Behavioral Interventions in the Diagnosis, Treatment and Rehabilitation of Children with Cancer

DuHamel, William H. Re Katherine Katherine N.

doi:10.1080/028418699432879

Cited by 34 publications

(8 citation statements)

References 46 publications

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“…19 Both can be viewed as instances of the broader phenomenon of suggestion. 20 Interventions that make use of suggestions (with or without the induction of a hypnotic trance) have been used successfully to control nausea related to chemotherapy, 18,21–23 and after anesthesia. 24 In this study, a hypnotic trance was not induced.…”

Section: Introductionmentioning

confidence: 99%

An Exploratory Study on the Effects of an Expectancy Manipulation on Chemotherapy-Related Nausea

O’Neill

Jean‐Pierre

Heckler

et al. 2010

Journal of Pain and Symptom Management

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Context Previous research has shown that the effectiveness of acupressure bands in reducing chemotherapy-related nausea is related to patients’ expectations of efficacy. Objective To test whether an informational manipulation designed to increase expectation of efficacy regarding acupressure bands would enhance their effectiveness. Methods We conducted an exploratory four-arm randomized clinical trial in breast cancer patients about to begin chemotherapy. All patients received acupressure bands and a relaxation CD. This report focuses on Arm 1(expectancy-neutral informational handout and CD) compared to Arm 4 (expectancy-enhancing handout and CD). Randomization was stratified according to the patient’s level of certainty that she would have treatment-induced nausea (two levels: high, low). Experience of nausea and use of antiemetics were assessed with a 5-day diary. Results Our expectancy-enhancing manipulation resulted in improved control of nausea in the 26 patients with high nausea expectancies, but lessened control of nausea in 27 patients having low nausea expectancies. This interaction effect (between expected nausea and intervention effectiveness) approached statistical significance for our analysis of Average Nausea (P = 0.084) and reached statistical significance for our analysis of Peak Nausea (P = 0.030). Patients receiving the expectancy-enhancing manipulation took fewer antiemetic pills outside the clinic (meanenhanced = 12.6; meanneutral = 18.5, P = 0.003). Conclusions This exploratory intervention reduced antiemetic use overall and also reduced nausea in patients who had high levels of expected nausea. Interestingly, it increased nausea in patients who had low expectancies for nausea. Confirmatory research is warranted.

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Section: Introductionmentioning

confidence: 99%

An Exploratory Study on the Effects of an Expectancy Manipulation on Chemotherapy-Related Nausea

O’Neill

Jean‐Pierre

Heckler

et al. 2010

Journal of Pain and Symptom Management

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“…Behavioural therapy techniques have been recognised as a valuable strategy to reduce paediatric distress and enhance compliance within healthcare 2,7 . Radiation therapists (RTs) and Certified Child Life specialists (CCLS) incorporate techniques of desensitisation, behavioural rehearsal, cognitive distraction and positive reinforcement into paediatric oncology care 2,7,9–18 . While published literature on general anaesthetic (GA) use in children during RT is minimal, papers published concluded that behavioural therapy interventions can reduce anaesthesia use 9,16,18 .…”

Section: Introductionmentioning

confidence: 99%

“…On average, 60 paediatric patients were treated each year at the RBWH until 2014, when paediatric radiation oncology services were centralised at Children's Health Queensland. RTs at the RBWH have applied behavioural therapy techniques to their work with paediatric patients since 1970, aligning with the early era of formal ‘play therapy’ research 10,21 . In 2005, the RBWH Paediatric Radiation Therapy Group (PRTG) was established, formalising a multidisciplinary care network to support paediatric patients accessing RT services.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the use and efficacy of behavioural therapy when treating paediatric patients with radiation therapy

McCoola,

Outhwaite,

Lathouras

et al. 2023

J of Medical Radiation Sci

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IntroductionThe paediatric radiation therapy group (PRTG) provided a multidisciplinary network to support patients accessing radiation therapy (RT). This study aims to evaluate the use and efficacy of behaviour therapy practices used by the PRTG.MethodsA retrospective cross‐sectional review of general anaesthetic (GA) utilisation for paediatric patients was completed between 1 January 2010 and 30 June 2014. The PRTG incorporated behavioural therapy techniques into all appointments but offered additional play appointments to children unable to comply with the requirements of RT. This aimed to increase their compliance and minimise GA use.ResultsTwo‐hundred and seventy‐four patients had 5402 occasions of service, of which 1361 were delivered under GA (25.2%). Two‐hundred and fifty‐seven patients met the eligibility criteria. Patients under 8 years who required GA for their entire treatment reduced for each year of increase in age (odds ratio 0.37, 95% confidence interval 0.27–0.51, P < 0.001). Participants 3 years and younger were shown not as likely to change their GA requirements with the use of play appointments. Seventy‐eight per cent (83/106) of 3–8‐year‐olds used no GA or ceased GA during treatment.ConclusionsMost paediatric patients <3 years will gain minimal benefit to reduce GA use from additional play appointments. Children older than nine were not likely to require play appointments to be compliant with RT. Encouragingly, 53.3% of 3–8‐year‐olds who were categorised as full GA after CT planning did not continue to a full course of GA due to the behavioural therapy interventions of the PRTG.

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“…The burden of the disease, and body modifications resulting from treatment and reduced physical activity, may lead to lower self-esteem and emotional well-being, and compromised social relationships, which negatively influence the quality of life for children with cancer [ 12 , 13 , 28 , 29 ]. However, it is unclear to what extent this is related to the disease and treatment burden, the child’s learning difficulties, physical decline, or changes in social position [ 30 - 32 ].…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, none of the intervention studies address the potential effects of early rehabilitation from the time of diagnosis as a tool to maintain the children’s social network during treatment [ 28 , 30 , 32 ]. The Rehabilitation including Social and Physical activity and Education for Children and Teenagers with Cancer (RESPECT) study is inspired by Erving Goffman’s symbolic interaction theory [ 33 - 35 ], Thomas Scheff’s theory and concepts of emotional and social bonds [ 36 , 37 ], and Venka Simovska’s definition of interactive processes and empowerment [ 38 ].…”

Section: Introductionmentioning

confidence: 99%

Study protocol: rehabilitation including social and physical activity and education in children and teenagers with cancer (RESPECT)

et al. 2013

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BackgroundDuring cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers.Methods/designThe RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n = 120) and a matched control group in western Denmark (n = 120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child’s schoolteachers and classmates, and the child’s parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs.DiscussionRESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use healthy classmates as ambassadors to facilitate the normalization of social life in the hospital. For children with cancer, RESPECT contributes to expanding knowledge on rehabilitation that can also facilitate rehabilitation of other children undergoing hospitalization for long-term illness.Trial registrationClinical Trials.gov: file. NCT01772849 and NCT01772862

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Behavioral Interventions in the Diagnosis, Treatment and Rehabilitation of Children with Cancer

Cited by 34 publications

References 46 publications

An Exploratory Study on the Effects of an Expectancy Manipulation on Chemotherapy-Related Nausea

An Exploratory Study on the Effects of an Expectancy Manipulation on Chemotherapy-Related Nausea

An evaluation of the use and efficacy of behavioural therapy when treating paediatric patients with radiation therapy

Study protocol: rehabilitation including social and physical activity and education in children and teenagers with cancer (RESPECT)

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