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Pain Experiences During Early Treatment for Pediatric Acute Lymphoblastic Leukemia: A Qualitative Study
Kimberly L Klages1,2, Cecelia I Nelson1,2, Julia K Herriott1
1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Pediatric acute lymphoblastic leukemia (ALL) patients face significant, multifaceted pain during early treatment. Effective pain management requires early, developmentally appropriate, and family-centered strategies.
Area of Science:
- Pediatric Oncology
- Pain Management
- Hematology
Background:
- Pain is a prevalent and distressing symptom for pediatric patients with acute lymphoblastic leukemia (ALL).
- Early treatment phases (induction, early consolidation) present complex, evolving pain sources.
- Pain experiences in this critical period are poorly understood.
Purpose of the Study:
- To qualitatively examine the pain experiences of children with ALL during induction and early consolidation.
- To characterize the multifaceted nature of pain in pediatric ALL patients early in treatment.
Main Methods:
- Semi-structured interviews with 20 caregivers and 8 pediatric patients (ages 2-17).
- Interviews captured pain experiences across early treatment phases.
- Thematic analysis of transcribed interviews.
Main Results:
- Eight key themes emerged, detailing pain dimensions: sources, characteristics, symptoms, influencing factors, impact, expression, management tools, and barriers.
- Findings highlight the evolving and multidimensional nature of pain during early ALL treatment.
Conclusions:
- Children with ALL experience substantial and multifaceted pain early in their cancer journey.
- Emphasizes the need for early, developmentally informed, family-centered pain assessment and management.
- Addresses the complex and evolving pain landscape during initial pediatric ALL treatment.
Background:
Pain is a common and distressing symptom for pediatric patients with acute lymphoblastic leukemia (ALL), arising from the disease itself, its treatment, and associated medical procedures. The early phase of treatment is particularly challenging, as children experience multiple, rapidly evolving sources of pain. Despite its prevalence, pain during this period remains poorly characterized. This study qualitatively examined pain experiences among children with ALL during induction and early consolidation.
Methods:
Twenty caregivers of children with ALL (ages 2-17) and eight patients (ages 8-17) participated in two semi-structured interviews capturing pain experiences across early treatment. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.
Results:
Eight themes described key dimensions of the pain experience: Sources of Pain, Pain Characteristics, Pain-Related Symptoms, Factors Influencing Pain, Pain Impact, Pain Expression, Pain Management Tools, and Barriers to Pain Management. These themes reflected the evolving, multidimensional nature of pain during early treatment.
Conclusions:
Children with ALL experience substantial and multifaceted pain early in their cancer trajectory. Findings underscore the need for early, developmentally informed, and family-centered approaches to pain assessment and management that address the complex and evolving nature of pain during initial treatment.
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