Jacques Amanda, Udowicz Mona, Bayliss Yvette, Jensen Katherine
Tom Baker Cancer Center, Calgary, Alberta, Canada.
Tom Baker Cancer Center, Calgary, Alberta, Canada.
J Med Imaging Radiat Sci. 2014 Sep;45(3):269-275. doi: 10.1016/j.jmir.2013.12.009. Epub 2014 Mar 7.
This article reports the changes made from 2009-2012 to the external beam radiation therapy (EBRT) preparation and treatment process provided to pediatric patients at the Tom Baker Cancer Center (TBCC) Calgary, Alberta, Canada.
The number of pediatric patients referred for EBRT at the TBCC doubled between the years 2008 (15 patients) and 2011 (30 patients). This increase in patient numbers prompted the staff of radiation therapists to evaluate the department's EBRT preparation and treatment process for pediatric patients.
A literature search was performed to obtain data and research findings that described pediatric care processes adopted by EBRT programs in Canada and other countries. A pediatric working group (PWG) was assembled at the TBCC, which identified two areas for internal review and evaluation. The PWG critically reviewed the process of determining the delivery of treatment under sedation versus nonsedation and reviewed and evaluated the current play therapy and educational tools used to reduce the anxiety of children and parents concerning EBRT.
The presence of a radiation therapist at each new patient pediatric consult resulted in positive effects in the management of the patient's journey through EBRT. The application of the Pediatric Care Pathway Assessment Tool at the time of consult helped to identify patients requiring sedation versus nonsedation for treatment. The implementation of play therapy sessions before the start of treatment in combination with the use of audiovisual aids during EBRT reduced the requirement of sedation for treatment. A time motion log was found to be an appropriate tool for measuring the amount of time a patient spends in the department and helped to validate the placement of the patient on the sedation or non-sedation pathway.
本文报告了加拿大艾伯塔省卡尔加里市汤姆·贝克癌症中心（TBCC）在2009 - 2012年期间对为儿科患者提供的外照射放射治疗（EBRT）准备和治疗过程所做的改变。
2008年（15例患者）至2011年（30例患者）期间，转诊至TBCC接受EBRT治疗的儿科患者数量翻了一番。患者数量的增加促使放射治疗师团队评估该科室针对儿科患者的EBRT准备和治疗过程。
进行文献检索以获取描述加拿大及其他国家EBRT项目所采用的儿科护理流程的数据和研究结果。TBCC组建了一个儿科工作组（PWG），该工作组确定了两个需要内部审查和评估的领域。PWG严格审查了确定镇静与非镇静状态下进行治疗的过程，并审查和评估了当前用于减轻儿童及其家长对EBRT焦虑的游戏治疗和教育工具。
在每次儿科新患者会诊时安排一名放射治疗师对患者接受EBRT的整个过程管理产生了积极影响。会诊时应用儿科护理路径评估工具有助于确定治疗时需要镇静还是非镇静的患者。在治疗开始前实施游戏治疗课程并在EBRT期间结合使用视听辅助工具减少了治疗时的镇静需求。发现时间动作记录是衡量患者在科室停留时间的合适工具，并有助于确定患者应采用镇静还是非镇静路径。
