The purpose of this study is to examine pain in children with acute leukemia following initial diagnosis, focusing on pain experience, management strategies, and outcomes.
The aims are to: 1) describe the pain of children for one year following diagnosis of acute leukemia; 2) describe the strategies used by children and their families to manage pain associated with acute leukemia; 3) examine the differences in pain before and after pain management strategies are used; 4) explore the predictors of pain outcomes; and 5) explore the relationships between pain, management, and outcomes. The knowledge gained will be vital toward developing intervention protocols for use by children, adolescents and parents seeking to manage pain associated with leukemia. It will also provide instruments translated to Spanish for use in other settings. Using a longitudinal design, 114 children, ages 4 through 16 years, will be studied from four pediatric oncology treatment centers in California. The children will be of any ethnicity, speak either English or Spanish, have any type of acute leukemia, be within 2-4 weeks of diagnosis and will not have a known cognitive disability, additional chronic illness associated with pain, fulminating disease process at diagnosis, or be unable to cope with participation in the research process. Two methods will be used to collect data. First, seven in-depth interviews plus self-report instruments will be used to elicit comprehensive data from the child and parent about the pain experience, management strategies, and outcomes. This includes inquiries regarding the location, intensity, frequency, quality, and temporal nature of pain; management strategies; and outcomes relating to pain status and functional status. Second, the child/parent will complete a home pain diary for four 5-day periods during a one year period. To encourage subject retention, interim phone and mail contact will be made with the child/parent. Data analysis will include descriptive statistics, content analysis, factor analysis, repeated measures ANOVA, regression analysis, path analysis, and discriminant function analysis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR004201-03
Application #
2873109
Study Section
Nursing Research Study Section (NURS)
Program Officer
Hare, Martha L
Project Start
1997-02-01
Project End
2001-04-30
Budget Start
1999-02-01
Budget End
2001-04-30
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Loma Linda University
Department
Type
Schools of Nursing
DUNS #
City
Loma Linda
State
CA
Country
United States
Zip Code
92350
Van Cleve, Lois; Bossert, Elizabeth; Beecroft, Pauline et al. (2004) The pain experience of children with leukemia during the first year after diagnosis. Nurs Res 53:1-10
Bossert, Elizabeth A; Van Cleve, Lois; Adlard, Kathleen et al. (2002) Pain and leukemia: the stories of three children. J Pediatr Oncol Nurs 19:2-11
Van Cleve, L; Munoz, C; Bossert, E A et al. (2001) Children's and adolescents' pain language in Spanish: translation of a measure. Pain Manag Nurs 2:110-8