The Effect of Educational Intervention On The Quality of Life of Acute Lymphocytic Leukemia Who Undergoing Chemotherapy
The Effect of Educational Intervention On The Quality of Life of Acute Lymphocytic Leukemia Who Undergoing Chemotherapy
The Effect of Educational Intervention On The Quality of Life of Acute Lymphocytic Leukemia Who Undergoing Chemotherapy
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151523
Research Article
*Correspondence:
Dwi Novrianda,
E-mail: [email protected]
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Increased knowledge of the parents about the problems and needs of children has an important effect
on family support so that parents can provide optimal care to improve the quality of life of children.
The purpose of study was to determine the effect of educational intervention chemotherapy for parents on the quality
of life of children acute lymphocytic leukemia.
Methods: The study design was a quasi-experimental design with The One Group Pretest-Posttest design. For the
first, it was performed measurements the quality of life of children using a questionnaire. Furthermore, giving
education for parents for 45 minutes, then measured using the same instrument on the seventh day after the education.
This research has been conducted in the Pediatric Inpatient Dr M. Djamil Hospital Padang start from February to
November 2014. The sample was taken using consecutive sampling. Based on the hypotheses sample test obtained the
minimum number of samples was 24. The instrument used was a quality of life questionnaire developed by J. W.
Varni i.e PedsQLTM 4.0 Generic Core Scale and PedsQLTM 3.0 Cancer Module.
Results: The results showed that there were significant differences in quality of life between the generic and cancer
module before and after the educational intervention in the elderly (p value = 0.012; 0.000).
Conclusions: Parent’s education about leukemia, chemotherapy, and management of side effects can improve quality
of life of children acute lymphocytic leukemia both generic and cancer module.
Keywords: Education, Quality of life, Acute lymphocytic leukemia, Generic, Cancer module
INTRODUCTION
Since the introduction of chemotherapy, 5-year survival
Leukemia is a cancer or malignancy involving the blood- rate of children with cancer has increased from 0% to
forming tissues of the bone marrow and the lymphatic nearly 75%.5 Further Litzelman also stated that since the
system (lymph nodes and spleen).1-3 Acute lymphocytic improvement of cancer treatment has improved the
leukemia is the most common type of leukemia in success rate of life.6 Patients and families receive
children that is about 75-80%.2 Currently, it is estimated effective education about diagnosis and treatment of
2-4% of all cancers in Indonesia affects children. Cancer cancer during extremely beneficial in reducing anxiety,7
accounts for about 10% of deaths in children.4 Indonesia can set him back as before the illness, and raises
has about 2000-3200 new cases of acute lymphocytic unrealistic expectations, reduce symptoms and side
leukemia each year.4 effects of treatment, increasing adherence to treatment
regimens, improving coping and adjustment to cancer
International Journal of Research in Medical Sciences | December 2015 | Vol 3 | Supplement Issue 1 Page S69
Novrianda D et al. Int J Res Med Sci. 2015 Dec;3(Suppl 1):S69-S73
diagnosis, reducing fatigue and improve the quality of period starting in May 2014. The study sample was
life.7-9 selected by consecutive sampling with inclusion and
exclusion criteria that have been set. The samples used in
Patient education about the disease, motivation and the study is calculated based on formula the estimated of
monitor patient adherence to therapy is an important sample of hypothesis testing of different two pairs
aspect in achieving a positive outcome.10 Several studies proportion so that the minimum number of samples
have also reported that an increase in parental knowledge obtained by 24 samples. Test presence/absence of
about the problems and needs of children with leukemia differences between the pretest and posttest with paired t-
have an important effect on family support so that parents test.
can provide optimal care which leads to a significant
improvement in the quality of life of children.11,12 RESULTS
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Novrianda D et al. Int J Res Med Sci. 2015 Dec;3(Suppl 1):S69-S73
children before educational intervention and standard of before and after the educational intervention in parents
deviation was 64.28 and 15.88, with a highest score 95.90 has a significant difference with p = 0.000.
