Evidence-Based Practices to Improve Sleep Quality in Pediatric Oncology Patients: A Systematic Review

Yıl 2025, Cilt: 7 Sayı: 1, 265 - 278, 21.04.2025

Hatice Oğuzhan , Gamze Akay , Fatma Güdücü Tüfekci

https://doi.org/10.46413/boneyusbad.1485275

Öz

Aim: The aim of this systematic review is to systematically examine the data from published studies on evidence-based practices to improve sleep quality in peediatric oncology patients.
Material and Method: Databases including Google Scholar, ScienceDirect, PubMed, Web of Science, Cochrane, Scopus, and the Multidisciplinary Digital Publishing Institute (MDPI) were searched between 1 January 2019 and 30 April 2024, yielding a total of 17,995 articles. Following an assessment for eligibility, 12 articles were ultimately included in the study. Exclusion criteria comprised abstracts, letters to the editor, review articles, systematic reviews, dissertations, and conference proceedings. Data analysis was conducted in accordance with PRISMA 2020 guidelines.
Results: The review included six randomised controlled trials, five quasi-experimental studies, and one systematic review with meta-analysis. The studies included in the review found a positive improvement in sleep problems in children who received exercise, a significant reduction in sleep problems in children who received sleep hygiene training, an increase in quality of life and elimination of sleep problems in children who received sleep therapy, and a significant increase in sleep quality in children who received music therapy and aromatherapy.
Conclusion: Evidence-based practices to improve sleep quality in paediatric oncology patients have shown positive results. However, the number of studies is limited. Therefore, the number of studies that include evidence-based practices to improve sleep quality in paediatric oncology patients should be increased. At the same time, nurses working in clinics should be trained and supported in evidence-based practice.

Anahtar Kelimeler

Cancer , Nursing interventions , Pediatrics , Sleep quality

Pediatrik Onkoloji Hastalarında Uyku Kalitesini Artırmaya Yönelik Yapılan Kanıta Dayalı Uygulamalar: Sistematik Derleme

Öz

Amaç: Pediatrik onkoloji hastalarında uyku kalitesini artırmaya yönelik yapılan kanıta dayalı uygulamalar ile ilgili yayımlanmış çalışmaların gözden geçirilerek elde edilen verilerin sistematik bir biçimde incelenmesi amaçlanmaktadır.
Yöntem: Google Scholar, Science Direct, PubMed, Web of Science, Cochrane, Scopus ve MDPI veri tabanları 01 Ocak 2019 ve 30 Nisan 2024 yıl sınırlandırılması yapılarak taranmıştır. Araştırmaya altı randomize kontrollü, beş yarı deneysel ve bir sistematik derleme ve meta analiz olmak üzere toplam 12 çalışma dâhil edilmiştir.
Bulgular: Araştırmaya alınan çalışmalarda; egzersiz yaptırılan çocukların uyku problemlerinde olumlu anlamda iyileşme, uyku hijyeni eğitimi verilen çocukların uyku bozukluklarında anlamlı derecede azalma olduğu, uyku terapisi alan çocukların yaşam kalitesinin artarak uyku sorunlarının giderildiği, müzik terapi ve aromaterapi uygulanan çocukların ise uyku kalitesinin önemli derecede arttığı tespit edilmiştir.
Sonuç: Pediatrik onkoloji hastalarında uyku kalitesini artırmaya yönelik kanıta dayalı uygulamalar olumlu yönde sonuçlanmıştır. Fakat bu çalışmalar sınırlı sayıdadır. Bu yüzden pediatrik onkoloji hastalarında uyku kalitesini artırmaya yönelik kanıta dayalı uygulamaları içeren çalışmaların sayısı artırılmalıdır. Aynı zamanda kliniklerde çalışan hemşireler kanıta dayalı uygulamalar konusunda eğitilerek, desteklenmelidir.

Anahtar Kelimeler

Hemşirelik Girişimleri , Kanser , Pediatri , Uyku Kalitesi

Etik Beyan

Elde edilen çalışmalar açık erişime sahip veri tabanlarından elde edildiği için etik kurul onayı alınmamıştır.

Destekleyen Kurum

Çalışmayı maddi olarak destekleyen herhangi bir kişi veya kuruluş yoktur.

