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- Title
GASTROINTESTINAL SYMPTOMS AND GROWTH PATTERNS IN CHILDREN POST BONE MARROW TRANSPLANT.
- Authors
Rodgers, Cheryl; Wills-Alcoser, Patricia; Monroe, Rebecca; McDonald, Lisa; Trevino, Melisa; Hockenberry, Marilyn
- Abstract
Children are at risk for long-term malnutrition after a bone marrow transplant (BMT) due to poor oral intake, altered absorption and increased metabolic demands as a result of medical complications and/or medication toxicities. Despite these known risks, little research has been performed to evaluate long-term nutritional issues in children post BMT. The purposes of the study were to identify the growth patterns and gastrointestinal (GI) symptoms in children during the first four months post BMT, and to assess if an association exists between acute graft-versus-host disease (GVHD) and growth pattern changes or GI symptoms. The University of California San Francisco Symptom Management Model, which emphasizes the need for a thorough assessment of the symptom experience to guide symptom management and avoid negative outcomes, provided a conceptual framework for this research. This descriptive study used a prospective, longitudinal cohort design. A convenience sample of 45 children receiving an allogeneic BMT completed the Memorial Symptom Assessment Scale and anthropometric measurements before BMT then 2 months and 4 months post BMT. Data analysis was performed with repeated measure ANOVA to evaluate anthropometric changes, descriptive statistics to analyze GI symptoms and a t-test and chi-square test to evaluate anthropometric measurements and GI symptoms between children with and without GVHD. All anthropometric measurements of children showed a significant change over the 4-month period. The mean height increased over the 4 months with all other anthropometric measurements including weight, skinfold triceps and midarm circumference showed a significant decrease. There was a common occurrence of symptoms such as lack of appetite, nausea and diarrhea throughout the repeated measures. No statistical significant difference was noted in any of the anthropometric measurements or frequency of GI symptoms between children with and without GVHD. Children experience several GI symptoms throughout the BMT recovery phase that can lead to poor outcomes, such as weight loss. Nurses need to monitor patients' GI symptoms frequently during the acute BMT recovery phase to identify changes that require nutritional assistance in order to guide symptom management to achieve positive outcomes. Funding Sources: Oncology Nursing Foundation through an unrestricted grant from Ortho Biotech Products, L.P.
- Subjects
GASTROINTESTINAL diseases; BONE marrow transplant complications; GRAFT versus host disease; TRANSPLANTATION of organs, tissues, etc. in children; PEDIATRIC surgery nursing
- Publication
Oncology Nursing Forum, 2007, Vol 34, Issue 2, p530
- ISSN
0190-535X
- Publication type
Article