Study of Complementary and Integrative Interventions in Pediatric Patients With Serious Illness

Pediatric patients report using complementary and integrative health interventions (CHI) for symptom management.

Feasibility and initial effect sizes of CHI with patients at two children's hospitals.

Using convenience sampling at two academic centers and accepting the wide age range of patients traditionally treated in children's hospitals, we examined feasibility of CHI and outcomes of quality of life (QOL) and symptoms with validated surveys and two physiologic measures. A priori feasibility thresholds were 90% accrual rate and 60% completion of at least two surveys and one CHI session.

Over 18 months we accrued 100 participants (Site 1, n = 34; Site 2, n = 66) who completed 811 assessments. Participants were aged 2-29 years (M = 13.5, SD = 5.6), 65% female, 23% from underrepresented populations, 52% with cancer versus other serious illness. Accrual rate was 94%, completion rate was 87%, acceptability was 96%. Ninety-nine participants received 191 total CHI sessions: acupuncture (39%), aromatherapy (35%), creative arts (20%), massage therapy (5%) and hypnosis (1%). After CHI heart rate decreased and symptom scores improved for anxiety, fatigue, nausea, pain, and sadness (Cohen's d effect sizes 0.22-0.99). Adjusted mixed-effects models suggested that the Faces Scale scores improved over time (b = -0.19, P < 0.01).

Prospective two-site data collection in relationship to CHI exceeded feasibility thresholds and was acceptable. When given the choice, CHI were popular and may have contributed to improved QOL immediately and longitudinally. These preliminary findings support further study of CHI for targeted symptoms in distinct populations with rigor.