Skip to main content
Top
Published in: Radiation Oncology 1/2018

Open Access 01-12-2018 | Research

Children’s experiences and responses towards an intervention for psychological preparation for radiotherapy

Authors: Gunn Engvall, Viveca Lindh, Tara Mullaney, Tufve Nyholm, Jack Lindh, Charlotte Ångström-Brännström

Published in: Radiation Oncology | Issue 1/2018

Login to get access

Abstract

Background

Children can experience distress when undergoing radiotherapy as a reaction to being scared of and unfamiliar with the procedure. The aim was to evaluate children’s experiences and responses towards an intervention for psychological preparation for radiotherapy.

Methods

A case control design with qualitative content analysis of semi-structured interviews and statistical analysis of anxiety ratings were used for evaluating a strategy for psychological preparation and distraction. Fifty-seven children aged 2 to 18 years and their parents participated – 30 children in the baseline group and 27 in the intervention group. Child interviews were performed and the child and their parents rated the child’s anxiety.

Results

The intervention was most appropriate for the younger children, who enjoyed the digital story, the stuffed animal and training with their parents. There were some technical problems and the digital story was not detailed enough to fit exactly with various cancer diagnoses. Children described suggestions for improvement of the intervention. The ratings of the child’s anxiety during radiation treatment showed no differences between the baseline group and the intervention group.

Conclusions

The children of all the age groups experienced their interventions as positive. The strength of the intervention was that it encouraged interaction within the family and provided an opportunity for siblings and peers to take part in what the child was going through. Future research on children’s experiences to interventions should be encouraged. The intervention and the technical solutions could improve by further development.

