Discussion or Conclusions: Age 20's patients have many varieties distress not only physical and psychological and psychosocial but problems of developmental stage. From these results, it is suggested that it is necessary to consider the need for support on various situations for cancer patients in 20's who have many distress.
Methodology or Methods: Nine leaders ie, core team in pediatric oncology and exercise were invited to oversee the multi-stage, iterative process of reaching consensus on the topic. Next, experts eg, researchers, clinicians were identified and invited to sit on the international committee. Subsequently, the core team developed and distributed the first survey consisting of closed- and open-ended questions. Items were developed to determine level of agreement on key terminology eg, exercise vs.
PA , exercise prescription ie, frequency, intensity, time, type , and current literature eg, behaviour change. Responses are being collected and analyzed using qualitative analysis and descriptive statistics. However, there is disagreement concerning exercise prescription, specifically, with regards to distinguishing between high, moderate, and low intensities.
The outputs from this project have the potential to guide further research and move exercise evidence into pediatric oncology practice at a local, national, and international level. The Standards have provided centers a blueprint for providing evidence-based care. Methodology or Methods: Methodology. Since the standards were published, centers have requested guidance on best practices for their implementation.
In response, a Matrix Institutional Scoring Measure for each standard has been developed.
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Accompanying the matrix, individual Guidelines how to implement each of the standards has also been developed. Impact on practice or Results: Impact on practice.
Psychosocial providers at over 20 centers are currently reviewing the Matrix and Guidelines using an online rating tool. Centers are rating the usefulness and clarity of each standard within the Matrix, and the flexibility allowed for scoring how their program can implement each standard within the Guidelines. They are also reviewing whether strategies and tools provided for each standard can help centers to improve their score and care. Discussion or Conclusions: Discussion. Following the current review, the Matrix and Guidelines will be revised and will then undergo evaluation at additional pediatric oncology centers.
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Funding through MMCF will be provided for centers to evaluate the feasibility, usefulness, and outcomes associated with the use of the newly developed Matrix and Guidelines. Methodology or Methods: The AYA service within the hospital comprising of Medical Oncology, Nursing, Allied Health and Palliative care have developed direct referral pathways in which patients are provided with opt out psychology services.
As a result almost all patients engage in routine psychological care from their diagnosis through to survivorship or palliation. Impact on practice or Results: Over the past eight years routine psychological care has been provided to all patients under the age of 30 within the hospital.
Very few have declined this input, and anecdotally this engagement with patients and families has normalised the impact of cancer on emotional functioning, allowed a proactive approach to clinical issues such as anticipatory nausea and vomiting and allowed for strong relationship building to foster difficult conversations when needed such as when making decisions about treatment or at end of life. Discussion or Conclusions: The process of making psychological treatment part of routine care has allowed young people to speak freely to both their oncologists but also other members of the team around their emotional distress, worries or anxieties.
By normalising this experience young people are more likely to identify when they are having difficulties and be engaged around strategies to help manage same. Amanda Wurz 1 , Gregory M. Nicole Culos-Reed 1,4. Methodology or Methods: Three inter-related studies will be conducted. Healthcare professionals e. Experts who have successfully implemented in-hospital PA practices and the subsample identified in Study 1 will be invited for interviews. Study 3 [longitudinal cohort mixed-methods] will test in-hospital PA practices and implementation tools e. Discussion or Conclusions: This project will address a service gap in pediatric oncology, add evidence for the feasibility of in-hospital PA practices, and may promote PA behaviour and health-related outcomes for children in pediatric oncology programs in Alberta.
The outputs from this project have the potential to extend and improve service delivery and health-related quality of life for children undergoing treatment for cancer across Canada. Methodology or Methods: Five data sources were used to identify established and ongoing programs offering physical activity to children diagnosed with cancer.
Upon confirming eligibility, correspondents were sent a series of open-ended questions via email. Responses were analyzed using qualitative content analysis and were summarized descriptively and narratively.
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Impact on practice or Results: Forty-six programs, in 10 countries, were identified and qualitative data was obtained for 36 programs, in 8 countries. Internationally, most programs are taking place in Europe, and are offering physical activity to children with mixed cancer types, at different stages of the cancer-trajectory, across a range of settings e.
