RESUMO
PURPOSE: The primary objective of this study was to examine the relationship between play-based procedural preparation and support intervention and use of sedation in children with central nervous system (CNS) tumors during radiation therapy. The secondary objective was to analyze the cost-effectiveness of the intervention compared to costs associated with daily sedation. METHODS: A retrospective chart review was conducted, and 116 children aged 5-12 years met criteria for inclusion. Outcome measures included the total number of radiation treatments received, the number of treatments received with and without sedation, and the type and duration of interventions, which consisted of developmentally appropriate play, education, preparation, and distraction provided by a certified child life specialist. RESULTS: The results of univariate analyses showed that age, tumor location, and total number and duration of interventions were significantly associated with sedation use during radiation therapy. Multivariate analyses showed that, after adjustment for age, tumor location, and craniospinal radiation, a significant relationship was found between the total number and duration of the interventions and sedation use. The implementation of a play-based procedural preparation and support intervention provided by a certified child life specialist significantly reduced health-care costs by decreasing the necessity of daily sedation. CONCLUSIONS: Support interventions provided by child life specialists significantly decreased both sedation use and the cost associated with daily sedation during cranial radiation therapy in children with CNS tumors. This study supports the value of the child life professional as a play-based developmental specialist and a crucial component of cost-effective healthcare.
Assuntos
Neoplasias do Sistema Nervoso Central/radioterapia , Irradiação Craniana/métodos , Ludoterapia/métodos , Neoplasias do Sistema Nervoso Central/psicologia , Criança , Análise Custo-Benefício , Irradiação Craniana/psicologia , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Estudos RetrospectivosRESUMO
Children and adolescents who undergo extensive health-related treatment benefit from sharing their experience. Here, we describe how one institution established a legacy program for patients during their chronic disease treatment and how their journeys were symbolized with the distribution of beads. The legacy bead program was designed to be individualized according to the patient's journey and treatment experiences. A bead program offers a concrete, tangible method for patients to share their treatment journeys while building legacies on which they can reflect.