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Cognitive-behavioral interventions for children's distress during bone marrow aspirations and lumbar punctures: a
1School of Nursing, University of Ottawa, Ontario, Canada.
Insights
Nonpharmacologic cognitive-behavioral strategies like distraction and hypnosis can help reduce procedural pain and anxiety in children with cancer. These methods offer a promising alternative to medication for managing distress during medical procedures.
Area of Science:
- Pediatric Oncology
- Clinical Psychology
- Pain Management
Background:
- Children with cancer experience significant distress from invasive procedures like bone marrow aspirations and lumbar punctures.
- Traditional methods such as general anesthesia, sedatives, and anxiolytics present risks, increased costs, and limited effectiveness.
- There is a need for effective nonpharmacologic interventions to manage procedural pain and anxiety in pediatric cancer patients.
Purpose of the Study:
- To critically examine intervention studies focusing on cognitive-behavioral strategies for procedural distress in children with cancer.
- To evaluate the efficacy of nonpharmacologic methods in reducing pain and anxiety during medical procedures.
Main Methods:
- Systematic review and critical analysis of intervention studies.
- Focus on cognitive-behavioral strategies including distraction, imagery, and hypnosis.
- Assessment of study designs and outcomes related to procedural distress.
Main Results:
- Cognitive-behavioral strategies show potential for reducing procedural distress in pediatric cancer patients.
- Distraction, imagery, and hypnosis are identified as key nonpharmacologic interventions.
- Further research is needed to establish definitive efficacy across diverse populations and procedures.
Conclusions:
- Nonpharmacologic cognitive-behavioral strategies offer a viable approach to managing procedural distress in children with cancer.
- These methods provide a safer and potentially more effective alternative to pharmacologic interventions.
- Continued investigation into these techniques is warranted to optimize their application in pediatric oncology care.
Abstract:
Children with cancer often have difficulty coping with the invasive medical procedures that are part of diagnosis and treatment. Bone marrow aspirations and lumbar punctures are painful and cause some children severe anxiety and distress. The increased risk and expense of general anesthesia and the relative ineffectiveness of sedatives and anxiolytics has prompted clinicians to examine nonpharmacologic methods for controlling pain and distress. This report critically examines intervention studies that focus on cognitive-behavioral strategies such as distraction, imagery, or hypnosis for reducing procedural distress in children with cancer.
