Family support in improving quality of life of children with cancer undergoing chemotherapy
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"documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Clin. 2020;30 Supl 7:30-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Improving self-efficacy and life activities of arthritis patients: A quasy-experiment study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "30" "paginaFinal" => "33" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cindi Teri Marni Oroh, Fitriana Suprapti, Wilhelmus Hary Susilo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Cindi Teri Marni" "apellidos" => "Oroh" ] 1 => array:2 [ "nombre" => "Fitriana" "apellidos" => "Suprapti" ] 2 => array:2 [ "nombre" => "Wilhelmus Hary" "apellidos" => "Susilo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862120304551?idApp=UINPBA00004N" "url" => "/11308621/00000030000000S7/v1_202012250829/S1130862120304551/v1_202012250829/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "titulo" => "Family support in improving quality of life of children with cancer undergoing chemotherapy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "34" "paginaFinal" => "37" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Kadek Cahya Utami, Luh Mira Puspita, Putu Ayu Emmy Savitri Karin" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Kadek Cahya" "apellidos" => "Utami" "email" => array:1 [ 0 => "cahyautami@unud.ac.id" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Luh Mira" "apellidos" => "Puspita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Putu Ayu Emmy Savitri" "apellidos" => "Karin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Division of Pediatric Nursing, Department of Nursing, Faculty of Medicine, Universitas Udayana, Indonesia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Division of Mental Health and Psychiatric Nursing, Department of Nursing, Faculty of Medicine, Universitas Udayana, Indonesia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cancer is a chronic disease that requires a long-term therapy. According to the National Cancer Institute or NCI (2014), there are more than six million cancer patients each year, and in the past ten years there has been an estimated nine million cancer deaths per year, four percent of which are cancer deaths of children.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a> In Indonesia, cancer is currently included in the top ten major causes of death in children. According to the data on the incidence of cancer in Indonesia from the Republic of Indonesia Ministry of Health (2015), every year there are 11,000 cases of children with cancer.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">2</span></a> The prevalence of childhood cancer in Bali Province based on Sanglah Hospital's medical records in 2013 were 64 children aged 1–14 years. In 2015, the number increased to 104 children. In December 2018, there were 41 children with cancer undergoing chemotherapy at Sanglah General Hospital.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">3</span></a> Based on these facts, cancer in children must be handled better to reduce child mortality due to cancer. According to Hockenberry and Wilson (2009), chemotherapy is one of the most effective therapies for cancer in children.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">4</span></a> Based on the results of a preliminary study at Bali Child Cancer Care Foundation, since the establishment of the foundation in 2013 until now, there have been 222 cases of children with cancer. Throughout 2018, there were 41 children with cancer.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In addition to its therapeutic effects, chemotherapy can also cause side effects in patients with cancer. This is because its chemotherapeutic agents are cytotoxic in cells that divide rapidly, such as cancer cells, but normal cells that undergo rapid division, such as epithelium, mucosa, and hair follicles also experience damage. The most common side effects of chemotherapy in children are nausea, vomiting, diarrhea, fatigue, nervous system damage, constipation, hair follicle damage, risk of infection, and oral health disorders, such as oral mucositis.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Moreover, long-term treatment of cancer not only affects the biological, psychological, social, and spiritual conditions of children, but will also affect the quality of life of children. Quality of life is something that is subjective and multidimensional.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">7</span></a> Various instruments can be used to assess the quality of life of children, one of which is the Pediatric Quality of Life Inventory (PedsQL™) questionnaire. This instrument consists of four assessment functions, including psychological, emotional, social, and school functions.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">8</span></a> Assessment of quality of life can provide benefits for health professionals to be able to inform the changes that occur due to cancer, and can help health professionals make decisions related to actions to be taken next.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A literature study conducted by Queiroz et al. (2015) reported that quality of life had a statistically significant difference in terms of age variants, cancer diagnosis in children, age of children and parents, children without treatment, nutritional status, and the ability of families to provide support during treatment.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">According to WHO in 2004, family support was the dominant factor that most affected the quality of life of cancer sufferers. The possibility of having a low quality of life increased by 8.2 times for the respondents with low family support, after being controlled by other variables.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">11</span></a> A similar research conducted by Hakim et al. (2013) also showed that there was a relationship between family support and the quality of life of cancer sufferers. The better the family support, the better the quality of life of cancer sufferers.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">12</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">These studies were mostly carried out on adult cancer patients, and there have been no studies discussing family support for the quality of life of children with cancer. The purpose of this study was to determine the relationship between family support and the quality of life of children with cancer undergoing chemotherapy. It was expected that the results of this study would be able to contribute to the science of pediatric nursing, especially in the care of children with cancer undergoing chemotherapy, in which family-centered care as one of the principles of pediatric nursing is applied.