Kaynakça

• Albrecht, T. A., Taylor, A. G. (2012). Physical activity in patients with advanced-stage cancer: a systematic review of the literature. Clinical Journal of Oncology Nursing, 16(3), 293–300. doi:10.1188/12.CJON.293-300
• Allenidekania, A., Nurachmah, E., Rustina, Y., Eryando, T. (2017). Implementation of fatigue management model to quality of life in children with cancer: Indonesia experience. In Abstracts of the MASCC/ISOO 2017 Annual Meeting (Vol. 25, No. S2, pp. 21–266). Washington, DC: Supportive Care in Cancer. doi:10.1007/s00520-017-3704-x
• Altuntaş, M. (2016). Palyatif bakımda semptom yönetimi. Klinik Tıp Aile Hekimliği, 8 (3), 26-30.
• Andriastuti, M., Halim, P. G., Tunjungsari, E., Widodo, D. P. (2019). Home-based palliative ıntervention to ımprove quality of life in children with cancer: A randomized controlled trial. Asian Pacific Journal of Cancer Prevention: APJCP, 23(9), 3029–3034. doi:10.31557/APJCP.2022.23.9.3029
• Arabacı Baysan, L. (2021). Temel hemşirelik esaslar, kavramlar, ilkeler, uygulamalar. M. Kaşıkçı Kara, E. Akın, (Ed). İstanbul, İstanbul Tıp Kitapevleri.
• Arbianingsih, A., Amal, A., Hidayah, N., Azhari, N., & Tahir, T. (2020). Massage with lavender aromatherapy reduced sleep disturbances on infant. Enfermeria clinica, 30 Suppl 3, 62-65. doi: 10.1016/j.enfcli.2019.12.028.
• Aslan, F., Olgun, N., Uzun, Ö. (2020). Dahili ve cerrahi hastalıklarda bakım. Karadakovan A. (Ed). Ankara, Akademisyen Kitapevi.
• Bandyopadhyay, S. (2021). P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer). BJS Open, 5. doi: 10.1093/bjsopen/zrab032.008.
• Bilsin, E., Özalp, G. (2018). Çocukluk çağı kanserlerinde uyku bozukluğu. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 11(1), 61-64.
• Boehm, K., Büssing, A., Ostermann, T. (2012). Aromatherapy as an adjuvant treatment in cancer care--a descriptive systematic review. African Journal of Traditional, Complementary, and Alternative Medicines: AJTCAM, 9(4), 503–518. doi:10.4314/ajtcam.v9i4.7
• Bradt, J., Dileo, C., Magill, L., Teague, A. (2016). Music interventions for improving psychological and physical outcomes in cancer patients. The Cochrane Database of Systematic Reviews, (8), CD006911. doi:10.1002/14651858.CD006911.pub3
• da Silva Santa, I. N., Schveitzer, M. C., Dos Santos, M. L. B. M., Ghelman, R., Odone Filho, V. (2021). Musıc ınterventıons ın pedıatrıc oncology: Systematic review and meta-analysis. Complementary Therapies in Medicine, 59, 102725.
• Dhillon, H. M., Bell, M. L., van der Ploeg, H. P., Turner, J. D., Kabourakis, M., Spencer, L., … Vardy, J. L. (2017). Impact of physical activity on fatigue and quality of life in people with advanced lung cancer: A randomized controlled trial. Annals of oncology: Official Journal of the European Society for Medical Oncology, 28(8), 1889–1897. doi:10.1093/annonc/mdx205
• Escalante, Y. (2011). Actividad física, ejercicio físico y condición física en el ámbito de la salud pública [Physical activity, exercise and fitness in the field of public health]. Revista Espanola de Salud Publica, 85(4), 325–328. doi:10.1590/S1135-57272011000400001
• Essam Masoud, A., Shaheen, A. A. M., Algabbani, M. F., AlEisa, E., AlKofide, A. (2023). Effectiveness of exergaming in reducing cancer-related fatigue among children with acute lymphoblastic leukemia: A randomized controlled trial. Annals of Medicine, 55(1), 2224048. doi:10.1080/07853890.2023.2224048
• Fernandes, A., Andriani, Y. (2021). Faktor-faktor yang mempengaruhi terjadinya gangguan tidur pada anak dengan leukemia limfoblastik akut (LLA) yang menjalani kemoterapi. Jurnal Keperawatan Silampari, 5(1), 196–206. doi:10.31539/jks.v5i1.1807
• Fernandes, A., Andriani, Y. (2024). EDBEHOS sleep therapy on sleep quality in children with acute lymphoblastic leukemia during chemotherapy. Jurnal Keperawatan Silampari, 7(2), 248-256.
• Halal, C., & Nunes, M. (2014). Education in children's sleep hygiene: which approaches are effective? A systematic review.. Jornal de pediatria, 90 5, 449-56. doi:10.1016/j.jped.2014.05.001.
