Acute lymphoblastic leukemia in children: NANDA, NIC-NOC care-givers intervention

Abstract

Background and objective: Childhood cancer is now considered a chronic cancer, and thanks to technological advances, survival has increased. Childhood cancer affects patients younger than 15 years. Acute lymphoblastic leukemia (ALL) is among the four primary causes of cancer-related mortality worldwide. ALL is a source of great concern, fear, and guilt for the caregiver due to the lack of knowledge regarding its complications and how to properly care for a child with this disease, highlighting the importance of caregiver education. An educational intervention was carried out according to the Nursing Interventions Classification (NIC): Teaching: Group intervention and based in the North American Nursing Diagnosis Association, Diagnostic: Disposition toward improving knowledge. To identify this program was named Acute Leukemia Program (Programa Leucemia Aguda “P-LEA”). The objective of this study was to analyze the effectiveness of group educational intervention in improving caregivers knowledge of the care of the child with ALL.

Methods: A pre-experimental study with a pre-test/post-test group was performed in which a pre-intervention questionnaire and two post-intervention questionnaires at the time of intervention and one month following were administered. These questionnaires measured the level of caregiver knowledge (n = 30; 80% mothers, 7% fathers and 3.3% siblings). The results were based on the Nursing Outcomes Classification (NOC) labels (“management of the cancer”, “disease process”), in the following indicators: “disease process”; “precautions for preventing treatment complications”, and “adverse effects of the medication”. The scores varied from zero to six (no knowledge) to > 25 (extensive knowledge). Caregiver interest in learning was also evaluated using an affective learning instrument based on Patricia Potter’s theoretical contribution.

Results: The mean level of knowledge prior to intervention was 16.63 (SD 3.6). The mean level immediately following intervention was 25.53 (SD 1.9). The mean one month following was 25.2 (SD 4.9), with 29 degrees of freedom (p = .000).

Conclusions: The group instructional intervention (NIC) “P-LEA” based on NANDA and NOC-NIC helps caregivers learn about the care of children with ALL.