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Helping preschool leukemia patients and their parents cope during injections
S W Powers1, R L Blount, P J Bachanas
1Children's Hospital Medical Center, Psychology Services, Cincinnati, Ohio 45229-3039.
Insights
Parents coached children with leukemia through painful medical procedures, teaching them coping skills. This intervention reduced children's distress during injections, improving their ability to manage medical challenges.
Area of Science:
- Pediatric Oncology
- Child Psychology
- Behavioral Medicine
Background:
- Children undergoing cancer treatment often experience significant distress during medical procedures.
- Effective coping strategies are crucial for managing pain and anxiety in pediatric patients.
- Parental involvement can enhance the effectiveness of interventions for children's medical coping.
Purpose of the Study:
- To teach preschool leukemia patients specific coping behaviors for painful injections.
- To train parents to coach their children in using these coping behaviors.
- To evaluate the impact of this intervention on children's behavioral distress.
Main Methods:
- A multiple baseline across-subjects design was employed.
- Intervention involved teaching coping behaviors to children and coaching to parents.
- Behavioral distress was assessed using the Child-Adult Medical Procedure Interaction Scale-Revised (CAMPIS-R) and Observation Scale of Behavioral Distress (OSBD), alongside parent and nurse ratings.
Main Results:
- Parents successfully learned and implemented coping-promoting behaviors.
- Children acquired and utilized specific coping behaviors during procedures.
- Children demonstrated a significant reduction in behavioral distress.
Conclusions:
- Parent-assisted coping interventions are effective in reducing distress in preschool leukemia patients.
- The learned coping behaviors were maintained, suggesting lasting benefits.
- Findings support the integration of such strategies into clinical practice for pediatric oncology care.
Abstract:
Taught 4 preschool leukemia patients (ages 3-5) to engage in specific coping behaviors before and during painful intramuscular and intravenous injections. Parents were taught to coach their children in the use of the coping behaviors. Intervention was delivered in a multiple baseline across-subjects design. Parent and child behavior was coded using the Child-Adult Medical Procedure Interaction Scale-Revised (CAMPIS-R, Blount, Powers, & Sturges) and Observation Scale of Behavioral Distress (OSBD, Elliott, Jay, Woody). Parents and nurses rated child behavior as well. Results indicated that parents learned coping-promoting behaviors, children learned specific coping behaviors, and children displayed less behavioral distress. Maintenance of behavior change was addressed. Contributions of this study to the current literature on children's coping with invasive medical procedures and implications for future research and clinical practice are discussed.