• Handayani, D., Kamila, S., Puspitasari, R., Nastiti, A., & Kusuma, E. (2023). The Effect of Music Therapy on Improving Sleep Quality in Children During Hospitalization: Literature Review. Proceedings of the International Conference on Nursing and Health Sciences. doi: 10.37287/picnhs.v4i1.1719.
• Hayati, M., Afiyanti, Y. (2019). “AeRop exercise” can improve the sleep quality of Indonesian pediatric cancer patients. Enfermeria Clinica, 29, 342-345.
• Harputluoğlu, N., Çelik, T. (2020). Pediyatrik palyatif bakım. Journal of Dr. Behcet Uz Children's Hospital, 10(1).
• Heywood, R., McCarthy, A. L., Skinner, T. L. (2017). Safety and feasibility of exercise interventions in patients with advanced cancer: a systematic review. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 25(10), 3031–3050. doi:10.1007/s00520-017-3827-0
• Heywood, R., McCarthy, A. L., Skinner, T. L. (2018). Efficacy of exercise ınterventions in patients with advanced cancer: A systematic review. Archives of Physical Medicine and Rehabilitation, 99(12), 2595–2620. doi:10.1016/j.apmr.2018.04.008
• Keyhanmehr, A., Movahhed, M., Sahranavard, S., Gachkar, L., Hamdieh, M., Afsharpaiman, S., & Nikfarjad, H. (2018). The effect of aromatherapy with Rosa damascena essential oil on sleep quality in children. Research Journal of Pharmacognosy, 5, 41-46.
• Kırca, K., Kutlutürkan, S. (2020). Progresif gevşeme egzersizlerinin kanser ve tedavi sürecinde kullanımı. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 6(2), 258-267.
• Klassen, J. A., Liang, Y., Tjosvold, L., Klassen, T. P., Hartling, L. (2008). Music for pain and anxiety in children undergoing medical procedures: A systematic review of randomized controlled trials. Ambulatory Pediatrics : The Official Journal of the Ambulatory Pediatric Association, 8(2), 117–128. doi:10.1016/j.ambp.2007.12.005
• Lee, J., Hur, M. H. (2022). The effects of aroma essential oil ınhalation on stress, pain, and sleep quality in laparoscopic cholecystectomy patients: A randomized controlled trial. Asian Nursing Research, 16(1), 1–8. doi:10.1016/j.anr.2021.11.002
• Liu, H., Gao, X., Hou, Y. (2019). Effects of mindfulness-based stress reduction combined with music therapy on pain, anxiety, and sleep quality in patients with osteosarcoma. Revista Brasileira de Psiquiatria (Sao Paulo, Brazil : 1999), 41(6), 540–545. doi:10.1590/1516-4446-2018-0346
• Masoud, A. E., Shaheen, A. A. M., Algabbani, M. F., AlEisa, E., AlKofide, A. (2023). Effectiveness of exergaming in reducing cancer-related fatigue among children with acute lymphoblastic leukemia: A randomized controlled trial. Annals of Medicine, 55(1), 2224048. doi:10.1080/07853890.2023.2224048
• Mogavero, M. P., Bruni, O., Delrosso, L. M., Ferri, R. (2020). Neurodevelopmental consequences of pediatric cancer and ıts treatment: The role of sleep. Brain Sciences, 10(7), 1–15. doi:10.3390/brainsci10070411
• Mustian, K. M., Sprod, L. K., Palesh, O. G., Peppone, L. J., Janelsins, M. C., Mohile, S. G.,…Carroll, J. (2009). Exercise for the management of side effects and quality of life among cancer survivors. Current Sports Medicine Reports, 8(6), 325–330. doi:10.1249/JSR.0b013e3181c22324
• National Cancer Institute. (2017). Cancer in children and adolescents. Erişim Tarihi: 05.05.2023, https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet#q2
• Oliveira, E. S., Oliveira, L. M., Oliveira, D. T., Viana, T. R. F., Silva, L. K. C., Bezerra, C. M.,… Cardoso, M. (2020). Child sleep: Assessment of the knowledge of parents of children aged zero to two years. European Journal of Public Health, 30(Supplement_5), ckaa165.1186. doi:10.1093/eurpub/ckaa165.1186
• Polit, D., Beck, C. (2020). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.
• Rogers, V. E., Zhu, S., Ancoli-Israel, S., Liu, L., Mandrell, B. N., Hinds, P. S. (2019). A pilot randomized controlled trial to improve sleep and fatigue in children with central nervous system tumors hospitalized for high-dose chemotherapy. Pediatric Blood & Cancer, 66(8), e27814. doi:10.1002/pbc.27814
• Santos, B., Santos, C., Couto, C., Almeida, J., & Castro, C. (2021). Quality of life in pediatric oncological disease: Integrative literature review. Annals of Medicine, 53, S100 - S100. doi: 10.1080/07853890.2021.1896045.
