Here are several steps for helping pediatric and adolescent patients to cope with cancer and its treatment.

• Give young patients control whenever possible, suggests Shawna Grissom, MS, CCLS, CEIM, Director of the Child Life Program at St. Jude Children’s Research Hospital, and offer them realistic choices for their treatment. “There are not many things patients can control while in the hospital,” said Ms. Grissom. “But they can choose who they want to support them during a procedure. Do they want to know what is going to happen or not? Where do they want to sit when the nurse starts their IV, and should we count to three first? Should we put the blood pressure cuff on the left or right arm?”
• Tell children what is happening and explain what is going to happen next using the five senses. “In any preparation situation, we try to let children know what they will see, hear, feel, taste, or smell,” said Ms. Grissom. “This helps patients have a better idea of what they can expect, rather than making up their own story of what they think will happen.”
• For instance, before an IV is placed in a child’s vein, “we might say who he or she will see during the procedure and what types of medical equipment will be used, explaining step-by-step what will happen. We will say that the nurse will put some numbing medicine on his or her arm first—it makes a popping noise and explain what things will feel like, for example, wet or cold, and that he or she might smell the cleaning solution.”
• Respect children’s privacy.
• Treat children as individuals, advises Lisa Scherber, Director of Patient and Family Programs at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. “No one falls in the same category.”
• When speaking to parents include the patient in the discussion, if appropriate. “Get down on the [patient’s] level and engage him or her,” said Ms. Grissom. “Don’t act like children cannot hear you—they can.” However, if you need to, talk to parents separately from the children.
• Take part in hospital events involving patients and their families. “When you see your patient outside of the clinic or hospital smiling and enjoying life, it allows you to understand him or her better,” said Ms. Scherber.
• Don’t forget the psychological needs of parents, who are often more distressed than their children, said Robert B. Noll, PhD, Professor of Pediatrics, Psychiatry, and Psychology at the University of Pittsburgh Cancer Institute in Pennsylvania. He recommends a research-based intervention called Bright IDEAS: Problem-Solving Skills Training, which is rooted in cognitive-behavioral therapy. In a study of mothers of children recently diagnosed with cancer, those who participated in an 8-week training program in the intervention experienced fewer symptoms of depression and post-traumatic stress disorder and less total mood disturbance than those who received the usual psychosocial care.¹ ■

Disclosure: Ms. Grissom, Ms. Scherber, and Dr. Noll reported no potential conflicts of interest.

Reference

1. Sahler OJ, Dolgin MJ, Phipps S, et al: Specificity of problem-solving skills training in mothers of children newly diagnosed with cancer: Results of a multisite randomized clinical trial. J Clin Oncol 31:1329-1335, 2013.