Trial registration

The study design was structured as an un-matched case-control study, baseline group vs. intervention group. Trial registration: ClinicalTrials.​gov NCT02993978, Protocol Record 2012–113-31 M. Retrospectively registered - 21 November 2016.
Literature
2.
go back to reference Bucholtz JD. Comforting children during radiotherapy. Oncol Nurs Forum. 1994;21(6):987–94.PubMed Bucholtz JD. Comforting children during radiotherapy. Oncol Nurs Forum. 1994;21(6):987–94.PubMed
3.
go back to reference Filin A, Treisman S, Peles Bortz A. Radiation therapy preparation by a multidisciplinary team for childhood cancer patients aged 31/2 to 6 years. J Pediatr Oncol Nurs. 2009;26(2):81–5.CrossRefPubMed Filin A, Treisman S, Peles Bortz A. Radiation therapy preparation by a multidisciplinary team for childhood cancer patients aged 31/2 to 6 years. J Pediatr Oncol Nurs. 2009;26(2):81–5.CrossRefPubMed
4.
go back to reference Haeberli S, Grotzer MA, Niggli FK, Landolt MA, Linsenmeier C, Ammann RA, Bodmer N. A psychoeducational intervention reduces the need for anesthesia during radiotherapy for young childhood cancer patients. Radiat Oncol. 2008;3:17.CrossRefPubMedPubMedCentral Haeberli S, Grotzer MA, Niggli FK, Landolt MA, Linsenmeier C, Ammann RA, Bodmer N. A psychoeducational intervention reduces the need for anesthesia during radiotherapy for young childhood cancer patients. Radiat Oncol. 2008;3:17.CrossRefPubMedPubMedCentral
5.
go back to reference Willis D, Barry P. Audiovisual interventions to reduce the use of general anaesthesia with paediatric patients during radiation therapy. J Med Imaging Radiat Oncol. 2010;54(3):249–55.CrossRefPubMed Willis D, Barry P. Audiovisual interventions to reduce the use of general anaesthesia with paediatric patients during radiation therapy. J Med Imaging Radiat Oncol. 2010;54(3):249–55.CrossRefPubMed
6.
go back to reference Soanes L, Hargrave D, Smith L, Gibson F. What are the experiences of the child with a brain tumour and their parents? Eur J Oncol Nurs. 2009;13(4):255–61.CrossRefPubMed Soanes L, Hargrave D, Smith L, Gibson F. What are the experiences of the child with a brain tumour and their parents? Eur J Oncol Nurs. 2009;13(4):255–61.CrossRefPubMed
7.
go back to reference Scott L, Langton F, O'Donoghue J. Minimising the use of sedation/anaesthesia in young children receiving radiotherapy through an effective play preparation programme. Eur J Oncol Nurs. 2002;6(1):15–22.CrossRefPubMed Scott L, Langton F, O'Donoghue J. Minimising the use of sedation/anaesthesia in young children receiving radiotherapy through an effective play preparation programme. Eur J Oncol Nurs. 2002;6(1):15–22.CrossRefPubMed
8.
go back to reference Klosky JL, Garces-Webb DM, Buscemi J, Schum L, Tyc VL, Merchant TE. Examination of an interactive-educational intervention in improving parent and child distress outcomes associated with pediatric radiation therapy procedures. Children's Healthcare. 2007;36(4):323–34.CrossRef Klosky JL, Garces-Webb DM, Buscemi J, Schum L, Tyc VL, Merchant TE. Examination of an interactive-educational intervention in improving parent and child distress outcomes associated with pediatric radiation therapy procedures. Children's Healthcare. 2007;36(4):323–34.CrossRef
9.
go back to reference Jacques A, Udowicz M, Bayliss Y, Jensen K. Thinking differently about the kids: an innovative approach to improve care provided to pediatric patients undergoing external beam radiation therapy. JMIRS. 2014;45(3):269–75. Jacques A, Udowicz M, Bayliss Y, Jensen K. Thinking differently about the kids: an innovative approach to improve care provided to pediatric patients undergoing external beam radiation therapy. JMIRS. 2014;45(3):269–75.
10.
go back to reference Engvall G, Ångström-Brännström C, Mullaney T, Nilsson K, Wickart-Johansson G, Svärd AM, Nyholm T, Lindh J, Lindh V. It is tough and tiring but it works-Children's experiences of undergoing radiotherapy. PLoS One. 2016;11(4):e0153029.CrossRefPubMedPubMedCentral Engvall G, Ångström-Brännström C, Mullaney T, Nilsson K, Wickart-Johansson G, Svärd AM, Nyholm T, Lindh J, Lindh V. It is tough and tiring but it works-Children's experiences of undergoing radiotherapy. PLoS One. 2016;11(4):e0153029.CrossRefPubMedPubMedCentral
