Implementation of Child Life Services in Pediatric HSCT: A Pilot Study From Thailand

Area of Science:

• Pediatric Hematology
• Child Psychology
• Healthcare Interventions

Background:

• Pediatric hematopoietic stem cell transplantation (HSCT) offers improved survival rates but often leads to significant physical and psychological distress in children.
• A notable gap exists in supportive care services for pediatric HSCT patients, particularly in resource-limited settings like Thailand.

Purpose of the Study:

• To evaluate the feasibility of implementing a child life program for pediatric HSCT patients in Thailand.
• To assess the preliminary effects of a child life program on the quality of life and psychological well-being of children undergoing HSCT.

Main Methods:

• A pilot pre-post study design was employed, including 10 children aged 2-8 years undergoing HSCT.
• The intervention incorporated an HSCT educational video, therapeutic play, art therapy, online group activities, and post-discharge homebound instruction.
• Outcomes were measured using validated instruments: Pediatric Quality of Life Inventory (PedsQL), Child Behavior Checklist (CBCL), and Parenting Stress Index (PSI), with data analyzed via paired t-tests.

Main Results:

• Significant improvements were observed in PedsQL total scores, as well as nausea and nutrition-related subscales.
• A slight decrease in Parenting Stress Index (PSI) difficult child scores was noted, while Child Behavior Checklist (CBCL) scores did not show significant changes.
• Six children successfully returned to school within one year of the intervention, indicating a positive impact on reintegration.

Conclusions:

• The child life program demonstrated feasibility in the context of pediatric HSCT care in Thailand.
• Preliminary findings suggest that child life services hold potential for enhancing the short-term quality of life for pediatric HSCT patients.