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Poster Sessions / European Journal of Oncology Nursing 18S1 (2014) S23S59

27.7% of children had CT and cranial radiotherapy (CRT), 24.1%

of children received CT, CRT and surgery. 28 patients feed orally
an one of the patients received total parenteral nutrition. About
37.9% children have neutropenic diet. The most common nutritional
problems are loss of appetite (51.7%), refusal to eat depending on
fatigue and body pain (68.9%) and stomatitis (13.8%). Parents of
children stated that nutritional problems caused by, respectively;
due to treatment (100%), their dislike of hospital food (51.7%) and
being hospitalized (27.6%). Parents (86.2%), had received education
on nutrition and 60% of them said that they received training
from nurses. Parents stated their most information requirements
about childrens nutrition as food drug interactions (65.5%), eating
frequency (58.6%) and eating time (55.2%).
Conclusion: In this study, it was determined that the majority
of children have nutritional problems and their parents have
requirements of the detailed information about nutrition. Paediatric
oncology nurses are recommended to regularly assess childrens
nutritional problems and parents information needs.
No conict of interest.
139
Effect of parents depression level on childrens quality of life
after hematopoietic stem cell transplantation
1
Z. Kisecik1 , N. Altay2 , L. Guneri

, E. Dogukaya1 . 1 Child Paediatric

Hematopoietic Stem Cell Transplantation Unit in the Childrens
Hospital in Ankara Turkey, nursery, Ankara, Turkey; 2 Gazi University
Health Sciences Faculty, nursery, Ankara, Turkey

Aim: This descriptive study is aimed to determine the relationship

between depression level of parents and childrens quality of life
after hematopoietic stem cell transplantation (HSCT).
Methods: The study was conducted in a bone marrow
transplantation unit of a children hospital in Ankara/Turkey.
Research sample consisted of 82 childrens parents. Children who
were 218 year-old and were monitored in polyclinics after 100 days
of transplantation were included in the study. Socio-demographic
data form, parental form of paediatric quality of life questionnaire
and Beck Depression Inventory were used. The higher the score
is in paediatric-quality of life questionnaire, the better life quality
is. Beck Depression Inventory scores could be between 0 and 63.
According to total score, it is evaluated as no depression for 9 or less
value, mild depression for 1016, moderate depression for 1723
and severe depression for 24 or more. Data was measured with
percentage and frequency distribution, and Spearman Correlation
Test.
Results: In the study, 48.8% of the participants were mothers.
The mean age of mothers was 39.25619.22398. 63.4% of children
were male and their mean age was 10.68294.80709. Mothers and
fathers education level were mostly primary or secondary school.
During their childrens disease, 34.1% of parents have not received
social support. 31.7% of children were diagnosed with thalassemia
and 35.4% of childrens duration after transplantation was between
25 and 36 months. Complications were developed in 54.9% of
children after transplantation. Total mean score of childrens quality
of life questionnaire was 61.374521.85863. Beck depression mean
score of parents were 14.573211.03197. 17.1% of parents have had
severe depression and 12.2% of parents have had moderate one.
Correlation was found between Beck Depression Score and total
questionnaire score of quality of life (r = 0.338; p = 0.002).
Conclusion: Parents depression level affects the childrens quality
of life after HSCT. Following transplantation, it is important that
parents depression level should be evaluated and supported.
No conict of interest.

