Assessment of the Mothers' Knowledge and Practice in Care of their Children Suffering from Oral Mucositis related to Acute Lymphoblastic Leukemia

Abstract

Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children. Early treatment can result in a good chance for cure (Hoffman, 2012). The ALL is a primary malignancy of the bone marrow in which normal bone marrow is replaced by malignant blast cells. Oral mucositis (OM) is one of the worst side effects that can appear while treating children with ALL (Sharon, 2008). The OM is a condition in which an individual develops painful lesions of the mucus membranes of the mouth. It is a side effect of cancer treatment and usually increases in severity as the dose of chemotherapy or radiotherapy increases. Mucositis can have a devastating effect on a person’s nutritional status, because the oral pain associated with the condition often prevents individuals from eating solid food (Balaban, 2011). This study aimed to: - Assess the mothers' knowledge and practice in caring for their children suffering from oral mucositis related to acute lymphoblastic leukemia.

Research question: - Is there a relation between mothers' knowledge in caring for their children suffering from oral mucositis related to acute lymphoblastic leukemia and their practice? Subjects and Methods I. Research design A descriptive design was utilized in the current study. Research settings This study was conducted at both outpatient and inpatient pediatric departments. In the outpatient setting, the child received chemotherapy from 6 to 12 hours. Many bathrooms for hand washing in addition to places and time to perform oral care were available. Moreover, within the in-patient pediatric departments, the child was hospitalized from 15 to 21 days. The research setting was affiliated to Children's Cancer Hospital (57357), as the hospital is being with highest admission rate of children suffering from oral mucositis (OM) related to Acute Lymphoblastic Leukemia (ALL).

Sample size and characteristics: A purposive sample that composed of 100 children with OM related to ALL and attending the previously mentioned setting was used. The inclusion criteria of the study involved children with confirmed diagnosis of all grades of OM related to ALL, receiving chemotherapy from both gender, aged from 1 day up to 18 years and all the mothers were accompanying their children regardless of their characteristics. Tools and technique of data collection: Data was collected through the following tools: 3.1. A pre-designed questionnaire format (Appendix II): A questionnaire was designed by the researcher after reviewing the related literatures. It was written in simple Arabic language to suit the understanding level of the studied mothers and their children. It was consisted of two parts: It was designed by the researcher after reviewing the related literatures. It was written in simple Arabic language to suit the understanding level of the studied mothers and their children. It consisted of two parts:

Part 1: Characteristics of the studied sample: A. Characteristics of the studied children including; age, gender, place of residence, level of education, child ranking in the family, reason and place of admission. B. Characteristics of the studied mothers including; age, level of education, occupation, consanguinity, positive family history of ALL and maternal exposure to risk factors during pregnancy. Part 2: Concerning mothers' knowledge regarding care of their children suffering from OM related to ALL, covered the following: A. Mothers' knowledge regarding ALL (definition, causes, signs, symptoms, complications, and diagnosis). B. Mothers' knowledge regarding chemotherapy (goal, route of administration and complications). C. Mothers’ knowledge regarding OM (definition, causes, degree, signs of each degree, complications and oral care). 3.2. Observational checklists (Appendix III): The observational checklists were adopted from (Cairns, 2010 and Gaylene et al., 2010 and the policy and procedure of the Children's Cancer Hospital, 57357). They were used to assess the mothers' actual practice regarding care of their children suffering from OM related to ALL. Two observational checklists were used including; hand washing, and mouth care.