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Reduction of distress associated with paediatric bone marrow transplant: complementary health promotion interventions
1Division of Behavioral Medicine, St. Jude Children's Research Hospital, 332 N. Lauderdale, Memphis, TN 38105-2794, USA. sean.phipps@stjude.org
Insights
Pediatric stem cell/bone marrow transplantation (BMT) causes significant distress. Massage and humor therapy show promise in reducing this distress for children undergoing BMT.
Area of Science:
- Pediatric Oncology
- Hematology
- Psychosocial Support
Background:
- Stem cell/bone marrow transplantation (BMT) is a demanding procedure for pediatric patients with malignancies or catastrophic disorders.
- High levels of somatic distress and mood disturbance are commonly experienced by patients and their families during BMT.
- Existing medical advances have not fully alleviated the psychological burden of BMT.
Purpose of the Study:
- To review laboratory work documenting distress in pediatric BMT patients.
- To identify and evaluate complementary medicine techniques for reducing BMT-related distress.
- To assess the feasibility and potential benefits of complementary health promotion techniques in pilot trials.
Main Methods:
- Review of laboratory findings on patient distress during BMT.
- Literature review of complementary medicine techniques (relaxation/imagery, massage, humor therapy, expressive therapy).
- Pilot studies assessing complementary health promotion techniques in the BMT setting.
Main Results:
- Somatic distress and mood disturbance are significant issues for pediatric BMT patients.
- Massage and humor therapy were perceived as most helpful by patients and parents in pilot trials.
- Complementary therapies offer potential for reducing BMT-related distress.
Conclusions:
- Novel interventions are needed to mitigate distress associated with pediatric BMT.
- Massage and humor therapy are promising complementary approaches for BMT patients.
- Further research, including randomized clinical trials, is warranted to validate these findings.
Abstract:
Despite numerous medical advances in stem cell/bone marrow transplantation (BMT) for children with malignancies or other catastrophic disorders, BMT remains a prolonged and physically demanding procedure that can be associated with high levels of distress for patients and their families. This paper reviews work from our laboratory that documents the high levels of somatic distress and mood disturbance experienced by patients undergoing the procedure, and points to the need for the development of novel interventions to reduce BMT-related distress. Issues of instrumentation and methodology for outcomes assessment are highlighted. Research is reviewed to support the potential benefits of a number of techniques from the field of complementary medicine (relaxation/imagery; massage, humour therapy, expressive therapy) for reduction of transplant-related distress. Finally, we described a series of studies in which complementary health promotion techniques were assessed in pilot trials. Based on patient and parent perception of helpfulness, two complementary treatments, massage and humour therapy, emerged as the most promising approaches for use in the BMT setting and are now the focus of a randomized clinical trial.