11.
go back to reference Giacomin J. What is human Centred design? Des J. 2014;17(4):606–23. Giacomin J. What is human Centred design? Des J. 2014;17(4):606–23.
12.
go back to reference Mullaney T. Thinking beyond the cure: a constructive design research investigation into the patient experience of radiotherapy. Sweden: Umeå: Umeå University; 2016. Mullaney T. Thinking beyond the cure: a constructive design research investigation into the patient experience of radiotherapy. Sweden: Umeå: Umeå University; 2016.
13.
go back to reference Ångström-Brännström C, Lindh V, Mullaney T, Nilsson K, Wickart-Johansson G, Svärd A-M, Nyholm T, Lindh J, Engvall G. Parents’ experiences and responses to an intervention for psychological preparation of children and families during the child’s radiotherapy. J Pediatr Oncol Nurs. 2017:1043454217741876. Ångström-Brännström C, Lindh V, Mullaney T, Nilsson K, Wickart-Johansson G, Svärd A-M, Nyholm T, Lindh J, Engvall G. Parents’ experiences and responses to an intervention for psychological preparation of children and families during the child’s radiotherapy. J Pediatr Oncol Nurs. 2017:1043454217741876.
14.
go back to reference McGrath PA, Seifert CE, Speechley KN, Booth JC, Stitt L, Gibson MC. A new analogue scale for assessing children's pain: an initial validation study. Pain. 1996;64(3):435–43.CrossRefPubMed McGrath PA, Seifert CE, Speechley KN, Booth JC, Stitt L, Gibson MC. A new analogue scale for assessing children's pain: an initial validation study. Pain. 1996;64(3):435–43.CrossRefPubMed
15.
go back to reference Rossi V, Pourtois G. Transient state-dependent fluctuations in anxiety measured using STAI, POMS, PANAS or VAS: a comparative review. Anxiety Stress Coping. 2012;25(6):603–45.CrossRefPubMed Rossi V, Pourtois G. Transient state-dependent fluctuations in anxiety measured using STAI, POMS, PANAS or VAS: a comparative review. Anxiety Stress Coping. 2012;25(6):603–45.CrossRefPubMed
16.
go back to reference Carter B, Ford K. Researching children's health experiences: the place for participatory, child-centered, arts-based approaches. Res Nurs Health. 2013;36(1):95–107.CrossRefPubMed Carter B, Ford K. Researching children's health experiences: the place for participatory, child-centered, arts-based approaches. Res Nurs Health. 2013;36(1):95–107.CrossRefPubMed
17.
go back to reference Driessnack M. Children's drawings as facilitators of communication: a meta-analysis. J Pediatr Nurs. 2005;20(6):415–23.CrossRefPubMed Driessnack M. Children's drawings as facilitators of communication: a meta-analysis. J Pediatr Nurs. 2005;20(6):415–23.CrossRefPubMed
18.
19.
go back to reference Rejno A, Berg L. Strategies for handling ethical problems in end of life care: obstacles and possibilities. Nurs Ethics. 2015;22(7):778–89.CrossRefPubMed Rejno A, Berg L. Strategies for handling ethical problems in end of life care: obstacles and possibilities. Nurs Ethics. 2015;22(7):778–89.CrossRefPubMed
20.
go back to reference Graneheim UH, Lindgren BM, Lundman B. Methodological challenges in qualitative content analysis: a discussion paper. Nurse Educ Today. 2017;56:29–34.CrossRefPubMed Graneheim UH, Lindgren BM, Lundman B. Methodological challenges in qualitative content analysis: a discussion paper. Nurse Educ Today. 2017;56:29–34.CrossRefPubMed
21.
go back to reference Compas BE, Connor-Smith JK, Saltzman H, Thomsen AH, Wadsworth ME. Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychol Bull. 2001;127(1):87–127.CrossRefPubMed Compas BE, Connor-Smith JK, Saltzman H, Thomsen AH, Wadsworth ME. Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychol Bull. 2001;127(1):87–127.CrossRefPubMed
22.