The majority allow children to bring a support person e. All programs are professionally supervised; however, there is considerable variability with regards to other program characteristics e. Moreover, findings underscore the necessity of establishing international networks, conducting multi-site projects, and engaging in public relations to ensure high-quality research is being conducted and translated. Moving forward, concerted efforts are required to ensure all children diagnosed with cancer have access to physical activity programs as a means of enhancing their health and quality of life.
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The presentation offers a process and an ethics framework for making for assessments and interventions. Methodology or Methods: The method is to utilize a standard ethics decision making framework instrument. Impact on practice or Results: The intervention is a process contingent upon current national, provincial legislation and policies of health authorities as well as national healthcare codes of ethics. Our type of case details patients diagnosed with a very treatable form of brain cancer and yet there is resistance to the requisite steps to move forward with life-saving treatment. Discussion or Conclusions: What are the team's obligations since the patient is still a minor under government legislation?
What happens if pediatric oncologists decide to call the Ministry of Child Protection to force a patient into treatment? Chana Korenblum 1,2,3 , SarahRose Black 1,4. Few evidence-based interventions exist addressing AYA's unique needs. This study aims to determine feasibility and preliminary effectiveness of a novel, developmentally-informed group therapy using music as a coping tool. Feasibility data was collected, including referral information, attendance, and resources required. Participants completed pencil and paper measures prior to the start and upon completion of the group. Quantitative scales assessed social isolation, depression, anxiety and distress.
Qualitative surveys evaluated the patient experience. Impact on practice or Results: Results: Of 16 referrals received, 12 participated in the group, and 10 in the study. At least 10 attended all six sessions. Mean age was Cancer diagnoses included lymphoma, breast, testicular, colon, CNS, and endometrial.
Quantitative data will be aggregated with future iterations of the group to achieve adequate statistical power. Qualitative data was analyzed using summative content analysis, and through coded categories revealed themes of connectedness, enjoyment, accessibility, and self-expression. Discussion or Conclusions: Conclusion and Clinical Applications: Positive initial impressions from participants, coupled with feasible methods of delivery, make this pilot a promising, innovative intervention addressing gaps in AYA psychosocial care. Further research directions include quantitative and more in-depth qualitative evaluation, as well as expansion to other sites.
Sperm banking rates remain low, and little is known about how adolescent and young adult AYA males and their families make fertility preservation FP decisions. To date, prospective fertility research at cancer diagnosis has been limited due to concerns about burdening families. Methodology or Methods: Forty-four participants 19 mothers, 11 fathers, 14 male AYAs 12—25 years old from 22 families completed brief assessments at diagnosis before beginning treatment , including an FP decision tool, and subsequently participated in a qualitative interview exploring the impact of study participation.
Verbatim transcripts were coded using the constant comparison method using selective coding. The three main subthemes among those who reported positive effects were: participation promoted deeper thinking; participation influenced conversations; altruism. AYAs and their parents noted participating in the study helped them think about and discuss FP. Facilitating FP decisions before treatment may mitigate future regret and optimize psychosocial and reproductive outcomes.
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It is complicated by the medical co- morbidity which warrants a long term stay. Psychiatric diagnoses can present and change depending on the severity of medical co- morbidity. It is imperative for clinicians to monitor patients for psychiatric problems in the long term. Methodology or Methods: Regular history taking from the patient, corroborative history from family and collaboration with the nurses and other specialists treating the patient becomes essential. Impact on practice or Results: Open mindedness and readiness to diagnose and treat psychiatric problems along with close collaboration and support not only for patient, but for treating team has a better prognosis for the patient.
Discussion or Conclusions: Readiness and willingness to diagnose and treat psychiatric issues Collaboration with and support to the treating team. Julie M. Deleemans 1 , Fatima Chleilat 2 , Raylene A. Reimer 1 , Linda Carlson 1.
Chemotherapy adversely affects the gut microbiome, and alters physiological and psychological function. Gut microbiota composition will be measured from fecal samples. Psychological and cognitive measures will include depression, anxiety, PTSD, pain, and social and cognitive function. Pro-inflammatory cytokines will be assayed from blood serum, and long-term cortisol will be assayed from hair samples. Impact on practice or Results: Regression and linear mixed model analyses will investigate associations within time points T1 — T3 , between groups, and covariates with gut microbiota, cognitive, psychological, and physiological parameters.
Discussion or Conclusions: Knowing what bacterial species are depleted after chemotherapy is crucial as future studies could aim to help survivors by co-administering specific health promoting bacteria i. Not much is known about hope as resource and the nature of hope and its relation to distress among older cancer patients.
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