Effectiveness of Non-Pharmacological Interventions to Reduce Procedural Anxiety in Children and Adolescents Undergoing Treatment for Cancer: A Systematic Review and Meta-Analysis

Dominic Mayhew*, Michael Nunns**, Darren Moore***, Tamsin Ford****
Peninsula College of Medicine and Dentistry*, PenCLAHRC, UEMS**, PenCLAHRC, UEMS***, PenCLAHRC, UEMS****
Children and young people (CYP) with cancer undergo numerous painful and distressing procedures such as lumbar punctures and bone marrow aspirations. We aimed to systematically review the effectiveness of non-pharmacological interventions to reduce procedural anxiety in CYP. We hypothesize that some non-pharmacological interventions will be effective at reducing procedural anxiety in CYP with cancer.
Extensive literature searches sought randomized controlled trials quantifying the effect of any non-pharmacological intervention for procedural anxiety in CYP. Anxiety and pain outcomes were extracted from included studies. Where similar intervention, comparator and outcomes presented, meta-analysis was performed, producing pooled effect sizes (Cohen's d) and 95% confidence intervals (95% CI). Quality and risk of bias appraisal was performed, based on the Cochrane Risk of Bias tool.
Screening of 11,727 records yielded 56 relevant full texts. There were large, statistically significant reductions in anxiety and pain for hypnosis, particularly compared to treatment as usual (anxiety: d=2.30; 95% CI: 1.30 to 3.30, p<0.001; pain: d=2.16; 95% CI: 1.41 to 2.92, p<0.001), but with similar effects versus attention and active controls. Evidence from non-hypnosis interventions was equivocal, with some promising individual studies.
Evidence suggests promise for hypnosis interventions to reduce procedural anxiety in CYP undergoing cancer treatment. These results largely emerge from one research group, therefore wider research is required. Promising evidence for individual non-hypnosis interventions must be evaluated through rigorously conducted randomized controlled trials. Similar interventions targeting the procedural anxiety of CYP without cancer may also be effective and warrants further research.
How to Cite URL :
Mayhew D, Nunns M, Moore D, Ford T.. Available From : http://www.pediatriconcall.com/conference/abstract/37/view/861
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