Holt Douglas E, Hiniker Susan M, Kalapurakal John A, Breneman John C, Shiao Jay C, Boik Nicole, Cooper Benjamin T, Dorn Paige L, Hall Matthew D, Logie Natalie, Lucas John T, MacEwan Iain J, Olson Adam C, Palmer Joshua D, Patel Samir, Pater Luke E, Surgener Stephanie, Tsang Derek S, Vogel Jennifer H, Wojcik Alyssa, Wu Cheng-Chia, Milgrom Sarah A
Department of Radiation Oncology, University of Colorado, Aurora, Colorado.
Department of Radiation Oncology, Stanford University, Stanford, California.
Int J Radiat Oncol Biol Phys. 2021 Feb 1;109(2):505-514. doi: 10.1016/j.ijrobp.2020.09.002. Epub 2020 Sep 12.
Treatment with radiation therapy (RT) can cause anxiety and distress for pediatric patients and their families. Radiation oncology teams have developed strategies to reduce the negative psychological impact. This survey study aimed to characterize these methods.
A 37-item questionnaire was sent to all radiation oncology members of the Children's Oncology Group to explore strategies to improve the pediatric patient experience. The Wilcoxon rank-sum test was used to assess factors associated with use of anesthesia for older children.
Surveys were completed by 106 individuals from 84/210 institutions (40%). Respondents included 89 radiation oncologists and 17 supportive staff. Sixty-one percent of centers treated ≤50 children per year. Respondents described heterogenous interventions. The median age at which most children no longer required anesthesia was 6 years (range: ≤3 years to ≥8 years). Routine anesthesia use at an older age was associated with physicians' lack of awareness of these strategies (P = .04) and <10 years of pediatric radiation oncology experience (P = .04). Fifty-two percent of respondents reported anesthesia use added >45 minutes in the radiation oncology department daily. Twenty-six percent of respondents planned to implement new strategies, with 65% focusing on video-based distraction therapy and/or augmented reality/virtual reality.
Many strategies are used to improve children's experience during RT. Lack of awareness of these interventions is a barrier to their implementation and is associated with increased anesthesia use. This study aims to disseminate these methods with the goal of raising awareness, facilitating implementation, and, ultimately, improving the experience of pediatric cancer patients and their caregivers.
放射治疗（RT）会给儿科患者及其家属带来焦虑和困扰。放射肿瘤学团队已制定策略以减少负面心理影响。本调查研究旨在描述这些方法。
向儿童肿瘤学组的所有放射肿瘤学成员发送了一份包含37个条目的问卷，以探索改善儿科患者体验的策略。采用Wilcoxon秩和检验来评估与大龄儿童使用麻醉相关的因素。
来自84/210家机构（40%）的106人完成了调查。受访者包括89名放射肿瘤学家和17名支持人员。61%的中心每年治疗的儿童≤50名。受访者描述了多种不同的干预措施。大多数儿童不再需要麻醉的中位年龄为6岁（范围：≤3岁至≥8岁）。大龄儿童常规使用麻醉与医生对这些策略缺乏认识（P = 0.04）以及儿科放射肿瘤学经验不足10年（P = 0.04）有关。52%的受访者报告称麻醉使用使放射肿瘤学部门每天增加了>45分钟的时间。26%的受访者计划实施新策略，其中65%专注于基于视频的分散注意力疗法和/或增强现实/虚拟现实。
许多策略被用于改善儿童在放射治疗期间的体验。对这些干预措施缺乏认识是其实施的障碍，并且与麻醉使用增加有关。本研究旨在传播这些方法，以提高认识、促进实施，并最终改善儿科癌症患者及其护理人员的体验。
