Jibb, L.A., Nathan, P.C., Stevens, B.J., Seto, E., Cafazzo, J.A., Stephens, N., . . . Stinson, J.N. (2015). Psychological and physical interventions for the management of cancer-related pain in pediatric and young adult patients: An integrative review. Oncology Nursing Forum, 42, E339–E357. 

DOI Link

Purpose

STUDY PURPOSE: To appraise the effectiveness of nonpharmacologic pain management approaches in children and young adults with cancer

TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science
 
KEYWORDS: Not provided
 
INCLUSION CRITERIA: Patients aged 1–21 years; examined an intervention that was not only pharmacologic; pain measured using self-reports; proxy report or physical or behavioral indices of pain; English language
 
EXCLUSION CRITERIA: Not stated

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 8,278
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: United States Preventive Services (USPS) taskforce hierarchy of evidence; all references rated as poor or fair in terms of internal and external validity

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 32
  • TOTAL PATIENTS INCLUDED IN REVIEW = 1,117
  • SAMPLE RANGE ACROSS STUDIES: 8–124 patients
  • KEY SAMPLE CHARACTERISTICS: The studies included various tumor types, and the majority involved acute procedure-related pain.

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Results

Six studies examining distraction, including music and virtual reality, showed mixed results. Nine studies used hypnosis, seven of which showed a positive effect on procedure-related pain. Sample sizes in these studies ranged from 23–80 (357 total) patients. Four studies used touch therapy, including healing touch, massage, and acupressure, with mixed results. Nine studies provided multimodal cognitive behavioral interventions including relaxation, procedure preparation, deep breathing, and other approaches. These showed mixed results. Aromatherapy and art therapy were examined in one study each.

Conclusions

The findings of this study suggested that hypnosis had relatively consistent positive results for the management of acute pain in this patient population.

Limitations

All studies were identified as low-quality with only fair or poor internal and external validity. The USPS grading system was only designed to grade the level of individual studies, and it was not appropriate for all the study designs included.

Nursing Implications

The findings of this study suggested that hypnosis may be an effective intervention to reduce procedure-related acute pain in children and young adults. Its findings for touch therapy also showed some promise. Additional well-designed research with larger samples is needed to provide stronger evidence in this area. These findings were limited by the low quality of evidence included.

Legacy ID

5585