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">The present study was a descriptive–correlative study. The population in this study was 41 children, and the sampling method used was consecutive sampling. The sample consisted of all parents and children with cancer who were receiving chemotherapy and undergoing treatment from Bali Child Cancer Care Foundation Shelter House. The instruments used in this study were the family support questionnaire for parents and the PedsQL™ questionnaire for children to measure quality of life. Data collection was conducted for three months from July to September 2019. Data analysis included a univariate analysis using a frequency distribution table and a bivariate analysis using a Pearson correlation test with a 95% confidence interval.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">13</span></a> The research ethics used in this study was based on the values of self-determination, protection from discomfort, confidentiality, and fairness.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">Based on <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, it can be seen that most of the parents who were respondents in the research were female, with a total of 28 persons (93.3%). Most of the respondents’ level of education was secondary education, with a total of 25 persons (83.3%). Concerning the respondents’ occupation, most of the parents were housewives, with a total of 24 persons (80.0%).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Based on <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, it is known that there was a moderate and significant positive relationship between family support and the quality of life of children with cancer (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.405, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.026, <span class="elsevierStyleItalic">α</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05). The positive correlation showed that the higher the family support, the higher the quality of life of children with cancer.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">In addition to its therapeutic effects, chemotherapy can also cause side effects in cancer sufferers. This is because its chemotherapeutic agents are cytotoxic in cells that divide rapidly, such as cancer cells, but normal cells that also undergo rapid division, such as epithelium, mucosa, and hair follicles also experience damage. The most common side effects of chemotherapy in children are nausea, vomiting, diarrhea, fatigue, nervous system damage, constipation, hair follicle damage, risk of infection, and oral health disorders such as oral mucositis.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In addition to physical problems, children undergoing hospitalization and chemotherapy also experience psychological problems such as anxiety, fear, mood disorders, and decreased self-perception. This will greatly affect the quality of life of children as a whole.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a> Assessment of quality of life in children will provide benefits for health workers to be able to give information about the changes that occur due to cancer suffered, and can help health workers make decisions related to the actions to be taken next.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">9</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The results of the analysis in this study indicate that there is a significant relationship between family support and the quality of life of children with cancer, with a <span class="elsevierStyleItalic">p</span> value of 0.026. The Pearson correlation value of 0.405 shows a positive correlation with the strength of the correlation being moderate. This indicates that the higher the family support, the higher the quality of life of children with cancer. Some studies reported that family support could affect the quality of life of patients. In addition to this, a research conducted by Sari et al. (2012) also reported that there was a significant relationship between family support and motivation of breast cancer patients undergoing chemotherapy.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">15,16</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">In addition, the results of the present study are also in congruence with a study conducted by Ryff (1995).<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a> Ryff explained that children who received good family support would show positive behaviors, including adherence to a therapy program. This would indirectly increase the success of a therapy, which would have an impact on improving the condition and quality of life of children, especially children with cancer.</p><p id="par0070" class="elsevierStylePara elsevierViewall">A study conducted by Okado et al. (2014) reported that the psychological condition of parents affects the physical and psychological conditions of children.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a> This means that parental involvement plays a major role in improving the condition and quality of life of children. This finding is also supported by a research conducted by Northouse et al. (2012). Northouse explained that family support had a great influence in overcoming emotional disorders in children such as anxiety, fear, anger, and feelings of hopelessness.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Based on these findings, parents who have children with cancer must be able to stay strong, cover up feelings of sadness, show a supportive attitude toward the child, and always try to accompany the child so that he/she does not feel alone in dealing with the illness and therapy programs. Parents must also involve the child during the treatment process and be a good intermediary in communicating between the child and the health professionals. According to Ryff (2014), good, pleasant, and open communication from parents can help parents to provide the best holistic care to children. All of these behaviors when applied well will make the child feel calm, comfortable, and not focused on his/her illness. The expression of warmth shown by parents will also improve the condition of the children, which will also have an impact on improving the quality of life of children with cancer.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">20</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">According to Gibson et al. (2010), a good quality of life in children with cancer is indicated by the children sometimes or almost never feeling pain, nausea, or fear of procedures which cause anxiety. In this case, the children are able to have a good perception of themselves, and able to communicate what they feel to parents or health professionals. A good quality of life in children will also make them able to deal with everything that they feel or experience, which can improve the children's condition.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">21</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Based on the results of the study, a poor quality of life in children with cancer is indicated by the children often or even almost always feeling frightened by their condition or the treatment that is performed. The results of this study are in congruence with a research conducted by Hendrawati et al. (2016), which reported that children with cancer were worried about treatment procedures. A poor quality of life also causes a change in children's behaviors, which affects their health condition.