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

Abstract

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

Influences and Barriers on Physical Activity in Pediatric Oncology Patients

“…A recent protocol was published in order to educate schools and peers about a child with cancer’s condition and expectations with PA (31). It requires peers of the child with cancer to act as ambassadors for the child to improve PA.…”

“…Additionally, boredom and lack of ideas for PA can be resolved with the implementation of interventions such as those used in the LEAP program, which has been reported to increase enjoyment of physical exercise (45). A recent study showed that supervised-, targeted-exercise interventions increased PA more than encouraging participants to continue with exercise regimes at home suggesting that physical therapy-targeted interventions may be more efficacious than home-based programs (31). Additionally, an adventure-based training program and health education program has also been shown to increase PA and self-efficacy in this population, which may prevent several barriers identified such as boredom and lack of sports equipment.…”

Scolarité et devenir social après un cancer dans l’enfance

“…Il faut donc envisager de faire entrer l'école « ordinaire » à l'hôpital. C'est ce que suggère l'étude danoise RESPECT (Rehabilitation including Social and Physical activity and Education in children and teenagers with cancer), qui a proposé à 120 enfants de bénéficier d'un programme de soutien scolaire individualisé, avec notamment l'intervention de deux « ambassadeurs », camarades de l'école d'origine, au sein de l'hôpital [24]. Mais l'impact psychologique sur ces sujets sains confrontés à la maladie ne doit pas être négligé et doit nous rendre prudents vis-à-vis de ces pratiques.…”

“…Récemment, l'étude RESPECT au Danemark propose un programme de réhabilitation basé sur une réadaptation scolaire, physique et sociale précoce, structurée, individualisée [24]. Tout comme pour la scolarité, la réhabilitation ou la re-sociabilisation des patients doit devenir une priorité et bien au-delà de la prise en charge initiale.…”

Effects of educational versus peer discussion interventions on perceived competence in adolescents with medulloblastoma

“…6 Moreover, the educational intervention can enhance capacity for self-expression, emotional stability, insight and selfreflection and expand knowledge on rehabilitation in cancer patients. 7,8 Through clinical education intervention, nurses can help adolescents maintain and improve their quality of life. 9 Peer discussion intervention offers patients emotional support, improving self-confidence and promoting helpful downward comparisons (feeling lucky in comparison with others who are worse off).…”