How Effective Are Spiritual Care and Body Manipulation Therapies in Pediatric Oncology? A Systematic Review of the Literature

Abstract

Background:The effects of cancer and associated treatments have a considerable impact on the well-being and quality of life of pediatric oncology patients. To support children and their families, complementary and alternative medicines are seen by nurses and doctors as practical to integrate to the services offered by hospitals.Objective:The purpose of this paper is to examine if the practice of complementary and alternative medicine, specifically spiritual care and treatments based on body manipulation, is likely to improve the health and well-being of children suffering from cancer.Method:This objective is achieved through a systematic review of the literature. The level of evidence associated with each practice of complementary and alternative medicine was assessed according to the methodological design used by the studies reviewed.Results and Conclusion:Studies reviewed are of a methodological quality that could be described as fair due to the small sample size of patients and the existence of a number of biases in the conduct and analysis of these studies. However, results obtained are consistent from one study to another, allowing us to make certain recommendations. It is thus advisable to consider the introduction of hypnotherapy in pediatric oncology services. Based on the data collected, it is the complementary and alternative medicine with the most evidence in favor of effectiveness of the well-being of pediatric oncology patients, especially during painful procedures. It is also recommended to use art therapy and music therapy. Conversely, too little evidence is present to be able to recommend the use of acupuncture, chiropractic or osteopathy.

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).…”

“…Review articles and almost all studies found some benefit of distraction, such as reduced pain and distress (anxiety/fear). [64,65,67,84,86,90,91] Even when distraction was no more effective than standard care, children and parents still reported it to be helpful, enjoyable, and that they would like to use it again. [80,98] Despite this evidence, it remains unclear what make an effective distraction intervention, although considerations of adult involvement, child choice of distracter, requirement to interact with a distracter, and/or use of technology may be helpful.…”

“…[119][120][121][122][123] Increased practice of intervention strategies at home prior to the procedure appears associated with more benefit. [115] Individual RCT, quantitative studies, and review articles support hypnosis for reducing child procedural pain and/or distress, [35,64,67,84,[86][87][88]91,[124][125][126][127] although some inconsistent evidence is also found. [92,104] Hypnosis is a state of heightened awareness and focused attention, often involving relaxation.…”

Biological Effects of Music in Cancer Patients: Contributing to an Evidence-Based Practice

“…5,12 North American and Canadian articles observed, likewise, improvement of pediatric patients with cancer's mood and pattern of anxiety. 17,18,19,33 A clinical study involving children attending ambulatory care to cancer disease follow-up exposed patients to 20 minutes of music in their second consultation, being the control group composed by the same patients, in their first consultation. It was attested promotion of comfort and relaxation after the intervention.…”

Used of Complementary and Alternative Medicine on Symptoms Management and Quality of Life

“…Complementary and alternative medicine (CAM), which is not considered as a part of traditional medicine, can be deined as a various medical health care systems, practices, and products. Nowadays, among the most known and applied CAM methods are acupuncture, aromatherapy, osteopathy, yoga, massage, and various herbal supplements [1,13,14]. According to the National Center for Complementary and Alternative Medicine (NCCAM), there are three broad categories of CAM: natural products, spiritual care (mindbody), and treatments based on body manipulation [14].…”