140
Care burden of parents having children with cancer at the
hospital and at home
C. Ceylan1 , E. Erdem1 , N. Altay1 , E. Kilicarslan Toruner1 . 1 Gazi
University Faculty of Health Sciences, Nursing, Ankara, Turkey
Introduction: Cancer is a disease which affects both children and
their families.
Objective: The purpose of this study was to determine the difference
between the burden cares of parents who have children aged 018
with cancer at the hospital and at home.
Material and Method: It was conducted as a descriptivecomparative type at a university hospital in Ankara/Turkey.
Sampling of this study was parents having children with cancer
(total = 31) who received a treatment at the hospital unit (n = 19)
and who was monitored at the polyclinics (n = 12) between 15
February and 25 March 2014. In the gathering of data, a descriptive
characteristics form related to the children and their parents, a data
form related to the childs disease and treatment and the Zarit
Burden Interview Scale was used. The scores received from the
Scale were evaluated by being ranked as (020) little/no burden,
(2140) moderate burden, (4160) high burden and (6188) severe
burden. Frequency and percentage distribution concerning the data
was collected. The Mann-Whitney U test and a Spearman correlation
analysis were conducted. Written assent was received from the
institution and parents.
Results and Discussion: The average ages of the children were
found to be 10.154.76 monitored at the hospital and 7.584.11
at the polyclinic. It was determined that the majority in both
groups was male, the diagnosis was ALL and their treatments
were chemotherapy. At the hospital and polyclinic group, age of
diagnosis respectively were 9.864.74 and 6.254.14, the period
of treatment were 4.173.60 and 15.0811.42 months. In both
groups, those caregivers were mostly the mothers, the types of
families were nuclear families and the mothers were housewives.
The Zarit Burden Interview Scale score was found to be 37.8413.38
at the hospital group, 35.0812.94 at the polyclinic group, but the
difference between them was not found to be statistically signicant
(U = 108.5; p = 0.82). It was determined that as the treatment period
of children increases, the burden care of parents increases (r = 0.395;
p = 0.02).
Conclusion: It was determined that the parents burden care was
moderate in both groups. It is recommended that parents of children
who having to receive long term treatment, should be observed in
terms of their burden care and should be supported.
No conict of interest.
141
The importance of nursing interventions for oral mucositis
and malnutrition with head and neck cancer
1 1

F. Arikan1 , Z. Karakus1 , Z. Ozer

. Akdeniz University, Department of
Internal Medicine Nursing, Antalya, Turkey

Head and neck cancer refers to primary tumors occurring of the

larynx, pharynx, oral cavity, tongue, lip, paranasal sinuses, and the
salivary glands. The ve years prevalence of head and neck cancer
are for larynx1.4%, oral cavity/tongue 2.2%, nasopharynx 0.7% and
pharynx 1.0% in worldwide. According to GLOBOCAN estimates for
Turkey, head and neck cancer incidence and mortality rates are for
larynx 1.91.3%, lips and oral cavity 1.00.5% nasopharynx 0.50.4%
and pharynx 0.30.3%. Due to the side-effects of radiotherapy,
patients commonly experience mouth dryness, mucositis, changed
viscosity of the saliva, taste changes, swelling, pain in the mouth
and throat, speaking and eating difculties and loss of appetite.
Oral mucositis is considered as one of the most stressful acute
reactions during chemo-radiotherapy. In a systematic review, all
of the patients with altered fractionation radiotherapy and only
22% of patients with chemotherapy reported that they experienced
oral mucositis. Pain associated with oral mucositis seriously impairs

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functions of patients such as swallowing, taste and phonation. These

problems reduce patients orally food intake, causes severe weight
loss and malnutrition.
Malnutrition is known to be effective on morbidity and mortality
of head and neck cancer patients but that is often neglected or
as needed to focus on an important issue. However, malnutrition
can cause impaired immune function, reduced resistance to disease,
increased morbidity and mortality. Therefore, supporting nutritional
status of head and neck cancer patients and eliminating their
treatment-related complications are needed to improve their quality
of life. At baseline of the radiotherapy, the patients should taken
counselling about nutrition and nutritional support for their
weight loss. Several studies showed that nurses were the primary
source of knowledge and practical advice regarding nutrition to
cancer patients. However, there is scarce research about nursing
interventions in head and neck cancer patients. To conclusion, there
is urgent need for descriptive research studies that determine the
patients care needs, randomized controlled trials that shows the
effectiveness of nursing interventions to patients.
No conict of interest.

consent, were assigned in a random method to one of the 2 groups:

group 1 buttery was positioned with the needles bevel up this
was considered to be the control group as this modality of inserting
the needle is considered standard practice; group 2 buttery was
positioned with the needles bevel down experimental group. The
drugs used for pain relief were sc Tramadol for moderate pain and
sc Morphine for severe pain.
Conclusions: In our research supported the hypothesis that the
occurrence of local complications comes together with the decrease
of sc buttery resistance in time at the place of insertion and the sc
butteries have a higher rate of resistance in time at the insertion
site if the frequency of injectable opioids administration is lower
(twice per day) than if the sc butteries positioned with the bevel
down. This placement position is associated with a longer resistance
in time at the site of insertion and causes less local complications
compared to the sc butteries positioned with the bevel up.
No conict of interest.

