Oral care practices and oral mucositis in the pediatric oncology patients receiving chemotherapy at a tertiary care hospital, Karachi, Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Nursing (MScN)


School of Nursing and Midwifery, Pakistan


Advanced treatment modalities improve the chances of survival in pediatric oncology patients but result in numerous acute and long term side effects that can have devastating impact on the quality of life of children suffering from cancer. Mucositis, an inflammation and ulceration of oral and gastro-intestinal mucosa, is one such acute side effect of the treatment, that can lead to severe pain, inability to take food and fluids, infections and septicemia, unnecessary hospitalization, and treatment delays; thereby, significantly increasing morbidity and mortality in pediatric oncology patients. Objectives: This study was conducted to identify the oral care practices that were performed by the pediatric oncology patients during their chemotherapeutic treatment and the association of those practices with the development of oral mucositis. Methodology: A descriptive study was conducted at a pediatric oncology inpatient and outpatient department of a private tertiary care hospital in Karachi, Pakistan. The data was collected from 47 pediatric oncology patients, between the ages 6-18 years, who were receiving chemotherapy treatment, at two intervals. Oral care practices were explored using a self-developed questionnaire and mucositis was assessed by using the WHO and ChIMES mucositis scales. Findings: Good oral care practices were performed by 57.44% (27/47) of the participants and mucositis was observed in 42.5% and 41.9% of the participants during the first and second encounters, respectively. Oral care practices performed by the participants were significantly associated with the occurrence of mucositis (p=0.036). Participants' age (p=0.021), purpose of chemotherapy treatment (p=0.021), chemotherapeutic agents received (p=0.045), and mouth care education provided to the participants (p=0.035) at the start of the chemotherapy were also significantly associated with the occurrence of mucositis. Conclusion: Oral care practices influence the development of mucositis. Evidence based oral care protocols, which include timely assessment of mucositis, oral care practices to maintain oral hygiene, and dental care, preferably at the start of the treatment, help prevent and reduce the severity of oral mucositis in pediatric oncology patients. Mouth care education to improve oral practices is also important in reducing the occurrence of oral mucositis

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