Principles of psychosocial programming for children and cancer

Pediatric psycho-oncology care: standards, guidelines, and consensus reports

OBJECTIVE

The aim of this study was to identify existing guidelines, standards, or consensus-based reports for psychosocial care of children with cancer and their families.

PURPOSE

Psychosocial standards of care for children with cancer can systematize the approach to care and create a replicable model that can be utilized in pediatric hospitals around the world. Determining gaps in existing standards in pediatric psycho-oncology can guide development of useful evidence-based and consensus-based standards.

METHODS

The MEDLINE and PubMed databases were searched by investigators at two major pediatric oncology centers for existing guidelines, consensus-based reports, or standards for psychosocial care of patients with pediatric cancer and their families published in peer-reviewed journals in English between 1980 and 2013.

RESULTS

We located 27 articles about psychosocial care that met inclusion criteria: 5 set forth standards, 19 were guidelines, and 3 were consensus-based reports. None was sufficiently up to date, comprehensive, specific enough, or evidence- or consensus-based to serve as a current standard for psychosocial care for children with cancer and their families.

CONCLUSION

Despite calls by a number of international pediatric oncology and psycho-oncology professional organizations about the urgency of addressing the psychosocial needs of the child with cancer to reduce suffering, there remains a need for development of a widely acceptable, evidence-based and consensus-based, comprehensive standard of care to guide provision of essential psychosocial services to all patients with pediatric cancer.

Preparing children to be bone marrow donors

PURPOSE/OBJECTIVES

To review literature regarding children as bone marrow donors and describe the evaluation of an individualized intervention to support children who will be donors for parents or siblings.

DATA SOURCE

Research studies, abstracts, and clinical reports describing interventions or psychosocial issues related to child donors, parent interviews, and clinical experiences.

DATA SYNTHESIS

Child marrow donors and caregivers benefit from interventions that illuminate the process and provide psychosocial support. Use of a teaching book enhances intervention and provides a tool for parents to use after transplantation.

CONCLUSIONS

Psychosocial distress in child marrow donors and parents can be minimized through education and therapeutic interventions. Research is needed to validate the efficacy of interventions and determine whether psychosocial complications are decreased.

IMPLICATIONS FOR NURSING

Child donors, especially those for parents, should receive support and attention for their unique psychosocial needs.

Structuring psychosocial care in pediatric oncology

The requirements for high quality psychosocial care for children with cancer and their families are steadily increasing. As an additional supplement to medical and nursing care, psychosocial work has to consider both the requirements of the medical treatment and the associated stress factors. It is essential to structure the different possibilities of intervention in a way which guarantees the practice of psychosocial care within the ongoing medical care. This requires a standardized psychosocial care manual. In July 1994, a 'Manual for Psychological Care in Pediatric Oncology' was put into practice and has been continually improved in the Department of Pediatric Hematology/Oncology of the University of Bonn. It contains special indications for different standards of psychosocial care, is oriented according to the phases and situations of medical treatment, and consists of a health education program as well as special care measurements. The latter are related to both the stressors primarily caused by the requirements of familial adherence to medical and nursing care and the stressors primarily caused by factors of the individual or the familial life circumstances. The theoretical basis of this manual and concrete information for its use are described in this paper.