Pediatric Integrative Medicine

McClafferty, Hilary; Vohra, Sunita; Bailey, Martha J.; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Niemi, Anna-Kaisa; Sibinga, Erica; Weydert, Joy A.; Yeh, Ann Ming

doi:10.1542/peds.2017-1961

Cited by 126 publications

(35 citation statements)

References 143 publications

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“…Many of these approaches may not be evidence-based due to the difficulty of standardizing the products used and approaches or techniques employed. These impending trends underscore the need for effective models of integrative care that are both evidence-based and culturally sensitive [ 111 , 112 ]. Further research work evaluating the use of CAM among survivors of childhood cancer may help clarify and answer the many questions and concerns regarding the use of complementary and conventional therapy and better delineate its role in health care needs of childhood cancer survivors.…”

Section: Directions For Future Researchmentioning

confidence: 99%

Clinical ascertainment of health outcomes in Asian survivors of childhood cancer: a systematic review

Poon

Peng

et al. 2019

J Cancer Surviv

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Purpose Survivorship in children with cancer comes at a cost of developing chronic treatment-related complications. Yet, it is still an under-researched area in Asia, which shares the largest proportion of the global childhood cancer burden given its vast population. This systematic review summarizes existing literature on clinically ascertained health outcomes in Asian survivors of childhood cancer. Methods A search was conducted on Ovid Medline and EMBASE for studies that focused on survivors of childhood cancer from countries in East and Southeast Asia; adopted post-treatment clinical ascertainment of organ-specific toxicities or/and secondary malignancy. Studies were excluded if health outcomes were assessed during the acute treatment. Results Fifty-nine studies, enrolling a total of 13,442 subjects, were conducted on survivors of leukemia (34%), CNS tumor (14%), and cohorts of survivors with heterogeneous cancer diagnoses (52%). The studies used different medical evaluation methods to assess cardiovascular (15%), metabolic and infertility (32%), and neurological/neurocognitive (20%) outcomes in survivors. The collective findings suggest potential differences in the prevalence of certain late effects (e.g., secondary malignancy and obesity) among Asian and non-Asian populations, which may reflect differences in treatment regimens, practice, genetic variations, or/and socioeconomic disparity. Conclusions We recommend developing collaborative initiatives to build a regional repository of systematically assessed health outcomes and biospecimens to investigate treatment, social-environmental and genetic predictors, and interventions for late effects in this population. Implications for Cancer Survivors The existing types of chronic health problems identified in this review suggest the need for active screening, better access to survivorship care, and promotion of protective health behavior in Asia. Keywords Childhood cancer. Late effects. Survivorship. Risk-based. Asian. Organ toxicity The review was presented at the 8th Nursing Symposium on Cancer Care, Hong Kong (24th to 25th May), and was awarded the Best Poster Award.

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Section: Directions For Future Researchmentioning

confidence: 99%

Clinical ascertainment of health outcomes in Asian survivors of childhood cancer: a systematic review

Poon

Peng

et al. 2019

J Cancer Surviv

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“…27,47 Interest in CIM use has been growing in the pediatric medical community, with survey findings leading to increased education and dissemination efforts, and continued focus on CIM efficacy research in the pediatric context. [48][49][50][51] Less explored in pediatric CIM research is the unique role of parents in critically appraising evidence, and the range of proclivity for parents to engage based on a number of factors, including the severity and acuity of their child's condition, and their own health care practices. 52 In the current study, while some families did use scientific evidence to inform decision-making, the majority relied on providers to guide discussion of evidence, suggesting the need to prioritize new approaches to parent and patient engagement in the pediatric CIM research agenda.…”

Section: Limitationsmentioning

confidence: 99%

Employing Evidence in Evaluating Complementary Therapies: Findings from an Ethnography of Integrative Pain Management at a Large Urban Pediatric Hospital