• Sarman, A. (2019). Palyatif/pediatrik palyatif bakımın tarihsel gelişim süreci, ilkeleri ve hemşirelik bakımı. Balıkesir Sağlık Bilimleri Dergisi, 8(3), 153-160.
• Shahidi, B., Khajenoori, F., Najarzadegan, M., Mameneh, M., Sheikh, S., Babakhanian, M., Tabarestani, M.,
• Babakhanian, M., Ashrafinia, F., Nasibeh, R., & Ghazanfarpour, M. (2019). A Systematic Review of the Effectiveness of Aromatherapy Massage on Sleep in Children and Infants. International Journal of Pediatrics, 8, 11233-11241. doi: 10.22038/IJP.2019.44574.3689.
• Sriasih, N. K., Allenidekania, Wanda, D. (2019). The effects of the COMMASH-E intervention on the fatigue, sleep quality and functional status of children with cancer in Indonesia. Comprehensive Child and Adolescent Nursing, 42(sup1), 197-207.
• Sulistyawati, E., Allenidekania, A., Gayatri, D. (2021). Effect of progressive muscle relaxation on sleep quality and side effects of chemotherapy in children with cancer: Randomized clinical trial. Open Access Macedonian Journal of Medical Sciences, 9(T4), 300-308.
• Şentürk, S., Bıçak, D., Derya, A. (2018). Kanserli hasta yakınlarının yaşadıkları sorunlar ve hemşirelik yaklaşımı. Sağlık Akademisyenleri Dergisi, 5(1), 35-39.
• Tanriverdi, M., Cakir, E., Akkoyunlu, M. E., Cakir, F. B. (2022). Effect of virtual reality-based exercise intervention on sleep quality in children with acute lymphoblastic leukemia and healthy siblings: A randomized controlled trial. Palliative & Supportive Care, 1-7.
• Traube, C., Rosenberg, L., Thau, F., Gerber, L. M., Mauer, E. A., Seghini, T., … Kudchadkar, S. R. (2020). Sleep in hospitalized children with cancer: A cross-sectional study. Hospital Pediatrics, 10(11), 969–976. doi:10.1542/hpeds.2020-0101
• Triana, K. Y., Allenidekania, A., Hayati, H. (2022). The Effect of aromatherapy ınhalation on reducing chronic pain for children with cancer: A pilot study. Trends in Sciences, 19(4), 2669-2669.
• Tucker, P., Loew, M., Russell, K., Tynes, B. L., Mandrell, B. N., Witcraft, S. M., … Crabtree, V. M. (2023). Sleep health behaviors in pediatric patients with newly diagnosed cancer. Journal of Psychosomatic Research, 172, 111413. doi:10.1016/j.jpsychores.2023.111413
• Uğur, Ö. (2019). Olgu senaryolarıyla iç hastalıkları hemşireliği (S. Özer, Ed.). İstanbul Tıp Kitabevleri.
• Uysal, N., Kutlutürkani, S. (2016). Kanserli bireylerde semptom kontrolünde refleksoloji uygulaması. Medical Journal of Bakirkoy, 12(3), 103-106.
• Utami, K. C., Hayati, H., Allenidekania. (2017). Chewing gum is more effective than saline-solution gargling for reducing oral mucositis. Enfermería Clínica, 27, 5–8.
• Wu, W., Tang, C., Jou, S., & Yu, T. (2021). Associations Between Fatigue, Sleep Disturbance, Physical Activity, and Quality of Life for Children With Cancer. Cancer Nursing, 45, 421 - 429. doi: 10.1097/NCC.0000000000001001.
• van Bindsbergen, K. L. A., van der Hoek, H., van Gorp, M., Ligthart, M. E. U., Hindriks, K. V., Neerincx, M. A., … van
• Litsenburg, R. R. L. (2022). Interactive education on sleep hygiene with a social robot at a pediatric oncology outpatient clinic: Feasibility, experiences, and preliminary effectiveness. Cancers, 14(15), 3792. doi:10.3390/cancers14153792
• Van Den Ende, E. S., Merten, H., Van Der Roest, L., Toussaint, B., Van Rijn, Q., Keesenberg, M., … Nanayakkara, P. W. B. (2022). Evaluation of nonpharmacologic ınterventions and sleep outcomes in hospitalized medical and surgical patients: A nonrandomized controlled trial. JAMA Network Open, 5(9), E2232623. doi:10.1001/jamanetworkopen.2022.32623
• Yavuzşen, T., Alacacıoğlu, A., Çeltik, A., Yılmaz, U. (2014). Kanser ve uyku bozuklukları. Türk Onkoloji Dergisi, 29(3), 112-119.
• Yıldız, S. (2022) Pediatrik Hematoloji Onkoloji Hemşireliği. Törüner, E.K., Atalay, N. (Ed). Bölüm-13. Pediarik palyatif bakım ve spiritüel bakım. Ankara, Nobel Tıp Kitapevleri. 520-556.
• Zhou, E. S., Valenzuela, A. F., Robbins, R., Page, J. M., Bona, K. (2023). Gaps in parental understanding of sleep disturbances during maintenance therapy for pediatric acute lymphoblastic leukemia. Journal of Pediatric Hematology/Oncology Nursing, 40(6), 369–378. doi:10.1177/27527530231168587