This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind–body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology.

The literature related to the stress experienced by families who care for medically fragile children is analyzed. A model is generated from themes identified in the research literature. Four core themes were identified under which most of the stressors identified in the literature could be grouped. These are role conflict, financial burden, care burden, and independence. These are in turn arranged as a matrix in which the family, the child, the care professional, and health care system interact dynamically with the four core themes. The Family Stress/Task Matrix has the potential for facilitating research related to models that include a family-centered view among health professional and systems.

PURPOSE This study explored how the older traditional Filipino adults 65 years old and above living in Honolulu, Hawaii, describe their beliefs regarding exercise activity. The location of this research setting is unique because a blending of traditional Filipino culture exists within an acculturated social setting. The Filipino older adults who have relocated to this U.S. location may have also stayed close to their own cultural traditions. METHODOLOGIES A perception of exercise activity was generated through the lens of 47 participants using qualitative methodology. FINDINGS While focusing on the older adults’ beliefs about exercise activity, it became evident that exercise may have been seen as a proxy measure of physical activity. The study revealed four main domains: balancing barriers against benefits; engaging capabilities; intervening factors; and defining exercise. The data suggest that the four themes are juxtaposed among each other, with overarching social obligations to the kin group governing the older adults’ engagement in what constitutes structured exercise by Western definition. IMPLICATIONS Further investigation is needed to conceptualize what types of physical activities traditional Filipino elders perceive as exercise, and whether these activities fall into the Western definition of exercise.

The literature related to medically fragile children (MFC) is analyzed, and a model is generated to improve quality of care and cost effectiveness. The sources of stress for families include home care professionals, respite care, financial concerns, and limited community resources. Children cared for in hospitals often experience less than desirable quality outcomes. Community-based pediatric extended care facilities may be a means of reducing family stress, improving physiologic and developmental outcomes, and reducing cost. Case management may significantly reduce parental stress and improve the quality of life for these children. Additional systematic study of care options for MFC is essential.