Reducing pain and distress related to needle procedures in children with cancer: A clinical practice guideline

Loeffen, Erik A. H.; Mulder, Renée L.; Font-Gonzalez, Anna; Leroy, Piet L. J. M.; Dick, Bruce; Taddio, Anna; Ljungman, Gustaf; Jibb, Lindsay; Tutelman, Perri R.; Liossi, Christina; Twycross, Alison; Positano, Karyn; Knops, Rutger R. G.; Wijnen, Marc H. W. A.; Wetering, M. D. van de; Kremer, Leontien C. M.; Dupuis, L. Lee; Campbell, Fiona; Tissing, Wim J. E.

doi:10.1016/j.ejca.2020.02.039

Cited by 46 publications

(51 citation statements)

References 33 publications

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“…Although the number of cases has increased, the survival rate has also reached to 80% to 85%. With the increase in survival rate, children with cancer frequently go through prolonged medical processes involving repeated injection processes that can cause anxiety (Birnie et al, 2018; Loeffen et al, 2020). Therefore, needle procedures are still one of the most painful and stressful procedures used as part of the treatment of cancer in children (Jibb et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, needle procedures are still one of the most painful and stressful procedures used as part of the treatment of cancer in children (Jibb et al, 2015). The pain caused by the applied procedures and treatment has been reported to be a greater problem than the malignant disease itself for children with cancer (Jibb et al, 2015; Loeffen et al, 2020; Nilsson et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Children with cancer experience many potentially painful and stressful needle interventions such as access to the venous port access, intravenous access, and bone marrow punctures (Loeffen et al, 2020). Inadequate pain management could have a negative impact on children, parents, and health care providers (Atzori et al, 2018a; Wong et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Pain control is important for treatment of children and is one of the most fundamental duties of nurses (Matsangidou et al, 2017). Therefore, pain should be assessed and managed taking into consideration that children need to be approached in an appropriate manner that suits their cognitive development, and nurses need to be knowledgeable about innovative pain management methods (Loeffen et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Semerci

Kostak

Eren

et al. 2020

J Pediatr Oncol Nurs

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Purpose: Needle procedures are one of the most distressing practices for pediatric oncology patients. Virtual reality (VR) is a distraction method which offers an extremely realistic and interactive virtual environment and helps reduce needle-related pain and distress. The aim of this study was to evaluate the effects of VR method on pain during venous port access in pediatric oncology patients aged 7 to 18 years. Method: Children who had cancer and were between the ages of 7 and 18 years and undergoing a port-a-cath access were randomly assigned through blocked randomization to either the VR intervention group or control group. A commercially available VR headset was fitted to children in the intervention group. Immediately after the port access, pain scores were obtained from children’s self-reports and parents’ proxy reports, using the Wong–Baker FACES Pain Rating Scale. Results: Descriptive characteristics of the children ( n = 71) showed a homogeneous distribution between groups. During the procedure, children in the control group ( n = 36; 5.03 ± 3.35) experienced more pain than the children in VR group ( n = 35; 2.34 ± 2.76; p < .001). Proxy reports of the parents in the experimental group (1.77 ± 2.46) were found to be lower than those in the control group (4.67 ± 2.56; p < .001). Conclusions/Implications for Practice: VR method is effective for reducing pain during venous port access in pediatric oncology patients. VR should be used as a distraction method during venous port access.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Semerci

Kostak

Eren

et al. 2020

J Pediatr Oncol Nurs

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“…CPGs should be patient centered, valid, accessible, and practical. Assessing which outcomes and experiences are of greatest importance to families and clinicians has been prioritized in the development of many supportive care CPGs, including the following: avoiding death from toxicity 31 ; shortening the hospital stay 32 ; and minimizing pain, 33 mucositis, 34 nausea, 35 and fatigue. 36 CPG validity can be assessed by using a formal assessment tool (such as AGREE II [Appraisal of Guidelines for Research and Evaluation]) 37 or by using guidelines endorsed by an organization that has undertaken such an assessment.…”

Section: Interventions To Improve Symptomsmentioning

confidence: 99%

Improving symptom control and reducing toxicities for pediatric patients with hematological malignancies

2020

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The continuing improvement in pediatric cancer survival over time is largely attributable to the availability of intensive therapies. Increasing attention has been focused on addressing the physical and psychosocial impacts of cancer and cancer treatments. Evidence from adult oncology suggests that routine symptom screening and feedback to health care providers can improve patient-clinician communication, reduce distress, and improve quality of life and may even increase survival. Many questions remain regarding implementation of routine symptom screening in pediatric cancer care, including the best symptom assessment instrument and the reporter type and feasibility of integration with electronic health records (EHRs). Nonsymptom adverse events are also important, for both routine clinical care and adverse event reporting for patients enrolled in clinical trials. However, traditional mechanisms for reporting adverse events lead to substantial inaccuracies and are labor intensive. An automated approach for abstraction from EHRs is a potential mechanism for improving accuracy and reducing workload. Finally, identification of symptom and nonsymptom toxicities must be paired with prophylactic and therapeutic strategies. These strategies should be based on clinical practice guidelines that synthesize evidence and use multiprofessional, multidisciplinary expertise to place this evidence in clinical context and create recommendations. How best to implement clinical practice guidelines remains a challenge, but EHR order sets and alerts may be useful. In summary, although survival is excellent for pediatric patients receiving cancer therapies, more focus is needed on identification of symptoms and nonsymptom toxicities and their management. The EHR may be useful for promoting better supportive care through these mechanisms.

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Pain monitoring app leads to less pain in children with cancer at home: Results of a randomized controlled trial

Simon,

Schepers,

van Gorp

et al. 2023

Cancer

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BackgroundThe authors developed a pain monitoring app offering educational information, and real‐time health care professional feedback on clinically significant pain (>4 numeric rating scale [NRS]‐11) for children with cancer to reduce pain at home.MethodsThis monocenter, nonblinded randomized controlled trial enrolled Dutch children (0–18 years old) receiving cancer treatment (≥3 months after diagnosis, ≥2 months treatment remaining). Children were randomly assigned to use the app or receive usual care (two parallel groups). We assessed whether use of the app yielded less clinically significant pain (aim 1) and whether it affected pain severity, duration, interference, pain management strategies, and parental emotional well‐being (aim 2). The app was also evaluated by families (aim 3).ResultsA total of 94 children were randomized to use the app (15 drop‐outs), and 90 were to receive care as usual (11 drop‐outs). The app group (n = 79, mean age: 7.5 [5.1] years, 48% girls, 63% hemato‐oncology diagnosis) reported significantly less clinically significant pain compared to usual care (n = 79, mean age: 7.5 [5.4] years, 52% girls, 65% hemato‐oncology diagnosis) (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.198–0.734]) (aim 1), as well as significantly lower pain severity (β = –0.27; 95% CI, –0.407 to –0.142). No differences were found for duration, interference, or management strategies. Parents in the app group reported significantly less distress compared to usual care (β = –0.84; 95% CI, –1.61 to –0.03]) (aim 2). Families generally evaluated the app positively (aim 3).ConclusionsUse of the app resulted in less clinically significant pain at home. The exact working mechanisms of the app should be further elucidated.

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Reducing pain and distress related to needle procedures in children with cancer: A clinical practice guideline

Cited by 46 publications

References 33 publications

Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Improving symptom control and reducing toxicities for pediatric patients with hematological malignancies

Pain monitoring app leads to less pain in children with cancer at home: Results of a randomized controlled trial

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