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Play-based procedural preparation and support intervention for cranial radiation

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Abstract

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.

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Acknowledgments

This study was supported in part by the Child Life Council’s Advancing the Field of Play for Hospitalized Children Initiative grant from The Walt Disney Company, by the Cancer Center Core Grant CA 21765 from the National Institutes of Health, and by the American Lebanese Syrian Associated Charities (ALSAC).

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Authors and Affiliations

  1. Child Life Program, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS 121, Memphis, TN, 38105, USA

    Shawna Grissom, Jessika Boles, Katherine Bailey & Amy Kennedy

  2. University of Massachusetts, 100 Morrissey Blvd., Boston, MA, 02125, USA

    Kathryn Cantrell

  3. Department of Biostatistics, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS 723, Memphis, TN, 38105, USA

    April Sykes

  4. Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS738, Memphis, TN, 38105, USA

    Belinda N. Mandrell

Authors
  1. Shawna Grissom
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  2. Jessika Boles
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  3. Katherine Bailey
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  4. Kathryn Cantrell
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  5. Amy Kennedy
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  6. April Sykes
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  7. Belinda N. Mandrell
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Corresponding author

Correspondence to Shawna Grissom.

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The authors declare that they have no competing interests.

Informed consent

The study was approved by the hospital's institutional review board as exempt research with wavier of consent and assent.

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Grissom, S., Boles, J., Bailey, K. et al. Play-based procedural preparation and support intervention for cranial radiation. Support Care Cancer 24, 2421–2427 (2016). https://doi.org/10.1007/s00520-015-3040-y

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  • DOI: https://doi.org/10.1007/s00520-015-3040-y

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