go back to reference Zimmer-Gembeck MJ, Skinner EA. The development of coping across childhood and adolescence: Ann integrative review and critique of research. Int J of Behav Dev. 2011;35(1):1–17.CrossRef Zimmer-Gembeck MJ, Skinner EA. The development of coping across childhood and adolescence: Ann integrative review and critique of research. Int J of Behav Dev. 2011;35(1):1–17.CrossRef
23.
go back to reference Uman LS, Birnie KA, Noel M, Parker JA, Chambers CT, McGrath PJ, Kisely SR. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev. 2013;10:CD005179. Uman LS, Birnie KA, Noel M, Parker JA, Chambers CT, McGrath PJ, Kisely SR. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev. 2013;10:CD005179.
24.
go back to reference Birnie KA, Noel M, Parker JA, Chambers CT, Uman LS, Kisely SR, McGrath PJ. Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents. J Pediatr Psychol. 2014;39(8):783–808.CrossRefPubMedPubMedCentral Birnie KA, Noel M, Parker JA, Chambers CT, Uman LS, Kisely SR, McGrath PJ. Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents. J Pediatr Psychol. 2014;39(8):783–808.CrossRefPubMedPubMedCentral
25.
go back to reference Jibb LA, Nathan PC, Stevens BJ, Seto E, Cafazzo JA, Stephens N, Yohannes L, Stinson JN. Psychological and physical interventions for the Management of Cancer-Related Pain in pediatric and young adult patients: an integrative review. Oncol Nurs Forum. 2015;42(6):E339–57.CrossRefPubMed Jibb LA, Nathan PC, Stevens BJ, Seto E, Cafazzo JA, Stephens N, Yohannes L, Stinson JN. Psychological and physical interventions for the Management of Cancer-Related Pain in pediatric and young adult patients: an integrative review. Oncol Nurs Forum. 2015;42(6):E339–57.CrossRefPubMed
26.
go back to reference Flowers SR, Birnie KA. Procedural preparation and support as a standard of Care in Pediatric Oncology. Pediatr Blood Cancer. 2015;62(Suppl 5):S694–723.CrossRefPubMed Flowers SR, Birnie KA. Procedural preparation and support as a standard of Care in Pediatric Oncology. Pediatr Blood Cancer. 2015;62(Suppl 5):S694–723.CrossRefPubMed
27.
go back to reference Törnqvist E, Månsson A, Hallström I. Children having magnetic resonance imaging: a preparatory storybook and audio/visual media are preferable to anesthesia or deep sedation. J Child Health Care. 2015;19(3):359–69.CrossRefPubMed Törnqvist E, Månsson A, Hallström I. Children having magnetic resonance imaging: a preparatory storybook and audio/visual media are preferable to anesthesia or deep sedation. J Child Health Care. 2015;19(3):359–69.CrossRefPubMed
28.
go back to reference Koller D, Goldman RD. Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs. 2012;27(6):652–81.CrossRefPubMed Koller D, Goldman RD. Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs. 2012;27(6):652–81.CrossRefPubMed
29.
go back to reference Ullan AM, Belver MH, Fernandez E, Lorente F, Badia M, Fernandez B. The effect of a program to promote play to reduce children's post-surgical pain: with plush toys, it hurts less. Pain Manag Nurs. 2014;15(1):273–82.CrossRefPubMed Ullan AM, Belver MH, Fernandez E, Lorente F, Badia M, Fernandez B. The effect of a program to promote play to reduce children's post-surgical pain: with plush toys, it hurts less. Pain Manag Nurs. 2014;15(1):273–82.CrossRefPubMed
30.
go back to reference Thrane SE, Wanless S, Cohen SM, Danford CA. The assessment and non-pharmacologic treatment of procedural pain from infancy to school age through a developmental lens: a synthesis of evidence with recommendations. J Pediatr Nurs. 2016;31(1):e23–32.CrossRefPubMed Thrane SE, Wanless S, Cohen SM, Danford CA. The assessment and non-pharmacologic treatment of procedural pain from infancy to school age through a developmental lens: a synthesis of evidence with recommendations. J Pediatr Nurs. 2016;31(1):e23–32.CrossRefPubMed
31.
go back to reference Fortier MA, Chung WW, Martinez A, Gago-Masague S, Sender L. Pain buddy: a novel use of m-health in the management of children's cancer pain. Comput Biol Med. 2016;76:202–14.CrossRefPubMedPubMedCentral Fortier MA, Chung WW, Martinez A, Gago-Masague S, Sender L. Pain buddy: a novel use of m-health in the management of children's cancer pain. Comput Biol Med. 2016;76:202–14.CrossRefPubMedPubMedCentral
