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Age-appropriate preparations for children with cancer undergoing radiotherapy: A feasibility study
Jenny Gårdling1, Erna Törnqvist1, Marie Edwinson Månsson1
1Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Insights
Age-appropriate preparation for pediatric cancer patients undergoing radiotherapy (RT) was feasible and acceptable. While not statistically significant, individualized preparation may reduce the need for general anesthesia (GA), benefiting children and healthcare costs.
Area of Science:
- Pediatric Oncology
- Radiation Therapy
- Child Psychology
Background:
- Radiotherapy (RT) in children with cancer often requires general anesthesia (GA).
- Anxiety and emotional distress are common in pediatric patients during cancer treatment.
- Standardized preparation protocols may not adequately address the unique needs of children undergoing RT.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of age-appropriate information and preparation for children with cancer undergoing RT.
- To assess the impact of preparation on the need for general anesthesia (GA) and patient anxiety.
- To explore the relationship between GA and emotional behavior in pediatric RT patients.
Main Methods:
- A quasi-experimental controlled clinical trial comparing an intervention group (IG) with age-appropriate preparation to a control group.
- 17 children (3-18 years) in the IG and 16 in the control group were assessed.
- Feasibility (recruitment, compliance, acceptability) and effectiveness (need for GA, anxiety, emotional behavior) were measured using validated instruments.
Main Results:
- The preparation protocol was found to be feasible and acceptable, with no dropouts in the IG.
- No statistically significant differences were observed in the number of children requiring GA or in anxiety levels between groups.
- Three children in the IG, initially planned for GA, completed 73 fractions awake.
- Children receiving GA exhibited significantly higher negative emotional behavior, irrespective of the group.
Conclusions:
- Individualized, age-appropriate preparation for pediatric cancer patients undergoing RT appears feasible and acceptable.
- Preparation may reduce the reliance on general anesthesia, leading to fewer risks and restrictions for the child.
- Reducing GA use during RT offers significant benefits for children's well-being and can lower healthcare expenses.
Abstract:
The aim of this study was to test age-appropriate information and preparation procedures for children with cancer undergoing radiotherapy (RT) for feasibility and effectiveness in terms of the need for general anesthesia (GA) and anxiety. In a quasi-experimental controlled clinical trial, 17 children aged 3-18 years receiving age-appropriate preparation were compared with 16 children in a control group. Feasibility in terms of recruitment, compliance, and acceptability was assessed. Effectiveness was assessed by the number of children who underwent treatment without GA and their respective fractions and validated instruments measured the children's anxiety and emotional behavior. The preparation parts were delivered as intended without any additional personnel and without dropouts in the intervention group (IG) and therefore found feasible and acceptable. No statistic significances were found concerning the number of children receiving GA or anxiety. However, three children planned for GA in the IG completed their treatments, including 73 fractions awake. Children receiving GA, regardless of group, showed significantly higher negative emotional behavior. Giving children individualized preparation may decrease the need for GA during RT, which gives benefits in terms of fewer risks and restrictions in life for the child and lower costs for health care.
