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Play-based procedural preparation and support intervention for cranial radiation
Shawna Grissom1, Jessika Boles2, Katherine Bailey2
1Child Life Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 121, Memphis, TN, 38105, USA. shawna.grissom@stjude.org.
Insights
Play-based interventions by child life specialists significantly reduce sedation needs and healthcare costs for children with central nervous system tumors undergoing radiation therapy. This approach enhances patient care and demonstrates cost-effectiveness in pediatric oncology.
Area of Science:
- Pediatric Oncology
- Child Life Services
- Radiation Therapy
Background:
- Children with central nervous system (CNS) tumors often require sedation during radiation therapy.
- Sedation use incurs significant healthcare costs and potential risks.
- Play-based procedural preparation and support interventions may offer an alternative.
Purpose of the Study:
- To examine the relationship between play-based procedural preparation and support interventions and sedation use in pediatric patients with CNS tumors during radiation therapy.
- To analyze the cost-effectiveness of these interventions compared to daily sedation costs.
Main Methods:
- Retrospective chart review of 116 children aged 5-12 years undergoing radiation therapy.
- Interventions included developmentally appropriate play, education, preparation, and distraction by a certified child life specialist.
- Outcome measures: radiation treatments, sedation use, and intervention type/duration.
Main Results:
- Age, tumor location, and intervention number/duration were associated with sedation use.
- Multivariate analysis confirmed a significant relationship between intervention characteristics and reduced sedation needs.
- Play-based interventions significantly decreased healthcare costs by reducing the need for daily sedation.
Conclusions:
- Child life specialist-provided support interventions effectively decrease sedation use and associated costs during cranial radiation therapy for pediatric CNS tumors.
- This highlights the value of child life professionals in delivering cost-effective, play-based developmental care.
- The findings support the integration of child life services as a crucial component of pediatric cancer care.
Purpose:
The primary objective of this study was to examine the relationship between play-based procedural preparation and support intervention and use of sedation in children with central nervous system (CNS) tumors during radiation therapy. The secondary objective was to analyze the cost-effectiveness of the intervention compared to costs associated with daily sedation.
Methods:
A retrospective chart review was conducted, and 116 children aged 5-12 years met criteria for inclusion. Outcome measures included the total number of radiation treatments received, the number of treatments received with and without sedation, and the type and duration of interventions, which consisted of developmentally appropriate play, education, preparation, and distraction provided by a certified child life specialist.
Results:
The results of univariate analyses showed that age, tumor location, and total number and duration of interventions were significantly associated with sedation use during radiation therapy. Multivariate analyses showed that, after adjustment for age, tumor location, and craniospinal radiation, a significant relationship was found between the total number and duration of the interventions and sedation use. The implementation of a play-based procedural preparation and support intervention provided by a certified child life specialist significantly reduced health-care costs by decreasing the necessity of daily sedation.
Conclusions:
Support interventions provided by child life specialists significantly decreased both sedation use and the cost associated with daily sedation during cranial radiation therapy in children with CNS tumors. This study supports the value of the child life professional as a play-based developmental specialist and a crucial component of cost-effective healthcare.
