Douglas E Holt1, Susan M Hiniker2, John A Kalapurakal3, John C Breneman4, Jay C Shiao5, Nicole Boik6, Benjamin T Cooper7, Paige L Dorn8, Matthew D Hall6, Natalie Logie9, John T Lucas10, Iain J MacEwan11, Adam C Olson12, Joshua D Palmer13, Samir Patel14, Luke E Pater4, Stephanie Surgener15, Derek S Tsang16, Jennifer H Vogel17, Alyssa Wojcik15, Cheng-Chia Wu18, Sarah A Milgrom5. 1. Department of Radiation Oncology, University of Colorado, Aurora, Colorado. Electronic address: douglas.holt@cuanschutz.edu. 2. Department of Radiation Oncology, Stanford University, Stanford, California. 3. Department of Radiation Oncology, Northwestern University, Chicago, Illinois. 4. Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio. 5. Department of Radiation Oncology, University of Colorado, Aurora, Colorado. 6. Department of Radiation Oncology, Miami Cancer Institute, Miami, Florida. 7. Department of Radiation Oncology, NYU Langone Health, New York City, New York. 8. Department of Radiation Oncology, Rocky Mountain Hospital for Children, Denver, Colorado. 9. Department of Radiation Oncology, University of Calgary, Calgary, Alberta, Canada. 10. Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. 11. Department of Radiation Oncology, University of California San Diego, La Jolla, California. 12. Department of Radiation Oncology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania. 13. Department of Radiation Oncology, Ohio State University, Columbus, Ohio. 14. Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada. 15. Department of Oncology, Children's Hospital of Colorado, Aurora, Colorado. 16. Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada. 17. Department of Radiation Oncology Johns Hopkins University Medical Center, Baltimore, Maryland. 18. Department of Radiation Oncology, Columbia University Irving Medical Center, New York City, New York.
Abstract
PURPOSE: Treatment with radiation therapy (RT) can cause anxiety and distress for pediatric patients and their families. Radiation oncology teams have developed strategies to reduce the negative psychological impact. This survey study aimed to characterize these methods. METHODS AND MATERIALS: A 37-item questionnaire was sent to all radiation oncology members of the Children's Oncology Group to explore strategies to improve the pediatric patient experience. The Wilcoxon rank-sum test was used to assess factors associated with use of anesthesia for older children. RESULTS: Surveys were completed by 106 individuals from 84/210 institutions (40%). Respondents included 89 radiation oncologists and 17 supportive staff. Sixty-one percent of centers treated ≤50 children per year. Respondents described heterogenous interventions. The median age at which most children no longer required anesthesia was 6 years (range: ≤3 years to ≥8 years). Routine anesthesia use at an older age was associated with physicians' lack of awareness of these strategies (P = .04) and <10 years of pediatric radiation oncology experience (P = .04). Fifty-two percent of respondents reported anesthesia use added >45 minutes in the radiation oncology department daily. Twenty-six percent of respondents planned to implement new strategies, with 65% focusing on video-based distraction therapy and/or augmented reality/virtual reality. CONCLUSIONS: Many strategies are used to improve children's experience during RT. Lack of awareness of these interventions is a barrier to their implementation and is associated with increased anesthesia use. This study aims to disseminate these methods with the goal of raising awareness, facilitating implementation, and, ultimately, improving the experience of pediatric cancer patients and their caregivers.
PURPOSE: Treatment with radiation therapy (RT) can cause anxiety and distress for pediatric patients and their families. Radiation oncology teams have developed strategies to reduce the negative psychological impact. This survey study aimed to characterize these methods. METHODS AND MATERIALS: A 37-item questionnaire was sent to all radiation oncology members of the Children's Oncology Group to explore strategies to improve the pediatric patient experience. The Wilcoxon rank-sum test was used to assess factors associated with use of anesthesia for older children. RESULTS: Surveys were completed by 106 individuals from 84/210 institutions (40%). Respondents included 89 radiation oncologists and 17 supportive staff. Sixty-one percent of centers treated ≤50 children per year. Respondents described heterogenous interventions. The median age at which most children no longer required anesthesia was 6 years (range: ≤3 years to ≥8 years). Routine anesthesia use at an older age was associated with physicians' lack of awareness of these strategies (P = .04) and <10 years of pediatric radiation oncology experience (P = .04). Fifty-two percent of respondents reported anesthesia use added >45 minutes in the radiation oncology department daily. Twenty-six percent of respondents planned to implement new strategies, with 65% focusing on video-based distraction therapy and/or augmented reality/virtual reality. CONCLUSIONS: Many strategies are used to improve children's experience during RT. Lack of awareness of these interventions is a barrier to their implementation and is associated with increased anesthesia use. This study aims to disseminate these methods with the goal of raising awareness, facilitating implementation, and, ultimately, improving the experience of pediatric cancer patients and their caregivers.
Authors: Stephanie M Ntoukas; Tatiana Ritchie; Susan Awrey; David C Hodgson; Normand Laperriere; Ryan Yee; Vijay Ramaswamy; Barbara-Ann Millar; Nathan Becker; Derek S Tsang Journal: Pract Radiat Oncol Date: 2019-12-10
Authors: Katy E Balazy; Paulina M Gutkin; Lawrie Skinner; Rie von Eyben; Tyler Fowler; Daniel W Pinkham; Samuel Rodriguez; Peter G Maxim; Sarah S Donaldson; Billy W Loo; Karl Bush; Susan M Hiniker Journal: Pract Radiat Oncol Date: 2020-01-11
Authors: Shawna Grissom; Jessika Boles; Katherine Bailey; Kathryn Cantrell; Amy Kennedy; April Sykes; Belinda N Mandrell Journal: Support Care Cancer Date: 2015-12-04 Impact factor: 3.603
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