Resilience in Children Undergoing Stem Cell Transplantation: Results of a Complementary Intervention Trial

Abstract

BACKGROUND: Children undergoing stem cell transplantation (SCT) are thought to be at risk for increased distress, adjustment difficulties, and impaired health-related quality of life (HRQL). We report results of a multisite trial designed to improve psychological adjustment and HRQL in children undergoing SCT. METHODS: A total of 171 patients and parents from 4 sites were randomized to receive a child-targeted intervention; a child and parent intervention; or standard care. The child intervention included massage and humor therapy; the parent intervention included massage and relaxation/imagery. Outcomes included symptoms of depression and posttraumatic stress, HRQL, and benefit finding. Assessments were conducted by patient and parent report at admission and SCT week+24. RESULTS: Across the sample, significant improvements were seen on all outcomes from admission to week+24. Surprisingly, patients who had SCT reported low levels of adjustment difficulties at admission, and improved to normative or better than average levels of adjustment and HRQL at week+24. Benefit finding was high at admission and increased at week+24; however, there were no statistically significant differences between intervention arms for any of the measures. CONCLUSIONS: Although the results do not support the benefits of these complementary interventions in pediatric SCT, this may be explained by the remarkably positive overall adjustment seen in this sample. Improvements in supportive care, and a tendency for patients to find benefit in the SCT experience, serve to promote positive outcomes in children undergoing this procedure, who appear particularly resilient to the challenge.

Effects of the application of therapeutic massage in children with cancer: a systematic review

“…In one of the papers (16) the average age was 6.9 years. In the remainder studies, subjects were between 4 and 18 years old 13 , 17 - 19 .…”

“…In one of the intervention groups massage therapy and humor is applied and in the other in addition to the above the parents were instructed in massage and relaxation. The intervention consisted of massage applied on the body 13 - 19 .…”

“…Most studies used the Swedish massage 14 - 17 , 19 , applying techniques of effleurage, petrissage, frictions and compressions 13 - 15 , 17 - 19 with moderate pressure. The maneuvers were applied in combination (13- 19 , predominating effleurage, petrissage and digital kneading 15 - 16 , 18 .…”

Yoga in addition to standard care for patients with haematological malignancies

“…However, after obtaining the full text articles, we excluded the publications for the following reasons: 13 publications were not reporting on RCTs or did not compare yoga interventions with standard care only (Adamsen 2006; Buffart 2012; Feng 2004; Fonteyn 2005; Habermann 2009; Jarden 2013; Kelly 2009; Kvillemo 2011; Phipps 2012; Shvarts 2013; Silva 2011; van Haren 2013; Williams 2006) and one trial included less than 80% participants with haematological malignancies and focused only on breathing techniques (Dhruva 2012). For more details see the Characteristics of excluded studies table.…”

The Impact of Cancer and its Treatment on the Growth and Development of the Pediatric Patient

“…Many patients continue to do well at 5 and 10 years out from cancer treatment (Phipps et al, 2012). Those who do less well are more likely to have higher levels of distress during treatment, poor social and family support, and/or late-effects of their cancer treatment that interfere with their functioning (Bitsko et al, 2016;Kwak et al, 2013;Prasad et al, 2015;Schultz et al, 2007).…”