Ask an answerable question (PICO)：
School reentry is a vital recovery process for children with cancer to get back into standard routine and social interaction. However, due to the influence of illness, changes in cognition or physical appearance, and absence from the classes, poor interaction with peers, resulting in depression and leaving the school. The incidence of depression in children with clinical cancer after returning to school is 13.2%. Therefore, whether applying for the return-to-school programs during treatment can improve their depression condition when returning to school.
The Method and Analysis of Literature Review：
The clinical questions were analyzed and put into PICO, Patient/Population: Child* cancer/ Neoplasms, Intervention: School* reentry /Return to school, Outcome: Incidence of depression / levels of depression). Using Boolean Logic to search the database within Cochrane Library, ClinicalKey Nursing, PubMed, Embase, and Huayi Online Library (CEPS), etc., and use the "limit" and "Filters" search functions, and finally a Meta-Analysis article was included for appraisal.
Critical Appraisal：
The article was evaluated based on the CASP (2018) SR evaluation form and rated as Level 1 based on Oxford 2011 empirical rating. However, when using the Grade -Evidence Quality Scale score, the return-to-school programs could not be blinded, there were implement biases, the level of evidence was rated as weak. On the other hand, due to back-to-school programs being risk-free, children with cancer could effectively reduce the degree of depression by attending programs, so the recommended strength is “medium.
Clinical Application of Evidence：
Based on the results of the empirical literature, the specific intervention measures for the return-to-school programs are as follows: 1. Provide a handbook of return-to-school for sick children/family members; 2. Conduct emotional counseling with gamification for cancer children; 3. Arrange return-to-school meetings for providing teachers with relevant information; 4. Set standardized return-to-school case management model.
Evaluation of Effectiveness：
Within six months of the return-to-school program, ten children with cancer had tested, the incidence of depression dropped to 0% after returning to school for one month. The incidence of low self-concept remained at 0%. and parental stress was reduced to 0%. The implementation rate of health education for medical staff to prepare for returning to school could reach 100%, after discharge from the hospital, the attendance rate remained at 100%, and the satisfaction of parents with nursing guidance reached100%, and the satisfaction of school teachers were as high as 100%. During the outpatient follow-up, the children and their families were interviewed qualitatively. They expressed that they interacted well with their classmates and made good friends. The teachers would care about their academic and physical adaptation, and parents also expressed confidence in the school life of children.
Conclusions and Recommendations：
According to empirical literature results, cooperating the children's cancer care teams and using quality control circles to promote return-to-school planning strategies to reduce the incidence of depression of cancer children indicates. The result had shown that the return-to-school programs were an effective way to protect children's right to education and preserve their physical and mental health benefits.
