Graduation Year

2007

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Nursing

Major Professor

Susan C. McMillan, Ph.D.

Keywords

Children, Cancer, Distress, Job satisfaction, Nursing interventions

Abstract

A primary function of the pediatric oncology nurse is to provide symptom management to children with cancer. Symptom management strategies have been published, but there is scarce literature examining neither the actual use of these nursing interventions, nor the effects of using these interventions on the nurses' perceived work environment. The purpose of this study was to examine the nursing interventions used in treating pediatric oncology patients' symptoms, as well as the emotional sequelae from providing this care. Phase One of this study examined the content validity of the newly developed Nurses Distress and Interventions for Symptoms Survey (NDISS) utilizing content experts. Phase Two of this study involved both the reliability testing of the NDISS by test-retest and served as a pilot for Phase Three.

In Phase Three, a national sample of pediatric oncology nurses was surveyed about their patients' symptoms, the nurses' distress from the symptoms, the nursing interventions used to treat the symptoms, the perceived efficacy of the nursing interventions, and their job satisfaction. The response rate was 53%, and analysis of study hypotheses were evaluated using Pearson's correlation and multiple regression analyses. The main study variables were not related in the hypothesized direction; therefore four of the six hypotheses were not supported. However, quantity and perceived effectiveness of nursing interventions were both found to act as mediators in the study model, and as a result, these two hypotheses were retained.

The results of the survey demonstrated a high frequency of distressing patient symptoms as perceived by nurses (mean 6, range 0-7); nurses rated their distress from these symptoms as moderate (mean 2.9, range 0-4); nurses used an average of 12.7 nursing interventions per symptom (range 0-38); nurses found the nursing interventions moderately effective (mean 2.5, range 0-4); and nurses had moderately high overall job satisfaction (mean 3.9, range 1-5). Although many of the hypotheses were not supported, interesting trends in the data were found. In addition, the findings provided elucidation of specific nursing interventions used by pediatric oncology nurses as well as a description of the effects of providing patients' symptom management, including nurses' distress, perceived effectiveness of nursing interventions, and job satisfaction.

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