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Nausea, Pain, Fatigue, and Multiple Symptoms in Hospitalized Children With Cancer

Elizabeth Miller
Eufemia Jacob
Marilyn J. Hockenberry
ONF 2011, 38(5), E382-E393 DOI: 10.1188/11.ONF.E382-E393

Purpose/Objectives: To describe the prevalence, frequency, severity, and distress of multiple symptoms in hospitalized children with cancer and to examine the overall symptom scores and global distress in patients reporting nausea, pain, and fatigue.

Design: Descriptive design with repeated measures.

Setting: Inpatient pediatric hematology-oncology unit.

Sample: 39 inpatients (ages 10-17) diagnosed with cancer.

Methods: Five-day data collection using the Memorial Symptom Assessment Scale (MSAS) Pediatric 10-18.

Main Research Variables: Thirty-one symptoms included in the MSAS Pediatric 10-18.

Findings: The most common symptoms (prevalence greater than 34%) were nausea, fatigue, decreased appetite, pain, and feeling drowsy. Differences in symptom experiences occurred in the presence of nausea, pain, and fatigue compared to days when they were not reported (p < 0.001). Prevalence of pain and fatigue symptoms decreased over the five days (p < 0.05), but not nausea (p > 0.05).

Conclusions: Nausea, pain, and fatigue were among the most prevalent symptoms in hospitalized children with cancer; however, the most prevalent symptoms were not always the most severe or distressing. The presence of these symptoms significantly impacted symptom experience, including total burden of symptoms experienced by the child (i.e., global distress).

Implications for Nursing: Additional examination of symptom management is needed. Nausea and its related symptoms have received little attention and more effective interventions are warranted. Multidimensional scales and the use of handheld electronic devices to track symptoms may be used to provide a more comprehensive assessment and treatment of symptoms.

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