14 years of age. (Global Survey On Childhood Cancer , 2007)

The report states that although significant advances have been made, unfortunately chemotherapy affects other parts of the body. Common side effects from chemotherapy include pain, diarrhea, constipation, mouth sores, hair loss, nausea, vomiting (National Cancer Institute, 2007)

The problem which the cancer children face physically are unexplained weight loss, headaches, early morning vomiting ,increased swelling or persistent pain in the bones, joints, back or legs, lump or mass in the abdomen, neck, chest, pelvic or armpit region. Development of excessivebruishing,bleeding,rash,infections,nausea,vomitting,constant tiredness, paleness, eye or vision changes and recurrent or persistent fever, even psychological issues which lead to psychological problems. Worries can be about developing new health problems, feeling of resentment, discrimination, depression, loneliness, etc.,

Caregivers are taking more responsibility for providing care for children with cancer caregivers have become important members of the health care team they have to cope with a wide range of physical, emotional and social consequences of the diseases. Health professionals are now rely on the family caregivers to manage medications, help to control symptoms and side effects apart from providing support send guidance. The health educators should care for the child with COPE,

C for creativity

O for optimism

P for planning

E for expert opinion

Orderly and systematic plan such as 1.getting the facts 2.reviewing what you can do, 3.decide on the best strategy 4.consider obstacles 5. Carry out and adjust your plan. Problems are easier to solve when they are just starting and early intervention can often prevent problems from becoming serious.

SIGNIFICANCE AND NEED FOR THE STUDY

Cancer cell growth is different from normal cell growth. cancer cells can also invade other tissues, something that normal cells cannot do. Supportive care treatment of disease side effects or symptoms from various members of health care team, including dieticians and child life therapists can make nutritional aspects of treatment less difficult. Making tasty high calories snacks and possible alternative to oral nutrition are part of supportive care. Giving care to cancer children is a sense of satisfaction and confidence. Families who give care often feel closer to each other and to the young person who is ill. The ultimate goal of nursing care is to ensure the child's comfort, safety and prevent complications.

As there is a transition of children from hospital to home setting the caregivers who were depending on the health care professionals are unable to cope with giving care at home. Hence education is a must for caregivers.

Cancer treatments often go on for months and then must be resumed if the disease comes back. As a result, younger persons with cancer and their families must be prepared to cope with a wide range of physical, emotional, and social consequences of the disease and treatments for extended periods of time. In addition, as time in the hospital is shortened and as more and more treatments are given in the clinic, family caregivers are taking on more responsibility for providing care.

As a result, younger persons with cancer and their families must be prepared to cope with a wide range of physical, emotional, and social consequences of the disease and treatments for extended periods of time. In addition, as time in the hospital is shortened and as more and more treatments are given in the clinic, family caregivers are taking on more responsibility for providing care. Health professional assumes that, they can rely on caregiver of children to give care, provide support and encouragement to the young children with cancer, and also to manage medications, control symptoms and side effects, diet therapy, improve physical activity and report problems that require professional intervention.

Hansson H; et al., (2012) conducted a descriptive study to assess the experience of a hospital based home care programs in the families of children with cancer in Denmark. After 4 month program findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. It enhanced their quality of life during child's cancer trajectory.

Schmieglow K, et al., (2011) conducted a descriptive study to reviewed five studies to evaluate the potential effects of hospital based home care for children with cancer. It is widely applied in pediatric oncology. The studies that indicate hospital based home care for children is feasible and carries no crucial negative effects for children with cancer.

As the investigator specialized in pediatric nursing and during the postings at pediatric oncology ward, saw many children suffering with cancer and their parents who were anxious because they didn't know how to support their child after discharge from the wards. So, this made the investigator to choose this research study. Hence the investigator wanted to develop a homecare management to guide and support the caregivers of children with cancer at home.

STATEMENT OF THE PROBLEM

A pre experimental study to assess the effectiveness of multimedia package on knowledge and attitude regarding homecare management for cancer among caregivers of children with cancer at selected hospital, Chennai.