32.
go back to reference Compas BE, Jaser SS, Dunn MJ, Rodriguez EM. Coping with chronic illness in childhood and adolescence. Annu Rev Clin Psychol. 2012;8:455–80.CrossRefPubMed Compas BE, Jaser SS, Dunn MJ, Rodriguez EM. Coping with chronic illness in childhood and adolescence. Annu Rev Clin Psychol. 2012;8:455–80.CrossRefPubMed
33.
go back to reference Compas BE, Desjardins L, Vannatta K, Young-Saleme T, Rodriguez EM, Dunn M, Bemis H, Snyder S, Gerhardt CA. Children and adolescents coping with cancer: self- and parent reports of coping and anxiety/depression. Health Psychol. 2014;33(8):853–61.CrossRefPubMedPubMedCentral Compas BE, Desjardins L, Vannatta K, Young-Saleme T, Rodriguez EM, Dunn M, Bemis H, Snyder S, Gerhardt CA. Children and adolescents coping with cancer: self- and parent reports of coping and anxiety/depression. Health Psychol. 2014;33(8):853–61.CrossRefPubMedPubMedCentral
34.
go back to reference Fortier MA, Blount RL, Wang SM, Mayes LC, Kain ZN. Analysing a family-centred preoperative intervention programme: a dismantling approach. Br J Anaesth. 2011;106(5):713–8.CrossRefPubMedPubMedCentral Fortier MA, Blount RL, Wang SM, Mayes LC, Kain ZN. Analysing a family-centred preoperative intervention programme: a dismantling approach. Br J Anaesth. 2011;106(5):713–8.CrossRefPubMedPubMedCentral
35.
go back to reference Leroy PL, Costa LR, Emmanouil D, van Beukering A, Franck LS. Beyond the drugs: nonpharmacologic strategies to optimize procedural care in children. Curr Opin Anaesthesiol. 2016;29(Suppl 1):S1–13.CrossRefPubMed Leroy PL, Costa LR, Emmanouil D, van Beukering A, Franck LS. Beyond the drugs: nonpharmacologic strategies to optimize procedural care in children. Curr Opin Anaesthesiol. 2016;29(Suppl 1):S1–13.CrossRefPubMed
36.
go back to reference West CH, Bell JM, Woodgate RL, Moules NJ. Waiting to return to normal: an exploration of family systems intervention in childhood cancer. J Fam Nurs. 2015;21(2):261–94.CrossRefPubMed West CH, Bell JM, Woodgate RL, Moules NJ. Waiting to return to normal: an exploration of family systems intervention in childhood cancer. J Fam Nurs. 2015;21(2):261–94.CrossRefPubMed
37.
go back to reference Kazak AE, Kassam-Adams N, Schneider S, Zelikovsky N, Alderfer MA, Rourke M. An integrative model of pediatric medical traumatic stress. J Pediatr Psychol. 2006;31(4):343–55.CrossRefPubMed Kazak AE, Kassam-Adams N, Schneider S, Zelikovsky N, Alderfer MA, Rourke M. An integrative model of pediatric medical traumatic stress. J Pediatr Psychol. 2006;31(4):343–55.CrossRefPubMed
38.
go back to reference Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed
39.
go back to reference Gearing RE, El-Bassel N, Ghesquiere A, Baldwin S, Gillies J, Ngeow E. Major ingredients of fidelity: a review and scientific guide to improving quality of intervention research implementation. Clin Psychol Rev. 2011;31(1):79–88.CrossRefPubMed Gearing RE, El-Bassel N, Ghesquiere A, Baldwin S, Gillies J, Ngeow E. Major ingredients of fidelity: a review and scientific guide to improving quality of intervention research implementation. Clin Psychol Rev. 2011;31(1):79–88.CrossRefPubMed
40.
go back to reference Kain ZN, Fortier MA, Chorney JM, Mayes L. Web-based tailored intervention for preparation of parents and children for outpatient surgery (WebTIPS): development. Anesth Analg. 2015;120(4):905–14.CrossRefPubMedPubMedCentral Kain ZN, Fortier MA, Chorney JM, Mayes L. Web-based tailored intervention for preparation of parents and children for outpatient surgery (WebTIPS): development. Anesth Analg. 2015;120(4):905–14.CrossRefPubMedPubMedCentral
Metadata
Title
Children’s experiences and responses towards an intervention for psychological preparation for radiotherapy
Authors
Gunn Engvall
Viveca Lindh
Tara Mullaney
Tufve Nyholm
Jack Lindh
Charlotte Ångström-Brännström
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-017-0942-5

Other articles of this Issue 1/2018

Radiation Oncology 1/2018 Go to the issue