and the lowest 33.30. Next the average total score of
module cancer quality of life before the intervention was DISCUSSION
65.95 and standard deviation was 14.87. Lowest score
was 42.10 and the highest was 98.10. The results showed that the average total score of generic
and cancer module quality of life before intervention was
Table 2: Total score PedsQLTM 4.0 Generic Core 64.28 and 65.95 with a standard deviation of 15.88 and
Scale and PedsQLTM 3.0 Cancer Module of acute 14.87. These findings were below the results of research
lymphocytic leukemia’s children before educational conducted by Sitaresmi et al. where the average quality of
intervention (n=24). life of generic and cancer modules were 71.8 and 77.1.13
This happens possible differences of individual and
Quality of environmental characteristics. As according to Bredow
Mean SD Min-Max CI 95%
life and Peterson that quality of life is influenced by
PedsQLTM individual and environmental variables.14 Further review
15. 33.30- 57.57-
4.0 Generic 64.28 articles about the variables that are often studied to
88 95.90 70.98
Core Scale determine the quality of life of children who have cancer
PedsQLTM conducted by Klassen et al reported that some of these
14. 42.10- 59.66-
3.0 Cancer 65.95 are factors when assessing the child's age, age at
87 98.10 72.23
Module diagnosis, sex, phase of treatment/chemotherapy, and
socioeconomic status.15 In this study the characteristics of
Table 3: Total score PedsQLTM 4.0 Generic Core the child in terms of age at assessment gained an average
Scale and PedsQLTM 3.0 Cancer Module of acute of 6.9 years old and most are in the toddler (1-3 years old
lymphocytic leukemia’s children after educational children). As well as research conducted by Mounier et
intervention (n=24). al. that age was significantly associated with quality of
life. Poor quality of life in children with younger age.16
Quality of Min- This is in line with Sitaresmi et al. that the quality of life
Mean SD CI 95% of children in the age group 2-4 years is lower than the
life Max
PedsQLTM age group 5-16 years were significantly.13
4.0 33.28- 63.53-
69.65 14.49 Furthermore, in general children were male gender.
Generic 95.95 75.77
Core Scale Sabbah et al. reported that the quality of life of girls is
PedsQLTM higher than boys.17 According Tanir et al. differences in
47.70- 63.87- quality of life between boys and girls is likely due to the
3.0 Cancer 69.72 13.85
97.20 75.56 restriction of activity, social isolation and depression that
Module
develops in children with chronic diseases.18 The low
quality of life of children in this study probably
In Table 3 it was known that the average total score of
influenced by the phase of chemotherapy. This is
generic quality of life after educational intervention and
consistent with Mounier et al. that treatment-related
standard of deviation 69.65 and 14.49, with the lowest
quality of life significantly.16 Further Sitaresmi et al. also
score and the highest was 33.28 and 95.95. Next the
reported that the quality of life in the nonintensive phase
average total score of module cancer quality of life after
better than intensive phase.13 After the educational
education and standard deviation of 69.72 and 13.85.
intervention on the elderly about acute lymphocytic
Lowest score was 47.70 and the highest was 97.20.
leukemia, chemotherapy and efforts to overcome the side
effects of chemotherapy, nutritional support system and
Table 4: Mean differences generic and cancer module obtained an increase in the average quality of life of
quality of life between before and after the
children acute lymphocytic leukemia.
educational intervention (n=24).
The average quality of life of cancer generic modules
T p value
69.65 and 69.72. Further statistical tests showed a
Generic quality of life 0,012
-2,72 significant difference in the quality of life of children
Pretest – post test
both generic acute lymphocytic leukemia or cancer
Cancer module quality of module between before and after the educational
-7,27 0,000
life Pretest – post test intervention in the elderly.
From the above table it was found that there was Education of patients and families have been known as a
differences in the generic quality of life significantly central component to ensure that patients and families are
between before and after the implementation of able to determine treatment options, management of
educational interventions in parents with p = 0.012. health care needs, and the effectiveness of the use of
Furthermore, the quality of life of cancer module between drugs.19 According to The American Academy of Family
International Journal of Research in Medical Sciences | December 2015 | Vol 3 | Supplement Issue 1 Page S71
Novrianda D et al. Int J Res Med Sci. 2015 Dec;3(Suppl 1):S69-S73
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