OBJECTIVES

To assess the pre test level of knowledge and attitude regarding homecare management for cancer among caregiver of children with cancer.

To evaluate the effectiveness of homecare management on level of knowledge and attitude regarding homecare management for cancer among caregiver of children with cancer.

To correlate the mean differed knowledge score with attitude score regarding homecare management for cancer among caregiver of children with cancer.

To associate the mean differed level of knowledge and attitude score with selected demographic variables.

OPERATIONAL DEFINITION

EFFECTIVENESS

It refers to the change in knowledge and attitude regarding home care management for cancer among caregivers of children with cancer which is assessed by structured questionnaire and 4 point likert scale devised by the investigator.

MULTIMEDIA PACKAGE ON HOMECARE MANAGEMENT

It refers to the information package regarding homecare management for cancer devised by the investigator and includes information,

Diet therapy, Physical activity, Side-effects of various therapies and Infection control measures for children with cancer which is communicated using Lecture & Pamphlets .

Infection control measures and Diet therapy for children with cancer is educated using Video clipping

Physical activity for children with cancer is demonstrated by the investigator.

KNOWLEDGE

It refers to the questions understanding and ability of the caregiver of children with cancer to answer regarding homecare management which is assessed by using structured questionnaire

ATTITUDE

It refers to an expressed beliefs and ideas of caregiver of children with cancer on homecare management which is assessed by using 4 point likert scale.

CARE GIVER OF CHILDREN WITH CANCER

It refers to the significant caretaker who takes care of the children under 12 years of age diagnosed with cancer and living with disease for about 0-3 years.

ASSUMPTION

Caregiver of children with cancer may have some knowledge regarding homecare management for cancer.

Enhanced knowledge may create a positive attitude towards home care management for cancer among caregiver of children with cancer.

NULL HYPOTHESIS

NH 1: There is no significant difference in the pre & post test level of knowledge and attitude regarding homecare management for cancer among caregiver of children with cancer.

NH 2: There is no significant relationship between pre and post test level of knowledge with attitude regarding homecare management for cancer among caregiver of children with cancer.

NH 3: There is no significant association of the mean differed knowledge score and attitude score with selected demographic variables among caregiver of children with cancer.

DELIMITATION

The study is delimited to a period of 4 weeks.

CONCEPTUAL FRAMEWORK

The study is based on modified J.W kenny's open system model (1999).

The researcher adopted Kenny's open system model for conceptual framework. This theory was introduced by Jennet W. Kenny. She was born in the year 1946 at Scotland. The open system model was formulated in the year 1999.The open system enumerates various aspects of system and interaction. She formulated various theories based on management.

The researcher applied Kenny's open system model in order to assess the effectiveness of multimedia package regarding home care management for cancer among caregivers of children with cancer. This involves interaction between the researcher and the caregiver of children with cancer.

An open system is a system which continuously interacts with its environment. The interaction can take the form of information, energy or material transfers into or out of the system boundary, depending on the discipline which defines the concept. An open system should be contrasted with the concept of an isolated system which exchanges neither energy and matter nor information with its environment.

Open system theory is useful in breaking the whole process into sequential tasks to ensure goal realization. The three major aspects of the systems are:

Input

Throughput

Output

Input is any type of information, energy and material that enters the systems from environment through its boundaries. In this study it refers to pre assessment of knowledge regarding home care management of caregivers of children with cancer by using structured questionnaire and obtaining demographic variables from the caregivers of children with cancer.

Throughput is that any information, energy or material that is given to the caregivers of children with cancer on multimedia package which includes diet therapy, physical activity, side effects of various therapy, infection control measures in the system boundaries. In this study, the process includes the transformation of knowledge regarding home care management for cancer to the caregivers of children with cancer.

Output is the information that leave the system, enters the environment through the system. In this study it refers to improved level of knowledge either adequate, moderately adequate or inadequate level of knowledge after structured teaching program among caregivers of children with cancer. In this study, output is measured with structured questionnaire and 4 point likert scale.

The feedback for the system depends on the output which is either may be reinforcement or enhancement