Integrative Care Therapies and Pain in Hospitalized Children and Adolescents: A Retrospective Database Review

Abstract

Background: Complementary or integrative care therapies are promising adjunctive approaches to pain management for pediatric inpatients that are currently underused and understudied. The purpose of this study was to examine the potential benefits of integrative care therapies delivered to hospitalized children and adolescents at a large Midwestern academic pediatric medical center over a 1-year period. Methods: A retrospective chart review of an inpatient clinical database maintained by integrative care therapists over a 1-year period was used for the current study. Pre/post pain and relaxation scores associated with the delivery of inpatient integrative care therapies (primarily massage therapy and healing touch) were examined. Results: Five-hundred nineteen hospitalized children and adolescents were treated by integrative care therapists for primarily pain or anxiety needs. Patients had a mean age of 10.2 years (standard deviation, 7.0), 224 were female (43%), 383 were white (74%), and most (393 [77%]) received massage therapy. Mean pain and relaxation scores decreased significantly from pre-to post-therapy across all demographic and clinical subgroups ( p £ .001). Conclusions: Although integrative care therapies are increasingly requested and offered in children's hospitals, provision of these approaches is driven primarily by consumer demand rather than evidence-informed practice. Future controlled studies should examine the incremental effects of integrative care therapies as an adjunct to conventional treatment, assess how these therapies work mechanistically, and determine whether they improve outcomes, such as pain and cost, for hospitalized children and adolescents.

Referrals to integrative medicine in a tertiary hospital: findings from electronic health record data and qualitative interviews

“…Our study addresses several gaps in the literature with regard to the provision of IM in US hospitals, as IM referral processes within an inpatient setting have not been studied previously. Although IM is increasingly being provided to US inpatients in areas such as oncology 14 15 and paediatrics, 16 17 hospitals with well-established IM offerings for inpatients are more prevalent internationally (eg, in Israel, 18 19 Germany 20 21 and China 22 ). However, operational processes and cultural contexts surrounding acceptance of IM are substantially different internationally in comparison with the USA, where IM offerings are less widespread and assimilated.…”

Use of Acupuncture in an Infant with Restlessness and Agitation

“…Another primary reason that complementary methods have turned out highly beneficial in inpatient paediatric settings can be seen from the infants’ relaxation, especially in agitated babies with NAS [ 40 ]. It has also been shown that the combination of ear and body acupuncture is very successful [ 41 ].…”

Integrative Care Therapies and Physiological and Pain-related Outcomes in Hospitalized Infants

“…As previously described, the data collected were entered into a network-secured clinical database, along with standard demographic patient information, reason for integrative care referral, the type of integrative care therapy received, and the duration of the intervention. 36 Approval for this retrospective chart review was obtained from the hospital's institutional review board, and ethical standards were maintained throughout the research process.…”

“…Initial data cleaning was conducted on the full clinical database as described in our previous paper 36 ; the full database also contained child and adolescent data, while this investigation included only those assessed using the Neonatal Infant Pain Scale to create a previously unreported and distinct sample of 213 patients seen in the NICU. While the full clinical database included multiple interventions and even multiple hospitalizations for some patients, only the first intervention during the first hospitalization in the study period was included in analysis to limit potential effects from patients acclimating to therapies over time.…”