A Review of Supportive Care Interventions to Manage Distress in Young Children With Cancer and Parents

Abstract

The authors discuss the implications of review findings for clinical practice.

Procedural Preparation and Support as a Standard of Care in Pediatric Oncology

“…Psychological interventions involve cognitive and/or behavioral components that focus on modifying children's thoughts and beliefs or teaching behavioral strategies to enhance coping and reduce pain and distress from medical procedures. [64][65][66][67]79,[85][86][87][88][89][90][91][92] Strategies can be implemented prior (immediately or days/weeks before), during, and/or following completion of the procedure. Reviewed interventions included distraction (21 studies), combined cognitive-behavioral (11 studies), hypnosis (six studies), memory reframing (two studies), breathing (one study), art therapy (one study), behavioral training (one study), and biofeedback/relaxation (one study).…”

Effectiveness of nonpharmacological interventions to reduce procedural anxiety in children and adolescents undergoing treatment for cancer: A systematic review and meta‐analysis

“…Such procedures may induce internal feelings of anxiety and worry, which manifest in displays of emotional or physical distress. Distress for young patients and their families is high during cancer treatment and may persist after treatment ends, disrupting family dynamics . Often young patients consider treatment procedures, rather than the condition itself, as the most difficult part of having cancer, with procedural anxiety considered the most negative burden on quality of life in one sample of children and young people (CYP) with cancer .…”

“…Often young patients consider treatment procedures, rather than the condition itself, as the most difficult part of having cancer, with procedural anxiety considered the most negative burden on quality of life in one sample of children and young people (CYP) with cancer . Indeed, up to half of young children with cancer experience clinically significant emotional distress throughout acute treatment . Patients may require many invasive distressing needle procedures as part of intravenous (IV) therapy, such as lumbar puncture, bone marrow aspiration, IV catheter insertion, IV port access, and venepuncture …”

“…As such distress related to cancer treatment may be transient, dissipating after the procedure, while anxiety, fear, and worry may persist. Despite anxiety and distress being defined differently, much literature uses the terms synonymously alongside fear to describe procedural anxiety . Because anxiety, fear, and distress are different but closely linked, we consider all three outcomes as important.…”

“…No previous systematic reviews have conclusively reviewed the quality and effectiveness of trials of nonpharmacological interventions for procedural anxiety in CYP. Instead, previous reviews have focused on parent‐child interventions and populations that include young adults, , , , while an integrative review by Landier and Tse described relevant trials with a range of study designs but is now out of date. Perhaps of most relevance to the current review, Thrane examined the effectiveness of integrative modalities on pain and anxiety in 1 to 18 year olds with cancer.…”