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Based on the results of the study as explained above, it was found that family support had a significant relationship to quality of life of children. The better the family support, the better the quality of life of children with cancer. Therefore, parents must maintain support for their children in overcoming their biological, psychological, social, and spiritual problems. Good support from the family will make children able to complete the planned therapy program, and this will maintain their quality of life. If their quality of life increases, their life expectancy will also increase.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="par0095" class="elsevierStylePara elsevierViewall">The results of the analysis of the data that has been conducted show that there is a significant relationship between family support and quality of life of children with cancer who receive chemotherapy. Children with cancer have complex problems including biological, psychological, social, and spiritual. Good support from the family will enable children to complete the planned therapy program, which will maintain their quality of life. If the quality of life of children with cancer increases, their life expectancy will increase as well.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1441028" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1315172" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 8 => array:2 [ "identificador" => "xack503039" "titulo" => "Acknowledgements" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-05-12" "fechaAceptado" => "2020-07-15" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1315172" "palabras" => array:3 [ 0 => "Children with cancer" 1 => "Family support" 2 => "Quality of life" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chemotherapy is one of the most effective therapies for patients with cancer. In addition to its therapeutic effects, chemotherapy can also have side effects on children with cancer. Chemotherapy and its side effects can have an impact on children with cancer, particularly those requiring repeated hospitalizations, who are left with bad experiences from the therapies. In light of this fact, the treatment certainly can have an impact on the children's quality of life. One of the outstanding factors influencing the quality of life of children with cancer is family support. In this regard, the aim of the present study was to investigate the relationship between family support and the quality of life of children with cancer after chemotherapy. This study was a descriptive–correlational study with a cross-sectional design. The sample of the present study consisted of 30 children. The results showed that there was a significant relationship between family support and the quality of life of children with cancer undergoing chemotherapy (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.026). This finding showed the importance of family participation in taking care of children with cancer undergoing chemotherapy in order to increase their quality of life.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the International Nursing Research Conference of Udayana University. Full-text and the content of it is under responsibility of authors of the article.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>a. Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>b. Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Level of education</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>a. Elementary school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>b. High school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Occupation</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>a. Housewife \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>b. Private employee \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>c. Farmer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2478740.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Characteristics of research subjects.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">*<span class="elsevierStyleItalic">α</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">r</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Family support \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.405 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.026 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Quality of life of children with cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2478741.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Relationship between family support and quality of life of children with cancer.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0110" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fact sheets: childhood cancers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "National Cancer Institute" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2014" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0115" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Buletin Jendela Data dan Informasi Kesehatan: Situasi Penyakit Kanker" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Ministry of Health of the Republic of Indonesia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2015" "editorial" => "Pusat Data dan Informasi Kementerian Kesehatan RI" "editorialLocalizacion" => "Jakarta" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0120" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Data Prevalensi Kanker Anak Pada Tahun 2018" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Yayasan Peduli Kanker Anak Bali" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2018" "editorial" => "Yayasan Peduli Kanker Anak Bali" "editorialLocalizacion" => "Denpasar" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0125" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Wong's essentials of pediatric nursing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.J. 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Queiroz" 1 => "M.H.C. Amorim" 2 => "E. Zandonade" 3 => "M.H.M.AT Quality of life of children and adolescents with cancer: revision of study literature that used the Pediatric Quality of Life Inventory™ Monteiro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.17533/udea.iee.v33n2a17" "Revista" => array:6 [ "tituloSerie" => "Invest Educ Enferm" "fecha" => "2015" "volumen" => "33" "paginaInicial" => "343" "paginaFinal" => "354" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26535855" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0160" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Faktor yang Mempengaruhi Kualitas Hidup Pasien Kanker Payudara di RSUP Dr. M. 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The authors also extend appreciation and gratitude to the pediatric patients with cancer and the parents who participated as respondents in this study, and the Chairperson of Bali Child Cancer Care Foundation.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/11308621/00000030000000S7/v1_202012250829/S1130862120304563/v1_202012250829/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11308621/00000030000000S7/v1_202012250829/S1130862120304563/v1_202012250829/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862120304563?idApp=UINPBA00004N" ]
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