This is part 2 of an article exploring the endocrinopathies associated with cancer treatments, a growing area of care. More than 80% of all childhood cancers are treatable and the number of survivors of childhood cancer is increasing, but up to two thirds of these children reportedly present with significant health problems resulting from their treatments and about 25% of survivors have endocrine problems. This article explains how an understanding of oncology and endocrinology enables nurse specialists to educate young people about their past treatment, and its implications for their current and future health. It focuses on the specific endocrine risks to survivors of childhood cancer following treatment with chemotherapy and radiotherapy. This is the final article in a series that has illustrated the breadth of work undertaken by nurse specialists in endocrinology and oncology.
This article explores endocrinopathies associated with late effects of treatments for childhood cancers. It is the first of two articles on the subject, the second to be published in November. This is a growing area of care, as more than 80% of all childhood cancer is treatable, resulting in an increase in survivors of childhood cancer. However, up to two thirds of these children are reported to present with significant health problems resulting from their treatments, and approximately 25% of survivors have endocrine problems. This article explains how an understanding of oncology and endocrinology enables nurse specialists to educate young people about their past treatment and its implications for their health. This knowledge is the foundation for individually-tailored care plans that enable young people to be confident to self-care and self-monitor their long-term health.
Growth hormone deficiency (GHD) is a long-term condition, therefore creating ongoing partnerships with families is a fundamental part of the role of a paediatric endocrine nurse specialist (PENS). Teaching children, young people and their families about GHD and exploring what it means to them and how they can manage their ongoing treatment is central to building positive relationships. Educating children about the management of their growth hormone treatment (GHT) is an ongoing process and professionals must respond to the changing needs for that information children may have as they grow and develop. Long-term relationships with families are strengthened by recognising and respecting the developing expertise of families as they gain confidence and competence to manage GHT.
This article is the second of two parts. Part one was published in the February issue of Nursing Children and Young People and covered an overview of growth hormone, causes and clinical presentation of GHD, development and availability of GHT and the role of the PENS in building partnerships with parents. The focus of this article is the education role of the PENS and the importance of providing information that is appropriate to the child or young person’s developmental age.
The management of growth hormone deficiency is long term. Children may be diagnosed at pre-school age meaning relationships with the paediatric endocrine team may last more than 15 years. The education role of the paediatric endocrine nurse specialist is essential in working in partnership with families over a long period of time. Children and young people have changing needs for information to help them understand their condition and growth hormone deficiency treatment as they grow up. Developing positive working relationships with parents, children and young people enables their developmental needs and the context in which they live their lives to be central to any educational planning for them. Addressing developmental needs when providing information on growth hormone deficiency to children and young people reinforces the need for education to be an ongoing process and not a one-off event. This is part one of a two-part article. The second part will be published in the March issue of
There are some children and young people who will need specialist management for vitamin D deficiency in paediatric endocrine services. However, health problems caused by vitamin D deficiency are generally preventable, hence the National Institute for Health and Care Excellence recommendations for the provision of NHS Healthy Start vitamins to be available to all pregnant and breastfeeding women and children under five years of age. All health professionals, not just specialist services, need to be confident in their knowledge and understanding of the importance of vitamin D in normal growth and development to enable early identification of children and young people at risk who are in need of early intervention and education.
Children and young people referred to paediatric endocrinology services present with a wide range of illnesses and disorders varying from minor to life-threatening conditions. This article introduces the role of the children’s endocrine nurse in caring for children and families undergoing investigations that are frequently undertaken to identify specific problems associated with pituitary, adrenal and thyroid glands. Although children with endocrine problems may be cared for in specialist centres, they may also present, for other health reasons, in secondary and primary care. In schools some children may need teachers to administer emergency medication. There is a high incidence of children diagnosed with growth hormone deficiency and an even higher incidence of congenital hypothyroidism. These children would benefit from health professionals having a broader understanding of their conditions. This article – the third in the endocrinology nursing series – aims to disseminate information and educate colleagues in children’s nursing to raise the profile of children with long-term endocrine conditions.