142
Reliability and validity of the Turkish version of the Head and
Neck Information needs Questionnaire (HaNiQ) for patients
and their families

M. Golpur1 . 1 Sheba Medical Center, Oncology, Ramat Gan, Israel

1 1

Z. Karakus1 , F. Arikan1 , Z. Ozer

. Akdeniz University, Department of
Internal Medicine Nursing, Antalya, Turkey

Head and neck cancer affects patients health status and wellbeing
negatively. In this process, patients with head and neck cancer
have detailed information needs but no tools exist that can
simultaneously assess the needs among these patients and their
caregivers in Turkish language. The purpose of this study was
to develop a Turkish version of The Head and Neck Information
Needs Questionnaire (HaNiQ) and assess its reliability and validity
for patients and their families. The approval of Akdeniz University
Faculty of Medicine Clinical Research Ethics Committee and Director
of Akdeniz University Hospital were taken for the study. 180
patient/caregiver volunteers were included in to the study that
met the inclusion criteria.
No conict of interest.

Poster Session: Palliative Care

143
Evaluation of the optimal positioning of subcutaneous buttery
when administering injectable opioids in cancer patients
N. Mitrea1 , L. Rogozea2 , D. Mosoiu2 . 1 Hospice Casa Sperantei,
Education and National Development, Brasov, Romania; 2 University of
Transylvania, Faculty of Medicine, Brasov, Romania
Introduction: The growth in the number of cancer patients,
together with the development of new Palliative Care services
in Romania warrant the evaluation of nursing strategies used to
enhance the level of comfort of patients who are suffering with
advanced cancer.
Purpose: The main objective of this study was to evaluate optimal
positioning of the subcutaneous (sc) buttery, in accordance with
its resistance in the insertion tissue, the local complications that
occur and the evaluation of the time of resistance at the insertion
site (puncture) with the daily frequency of injectable opioid
administration.
Methods: A prospective experimental pilot study was designed
and conducted between January and May 2011. Patients admitted
at Hospice Casa Sperantei with moderate or severe cancer pain
receiving subcutaneously opioids, over the age of 18, with normal
Body Index ranging from 18.522.0, after signing the informed

144
Advance directive in patients end of life decisions: the
health care providers knowledge, skills and attitude

The dying patient law was established in the state of Israel in

2005. This law regulates the process of the patients right to avoid
and or to stop medical treatment in end of life period. One of its
parts included the advance directives (AD) guidelines. This enables
them to decide and inuence on their treatment choices while
the patient is incompetent to provide inform consent. The dying
patient law provides the health care professionals with knowledge
and guidelines regarding the proper use of the AD. Even though,
the implementation of the AD is not yet well established in our
routine.
Aim: To examine the health care professionals: knowledge, skills
and attitude towards AD in the cancer center and home care
hospice.
Methods: A self-ll, anonymous questionnaire was used, contained
demographic and occupational details, experience dealing with AD
in practice, experience in using the AD forms, positive and negative
attitudes.
Results: 58 questionnaires were received from 14 physicians, 34
nurses, 6 social workers and 3 psychologists. 46 woman and 12
men. The average age: 47 years old, the majority Jewish (93%), 57%
had more than 10 years work experience. 88% declared they nd
a benet in the use of AD by providing dignity, autonomy and
sense of legal validation to the patients. 75% feel comfortable with
the use of AD in their practice, 35% assisted patients and family
members preparing AD forms and felt positively being able to help,
discuss and being condent in their ability to assist. 34 professional
reported they actually cared for patients who had already AD
which make the medical decisions and the communication with
patients and families easier and well dened. Only 16% knew of
their organizational policy regarding the AD and 43% did not know
the existence of a special form regarding end of life decision.
Summary: We found that although the health care providers
recognize the benets of using the AD, they are lack of skills,
knowledge and the ability preforming an open discussion with
patients on those issues. Staff with experience caring for patient
who had AD reported that the patients decision making process
was clearer and distinct, they felt more comfortable caring them
and discuss with them end of life issues. There is a need to improve
staff knowledge, attitude and implementation regarding AD process
nationally in the health system in order to expose the public to its
advantages.
No conict of interest.