| Summary: | 碩士 === 長庚大學 === 護理學研究所 === 96 === The purpose of this study was to explore the effect of individually tailored intervention in reducing uncertainty of parents whose child was newly diagnosed cancer. The study was a “quasi-experimental” design, including intervention group and control group. All of the participants were recruited from a pediatric oncology ward of one medical center in the northern Taiwan. In total, 25 parents were enrolled at intervention group and 76 parents who were selected from a longitudinal data set were served as control group. For parents at intervention program, data were collected at baseline (newly diagnosed within 2 days) and followed at post-intervention. Parents at control group were received the usual health care from the study setting. Parents at control program were only assessed within 1 month when the child was newly diagnosed, and this data were served as the post-intervention comparison with intervention group.
The intervention group was designed as “individually tailored program”, and proceeds as 1-month long. The components of the intervention program included: 1) establish trusting relationship; 2) provide the opportunity for parents to express their emotion; 3) detect questions that parents concerned; 4) design individually tailored intervention focused on parental concerns; 5) implement the intervention; 6) evaluate the responses of parents and then revised the content of the intervention; 7) continuously revise the content of the intervention and implement the intervention; 8) evaluation of the effectiveness of the intervention at end of the intervention.
“The Parent Perception of Uncertainty Scale: Chinese version, Short Form (PPUS_C_SF)” was used to assess parental uncertainty. The PPUS_C_SF included 4 subscales, including “Uncertainty-child’s illness”, “Uncertainty-parenting and disease diagnosis”, “Uncertainty-clarity of disease”, and “Caregiver dependability”. Chi-square test, paired t test, and independent t test were used to examine the effectiveness of the intervention.
The results of this study shown that the individually tailored intervention can significantly improve the score of the subscale “Uncertainty-parenting and disease diagnosis”. However, there was no difference on the subscale of “Caregiver dependability” between baseline and post-intervention assessment. Subscale “Uncertainty-child’s illness” appears children’s illness itself is the major cause of uncertainty for these parents. Especially the changeful symptom is far beyond parents’ control which might pose impact and so does the high degree uncertainty occur. Constantly, receiving any message from doctor does also induce the uncertainty for parents with newly diagnosed cancer children.
Overall, the study shows individually tailored intervention is benefit to the parents with cancer children in terms of ease their uncertainty. There are two suggestions for future pediatric nursing: (1)To develop the pediatric oncology assessment along with guideline and clinical caring trail for the parents ever since their children are diagnosed as cancer diseases. (2)To add a Nursing Specialist who can focus on specific health education. This is not only to promote the effectiveness of the caring but also to ensure the quality of the nursing care. The initiative study can establish evidence base to further related researches.
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