Mother's View About the Preparation for Children Undergoing Proton Beam Therapy

Background

Proton beam therapy is one of the radiation therapy in pediatric cancer treatment. Proton beam therapy is expected to reduce the late complications. But the facility is few, it is often require changing hospital for treatment. So the family often get an adverse impact (Houtrow, Yock, Delahaye, & Kuhlthau, 2012). There are many that mothers feel a sense of confusion in the relationship with the new medical staff.

Radiotherapy itself is a noninvasive treatment, but it can be stressful and challenging for the children. Children are exposed to an unknown large radiation equipment and the new medical staff such as radiologists. Additionally, the children have to remain alone in the treatment room during treatment. These factors can cause the children stress and anxiety, so anesthesia is often used in radiation therapy for children’s safety.

However the preparation programs for children to receive radiation therapy has been studied in some countries, and preparation program has been shown that it is possible to reduce the amount of anesthetic. So we have created a program with reference to previous research, and carried out for the children to receive proton therapy in Japan. Through this program we were able to reduce the amount of sedatives. But we do not know about how the children and parents evaluate and feel to the care (Mizumoto et al ., 2015).

Although the radiotherapy treatment process involves interactions with the most advanced skills in pediatric oncology care, few studies have investigated the child’s and the parents’ view of this particular procedure. And the preparation program for proton beam therapy have to be based on the characteristics on the family of children receiving proton therapy as described above. There is a need to continue to improve the preparation program.

Purpose

 The purpose of this study is to clarify about mother's view about the preparation for children undergoing proton beam therapy and discuss about suggestions for preparation program.

Method

Subject: Our study’s subjects were mothers of the children (3~6years) received a preparation program about proton beam therapy.

Target facility: Our study’s target facility is the proton therapy center in Japan

At the center nurses and radiologists care the children using the preparation program. The preparation program starts at 1~2 days before the CT scanning for the proton beam therapy and continue during treatment. First they explain to the children about treatment using picture book or pamphlet. Next they invite the children to facility for become familiar with the treatment room and staff before starting the treatment. Then the children practice to stay a treatment bed with mothers, and little by little they practice to stay alone using favorite DVD or music for their relaxation. Nurses and radiologists play with the children every time after practice and we give them the stickers of the reward. 

 Data collection and analyses: We have created a questionnaire of own on the preparation program. Questionnaire is intended to ask the viwe of mothers for the preparation, it provided the freedom described column for each of the process. The results carried out content analysis, we found codes, subcategories, and categories. 

 

Ethical considerations: Our study obtained organization of the ethics committee’s proposal. We explained the purpose and method of this study, the participation is free, keeping anonymous in document. Participants signed on consent form.

Result

22 mothers participated in our study. Theirs children are 10male and 12 female, 3-6yearas old. 15 of the children could receive proton beam therapy without sedation.

As whole effect of the preparation program, we found 4 categories such as [The preparation was bring out the hidden forces in the children] [The preparation lead to the growth of the child] [The preparation reduced parental anxiety not only children] [Mothers worries about the burden of the children].

Mothers wanted the intervention to suit the characteristics of the children. For example explanation in plain language, gradually advance intervention, and to provide rich distraction so as not to increase the fears. Mothers evaluated that such interventions lead to bring out the forces of children, and by children facing the initiative in treatment, they were able to have the confidence. Also mothers had to take advantage of as an opportunity to mother itself to the medical staff and involved questions and deepen the understanding of the treatment through the preparation.  Finally it was clarify that while mothers felt the benefits of the preparation , mother suffered that it might be a burden to children .

Discussion

Effects of preparation for children as to reduce the anxiety and to increase understanding has been evaluated in the preparation of proton beam therapy, too. Not only assessment of medical staff, it would lead to better care than by providing the opportunity to share the mothers and information about the characteristics of the child.

In addition, although this time to investigate the evaluation of interventions to children, that the mother deepen their understanding of the treatment through the preparation. They utilized the preparation as an opportunity to build a trust relationship with medical staff and questions about treatment. The psychological situation of mother has been shown to affect children. Proton beam therapy is unknown of treatment even for the mother. In addition, given the background that will require changing hospital, it can be predicted that the mother of anxiety is high. Intervention for mothers as well as children is also suggested that there is a need to consider the future.

When taking into account such as the burden of children by practice, mothers worries that whether it is a good thing to be treated with a sedative. Until now, the evaluation of reduction of sedatives have been made by the intervention. But actually assessment of the psychological aspects such as whether a fear and emotional behavior of children has not been made. We have to evaluate the assessment in the future.