Use of Complementary and Alternative Medical Interventions for the Management of Procedure-Related Pain, Anxiety, and Distress in Pediatric Oncology: An Integrative Review

Abstract

This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind–body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology.

Oncologic pain relief: strategies told by adolescents with cancer

“…Distraction refers to focusing one's attention on another stimulus than the pain, and one of its main goals is to help and manage the anxiety before potentially painful procedures. 21 It is recommended when there is insufficient time to prepare the children and adolescents for the procedures and involves a large range of techniques, from the simplest, like counting (numbers), singing, to the most elaborate ones, like watching a video or using play and games. 21 As a result of the hospitalization needs of children and adolescents with cancer, often, the affective bonds between parents and children are tightened and strengthened and, frequently, the sick child turns into the focus of attention, due to the weakness the disease causes.…”

“…21 It is recommended when there is insufficient time to prepare the children and adolescents for the procedures and involves a large range of techniques, from the simplest, like counting (numbers), singing, to the most elaborate ones, like watching a video or using play and games. 21 As a result of the hospitalization needs of children and adolescents with cancer, often, the affective bonds between parents and children are tightened and strengthened and, frequently, the sick child turns into the focus of attention, due to the weakness the disease causes. Over time, the family stops being a spectator at the hospital and becomes a participatory agent in the treatment, besides serving as a protective elements of the children and adolescents' emotional, cognitive and social aspects, entailing a new form of care, the so-called family-centered care.…”

Ansiedad dental: evaluación y tratamiento

“…La distracción es particularmente efectiva en niños pequeños o cuando hay poco tiempo disponible para la preparación. Entre los tipos de técni-cas de distracción se encuentran el cantar, ver un video, jugar un juego o cualquier otra cosa que mantenga la atención del niño fuera del procedimiento clínico (49).…”

Distraction methods for pain relief of cancer children submitted to painful procedures: systematic review

“…Common during diagnosis and management, pain may result from painful procedures, disease progression or nerve compression, among other factors 3 . It is important to note REVIEW ARTICLE DOI 10.5935/1806-0013.20150028 that invasive procedures, common in different moments of the therapy imposed to cancer patients, induce the most distressing and difficult pain experiences for children and their parents, justifying further focus on handling pain related to such procedures 4 . Currently, adequate pain management is becoming increasingly relevant, since it is considered indicator both of quality of life (QL) and of the assistance itself 5 , being that such management should take into consideration physical, psychosocial and spiritual aspects of patients and their families 6 .…”

“…In addition, it is critical to prioritize the investigation of their most different application manners and of their results to manage other signs and symptoms different from pain, such as nausea, vomiting and anxiety 8 . Knowledge coming from available evidences is an important tool for the identification of different types of non-pharmacological therapies to prevent or decrease invasive procedure-related pain 4 . This study aimed at identifying in the scientific literature effective distraction interventions for pain relief and control in cancer children submitted to invasive procedures, summarizing identified results, so that health professionals may use such information for the benefit of better assistance to pediatric patients in terms of pain management.…”