Dados do Trabalho

Título

ENHANCING THE QUALITY OF LIFE AND DECREASING STRESS AND FATIGUE LEVELS IN PEDIATRIC CANCER PATIENTS UTILIZING UNIQUE COMPLEMENTARY THERAPY

Introdução

Introduction: With the increase in pediatric cancer rates, it is crucial for healthcare professionals to develop and/or be aware of interventions to relieve the burden of cancer treatment during hospitalizations. Pediatric cancer inpatients can take advantage of nonpharmacological interventions for managing fatigue and psychological stress. Within this context, hospital clowns stand out as a potential nonpharmacological approach to address some symptoms. However, few studies have examined the effectiveness of this intervention using biomarkers, mainly in pediatric oncology ward settings.

Objetivo

Objective: The purpose of this study was to assess the effectiveness of a hospital clown intervention on the levels of fatigue and stress in paediatric patients with cancer under chemotherapy.

Método

Methods: A quasi-experimental study was undertaken including 16 patients with cancer under chemotherapy from a pediatric oncology ward in a Brazilian hospital. Eight saliva samples were collected, comprising 4 at baseline and 4 after the hospital clown intervention (+1h/+4h/9h/+13h post-awakening). Salivary cortisol and α-amylase levels were determined using high sensitivity enzyme-linked immunosorbent assay kits. Fatigue and stress were measured by the PedsQL™ Multidimensional Fatigue Scale and Child Stress Scale-ESI™ respectively. Nonparametric statistics was used with 95% Confidence intervals and α set in 5%.

Resultado

Results: The mean age of the patients was 11.4 years. The most prevalent tumor was osteosarcoma, followed by leukemia. Most (81.3%, n=13) were primary neoplasia, and 68.7% (n=11) had metastases. In comparison with baseline, the total score of fatigue and stress levels improved after the hospital clown intervention (p=0.04 and p=0.003, respectively). Salivary cortisol showed a significant decrease following hospital clown intervention at the collection time points +1h, +9h, and +13h (P<0.05); however, α-amylase levels remained unchanged during the chemotherapy protocol. Also, the total stress scores from the patients correlated positively with cortisol Area Under Curve at baseline (r=0.35, p=0.03) and at post-intervention (r=0.02, p= 0.04).

Conclusão

Conclusion: These results provide evidence that hospital clown as adjuvant treatment to the conventional one merits further study as a way to relieve fatigue and stress in paediatric patients with cancer under chemotherapy.

Palavras-chave

Keywords: Hospital clowns; Cancer-related fatigue; Psychological stress; Pediatric cancer patients.

Área

Oncologia - Psico-oncologia