Complementary and alternative medical interventions for the management of anxiety in parents of children who are hospitalized and suffer from a malignancy: A systematic review of RCTs

The Effects of the Activity of Making Jewelry From Beads on the Anxiety Levels of Children With Cancer: A Randomised Controlled Study

Background: Children hospitalized for cancer treatment are known to experience high levels of anxiety. This study aimed to examine the effects of making jewelry from beads on the state and trait anxiety levels of children with cancer. Methods: This parallel group, randomized controlled trial was conducted on 62 children aged 7-18 who were being treated for cancer. The children were selected using the random sampling method. The jewelry-making sessions with the children in the intervention group were held twice a week for four weeks. Data were analysed using the chi-square test, the Student's t-test, the independent samples t-test and linear regression. Results: The state anxiety levels of the children in the intervention group decreased both in the first week and the fourth week after making jewelry. The difference in the average post-test scores between the two groups was found to be significant (p < .05). The fourth week average trait anxiety score of the children in the intervention group decreased (M  =  33.2) in comparison to the average score of the control group (M  =  36.5). The difference between the two groups was found to be significant (p < .001). Discussion: This study found that the activity of making jewelry from beads was effective in reducing the state and trait anxiety levels of children with cancer.

Effectiveness of a relaxation intervention (progressive muscle relaxation and guided imagery techniques) to reduce anxiety and improve mood of parents of hospitalized children with malignancies: A randomized controlled trial in Republic of Cyprus and Greece

PURPOSE

To explore the effect of Progressive Muscle Relaxation (PMR) and Guided Imagery (GI),in reducing anxiety levels among parents of children diagnosed with any type of malignancy receiving active treatment at a Paediatric Oncology Unit in Republic of Cyprus and in Greece.

METHOD

A randomized non-blinded control trial was conducted between April 2012 to October 2013, at two public paediatric hospitals. Fifty four eligible parents of children hospitalized with a malignancy were randomly assigned to the intervention (PMR and GI) (n = 29) and a control group (n = 25). The study evaluated the changes in anxiety levels(HAM-A) and mood changes(POMSb).

RESULTS

There was a statistically significant difference in the mean scores of the subjects in the intervention group in HAM-A scale between the T0 (14.67 ± 9.93) and T1 (11.70 ± 8.15) measurements (p = 0.008) compared to the control group in which a borderline difference (16.00 ± 11.52 vs 13.33 ± 8.38) was found (p = 0.066). The effect size for the intervention group was low to moderate (0.37). Regarding mood changes, there was a statistically significant difference in tension for parents in the intervention group between T0 and T1 (11.15 ± 5.39 vs 9.78 ± 4.26), (p = 0.027). Furthermore, the parents in the intervention group were significantly less sad following the intervention (T1) (2.81 ± 1.07 vs 2.19 ± 1.21), (p = 0.001), and felt significantly less tense (2.93 ± 0.91 vs 2.26 ± 0.90), (p = 0.001) and anxiety (2.63 ± 1.21 vs 2.19 ± 1.07), (p = 0.031) compared to those in the control group.

CONCLUSIONS

These findings provided evidence on the positive effect of the combination of PMR and GI in reducing anxiety and improving mood states in parents of children with malignancy.

The Effectiveness of Slow-Stroke Back Massage on Hospitalization Anxiety and Physiological Parameters in School-Age Children: A Randomized Clinical Trial Study

Background

The outcomes of hospitalization anxiety are mental health disorders. One of the methods of anxiety reduction is massage, which can cause reduction of pain and changes in physiological parameters.

Objectives

This study aimed to investigate the effects of slow-stroke back massage (SSBM) on hospitalization anxiety and physiological parameters in school-age children.

Methods

This clinical trial study included 80 school-aged children from Ali Ebne Abi Taleb hospital, located in Zahedan, who were selected using sequential sampling and randomly divided into two groups: a massage group (40) and a control group (40). Data were collected using a demographic questionnaire and the state-trait anxiety inventory for children (STAIC). Subjects in the massage group received SSBM, using sesame oil, for 3 days. Massage was given three times a day, and each massage session lasted for 15 - 20 minutes. Physiological parameters and hospitalization anxiety were determined from the second to fifth days. T-test and Chi-square were used for analysis data.

Results

There was a statistically significant difference (P < 0.05) between the mean of systolic blood pressure (SBP), diastolic blood pressures (DBP), and pulse rate (PR) in the massage group prior to intervention (97.05 ± 20.7, 60.35 ± 16.69 and 95.45 ± 13.02 respectively) and on the fifth day (88.32 ± 16.58, 55.95 ± 12.7 and 90.45 ± 15.1 respectively). However, no difference was observed in mean respiratory rate (RR) in the massage group from the second day (17.55 ± 3.6) to fifth day (17.62 ± 3.27) (P = 0.096). The mean of state of anxiety, which was 36.4 ± 5.1 before intervention, was reduced by the fifth day to 31.2 ± 5.1 in the massage group (P < 0.0001, t = 5.2).

Conclusions

The results suggest that massage reduced hospitalization anxiety, PR, and BP. Therefore, we propose that nurses can use massage to reduce anxiety in school-age children in hospital. This method has no side-effects and is easily applicable.