Roth

Highfield

Cuccaro

et al. 2019

The Journal of Alternative and Complementary Medicine

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Background: Complementary and Integrative Medicine (CIM) shows positive clinical benefit with minimal side effects, yet, challenges to effective integration of CIM providers in biomedical health care settings remain. This study aimed to better understand the role evidence played in the process of integration of complementary therapies into a large urban pediatric hospital from the perspective of patients, caregivers, providers, and administrators through applied medical ethnography. Methods: An ethnography was conducted over the course of 6 months in a large urban pediatric hospital in the Southern United States. At the time, the hospital was piloting an integrative medicine (IM) pain consult service. Purposive sampling was used to select providers, patients, administrators, and caregivers to follow as they engaged with both the preexisting pain service and pilot IM pain services. Field observation and interviews were conducted with 34 participants. Thematic content analysis was used to analyze field notes, interview transcripts, and documents collected. Findings: Analysis of the data revealed five themes regarding the role of evidence in the process of integration: Anecdotal Evidence and Personal Experience Effecting CIM Use, Open to Trying Whatever Works, Resistance to the Unfamiliar, Patients and Parents Trusting Doctors as Experts, and Importance of Scientific Evidence to Biomedicine. All themes address the role of evidence in relationship to acceptance of complementary therapies and correspond with three thought processes: critical thinking, relying on others for evidence, and reactionary thinking. Conclusion: Both scientific and anecdotal evidence informed CIM use in this context. Biomedical environments seeking to integrate CIM into pain treatment regimens will need to engage all relevant stakeholders in building education, clinical training, and research programs that are critically informed about the context and evidence for CIM.

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“…Further, randomly chosen websites and blogs about this topic frequently reveal far-reaching conclusions, with minimal mention of the still preliminary conclusions. Hopefully correcting this trend is a 2017 Clinical Report by the AAP about pediatric integrative medicine that noted that while recent studies suggest benefits of yoga for children, the committee advocated for more systematic studies to ferret out this inquiry [ 144 ].…”

Section: Integrating Yoga and Hypnosismentioning

confidence: 99%

Integrating Pediatric Hypnosis with Complementary Modalities: Clinical Perspectives on Personalized Treatment

Kaiser¹,

Kohen

Brown

et al. 2018

Children

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While pediatric integrative medicine (PIM) emphasizes an “evidence-based practice using multiple therapeutic modalities”; paradoxically, literature reviews examining the prevalence and/or efficacy of such mind–body approaches often address PIM modalities separately. Such contributions are relevant, yet documentation of how to deliver combined complementary approaches in children and youth are scarce. Nevertheless, integrative practitioners in clinical practice routinely mix approaches to meet the individual needs of each patient. Best practices are flexible, and include blending and augmenting services within the same session, and/or connecting modalities sequentially for an incremental effect, and/or referring to outside resources for additional interventions. Resonating with integrative medicine’s definition, this article’s goal is to demonstrate paradigms that “bring together complementary approaches in a coordinated way within clinical practice” by linking clinical hypnosis, the trail-blazer modality in PIM’s history, with mindfulness, biofeedback, acupuncture, and yoga. Following the consideration of the overlap of guided imagery with hypnosis and an abridged literature report, this clinical perspective considers the selection of modalities within a collaborative relationship with the child/teen and parents, emphasizing goodness-of-fit with patients’ contexts, e.g., symptoms, resources, interests, goals, and developmental stage. Case vignettes illustrate practical strategies for mixing approaches.

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Pediatric Integrative Medicine

Cited by 126 publications

References 143 publications

Clinical ascertainment of health outcomes in Asian survivors of childhood cancer: a systematic review

Clinical ascertainment of health outcomes in Asian survivors of childhood cancer: a systematic review

Employing Evidence in Evaluating Complementary Therapies: Findings from an Ethnography of Integrative Pain Management at a Large Urban Pediatric Hospital

Integrating Pediatric Hypnosis with Complementary Modalities: Clinical Perspectives on Personalized Treatment

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