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Assessment tools and physical therapy intervention for chemotherapy induced peripheral neuropathy in pediatric cancer patients
Votrubová, Barbora ; Jevič, Filip (advisor) ; Medunová, Kateřina (referee)
This bachelor thesis aims to provide a general overview of chemotherapy induced peripheral neuropathy (CIPN) in pediatric cancer patients. The first part describes common characteristics of polyneuropathy and specific attributes of CIPN, its incidence, clinical manifestation, risk factors and summary of most frequently used chemotherapy agents causing peripheral neuropathy. The second part reports current assessment strategies for CIPN based on clinical grading scales and then it reports present knowledge of rehabilitation interventions for patients with CIPN. The thesis also includes description and translation of "pediatric-modified Total Neuropathy Score" (ped-mTNS) and "Total Neuropathy Scale-Pediatric Vincristine" (TNS- PV). In discussion part, there are summarized both advantages and disadvantages of CIPN testing systems. The TNS-PV was concluded as the most feasible scale for use in rehabilitation or oncology clinic settings.
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Nutrition of children and adolescents with cancer
VLKOVÁ, Lucie
Diagnosis and treatment of these diseases are still significantly improving and it turns out that nutrition is a significant part of the outcome. But it can be sometimes difficult or even impossible for the patient to follow dietary guidelines. It's possible that patients can have problems with food intake, their taste can alter altogether, or some food can even raise the need to vomit. Furthermore, food doesn't fulfill just biological needs, but it's a significant for psychological needs, too. It's therefore necessary to look at this issue from broader point of view.The aim of this thesis was to describe the composition and serving methods of nutritious meals in various stages of treatment of children and adolescents with cancer, and to map the experiences as well as view of young patients, their families and their nursing staff on whether and how it is possible to meet the nutritional recommendations while satisfying taste preferences of children. I was looking for answers to two research questions: 1. How has the method of service and the composition of diet been changing throughout the treatment in order to maintain sufficient nutrition? 2. What are the views of young patients, their parents and their attending physicians on the possibilities of maintaining nutritional recommendations? The text is divided into two parts: theory and research. The theoretical part describes the Pediatric Oncology issues and the most common types of cancer in young patients, it also mentions the possibilities of prevention. Then this part deals with side effects of cancer therapy, changes in metabolism, malnutrition, cancer cachexia and anorexia. The biggest part is devoted to nutrition nutritional status assessment, nutritional needs and forms of nutritional support. The last section contains recommendations for situations with food intake complications and the ways of increasing the nutritional contents of diet. Due to complexity of the topic I chose a mixed research strategy, several different methods of collecting and processing of data as well as questioning of various groups of respondents. I was observing 45 oncology patients children and adolescents aged 4 to 18, who are undergoing treatment at the Clinic of Pediatric Oncology in Brno, their parents (7) and their nursing staff (2). The data processing method was qualitative and quantitative analysis of questionnaire responses, interviews content analysis, observation, creation of case study, calculations of menus from the program "Nutriservis Profesional". Results are presented in graphs, tables and plain text. It's divided into three subsections. The composition and method of serving the nutritional meals depends on the needs of patients, their age, diagnosis, treatment and complications, which occur in the course of treatment. It also depends on the cooperation of patients themselves and their families. Different approach is with adolescent patients and with children as well as when they're treated at home or in the hospital. At some stages it is necessary to adjust the nutritional diet to have an adequate nutrition, at other stages the nutritional support is in sipping and when there are complications, which accompany the treatment, the method of service is changed into oral, by probe, or parenterally. Keeping of dietary recommendations represent a significant problem for these patients, which are troubles with food intake during the treatment (95% of patients). Due to children's taste preferences are some forms of nutritional support rejected, even though they are able to maintain the nutritional recommendations. Both young patients as well as their parents have preference for children's taste rather than nutrition. There were some exceptions, however. Opinions of the nursing staff are the same it all depends on the attitude of patients themselves and their families.
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Biological and Social Reguirements of Oncological Treated Child
ŘÁDKOVÁ, Klára
The theory portion of the thesis is dedicated to the issue of cancer during childhood. The first chapter concentrates on possible causes for the genesis of the oncological disease in children. It also describes the kinds and types of children's tuber. The next chapter focuses on the developmental psychology of a child from birth through adolescence. The thesis is focused on children's vital needs so the chapter describes biological, mental and social needs. The chapter which deals with the socialisation of a child, describes the reintegration of him/her into society, specifically resocialisation and the importance of the child's interpersonal relationships after oncological treatment. Social worker's role in the department of the children's oncology is divided into communication with a child and with his family and to benefits for peole with disabilities. The final chapter of the theory portion of the thesis describes organisations which care for children who are treated for oncological disease. The aim of the practical part of the thesis is to propose possible changes in satisfying children's needs during oncological treatment. Qualitative research for picking data is chosen in view of the aim and focus of the thesis, this research enables deeper exploration of the given issues. Questioning and technique of half structured interview are chosen as methods of research. The diagram of the questions which are prepared in advance is composed of the fields of children's biological, mental and social needs, these children are oncological patients in Clinic of children's oncology in Brno. A method of repetitive pattern called gestalts is chosen for an analysis of discovered data. Six children's patients, who were intentionally selected in Clinic of children's oncology in Brno, form a research complex. Parents are engaged into the research due to addition of children's answers and they answer a range of questions about themselves. The results of the practical part of the thesis shows that the influence of cancer treatment leads to a greater or lesser changes in satisfying the living needs of children. Side effects of the oncological treatment include absence of appetite, sickness or fatigue and make day to day life difficult. Experience and perception of cancer treated children go through the ordeal and many changes, from which it is necessary to set out first of all the positives that indicate to children. Child's oncological treatment has an impact on relationships within a family. Relationship between five children and their parents has been already consolidated during treatment. In looking at six siblings relationships, it was noted that three of them became stronger, however two children became alienated from their siblings. Relating to relationships between these children and their classmates no negative response showed up, they were supported by a class. In regards to relationships between friends, children did not lose contact with them, their friends supported them and keep in touch with them by means such as the Internet, letters or visits. The results show that awareness about social benefits and assistance options is very satisfying. A social coordinator provides high-quality counseling and support for children and their parents. The thesis confirmed the fact that issues related to oncological treatment bring a lot of changes in the field of child's vital needs. The thesis could serve parents whose children become ill and it could serve as a valuable source of information for others who know a child who is fighting oncological disease.
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The usage of color modification of Wartegg´s drawing test by carcinogig patients
BUZKOVÁ, Adéla
The Bachelor thesis is focused on the usage of color modifications of Wartegg´s drawing test by the patients with oncologic diagnosis. The theoretical part provides the information based on the analysis of scientific literature about projective techniques and their dividing. The key part of the theoretical part is then the description of Wartegg´s drawing test and its color modifications. Another part is focused on pediatric oncology, especially on the psychosocial issue of adolescent cancer patients. The empirical part aims to identify and describe the typical elements occuring in the processing of the color modification of Wartegg´s drawing test by childhood cancer patients. The method is the qualitative analysis of acquired drawings. The results of the research group are then compared with the control group.
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