Janben et al. 2000(4242 JanBen G, Bode U, Breu H, Dohrn B, Engelbrecht V, Gobel U. Boswellic acids in the palliative therapy of children with progressive or relapsed brain tumors. Klin Padiatr. 2000;212(4):189-95. doi: 10.1055/s-2000-9676
https://doi.org/10.1055/s-2000-9676...
)
Germany |
To evaluate the effects of boswellic acid (H15*) administered to children with progressive or recurrent brain tumors receiving palliative care |
19 patients
(11 boys and 8 girls)
Age: 6 months to 18 years
(mean age: 8.4 years old) |
Use of boswellic acid (H15*) /
The oral dose of H15 was of 40±126 (median= 77) mg / kg weight/day administered in 3 doses during 1±26 (median= 9) months.
Fourteen patients received H15* as monotherapy, whereas 5 patients received H15* with additional conventional therapy |
- Clinical outcomes: muscular strength, hemiparesis, ataxia, and weight gain
- Symptom clusters: headache, fatigue, loss of appetite, and nausea |
Subjective analysis through the oncologists' observations |
No adverse effects were attributed to H15* in 19 patients.
Children who reported an improvement in their general health state amounted to 5/19; 3/17 patients presented a mainly transient improvement of neurological symptoms, such as hemiparesis and ataxia. |
Thrane et al. 2017(4343 Thrane SE, Maurer SH, Ren D, Danford CA, Cohen SM. Reiki Therapy for symptom management in children receiving palliative care: a pilot study. Am J Hosp Palliat Care. 2017;34(4):373-9. doi: 10.1177/1049909116630973
https://doi.org/10.1177/1049909116630973...
)
USA |
To examine the viability and acceptability of Reiki in children undergoing palliative treatment and the effect of Reiki therapy on pain and anxiety |
16 patients (8 verbal and 8 non-verbal)
(11 girls and 5 boys)
Age: 7 to 16 years old
(mean age: 12.6 years old) |
Use of Reiki /
The intervention consisted of two 24-minute Reiki sessions at the child's home, with a minimum of 1 and a maximum of 3 days between sessions. Each Reiki session used a protocol of 12 hand positions performed for 2 minutes each. The child was comfortably dressed and the parents were invited to watch the sessions. The interventionist was a pediatric nurse with 12 years of experience, who wrote down in a registry the number of minutes for the session, including any deviations from protocol or uncommon occurrences |
- Clinical outcomes: heart and respiratory rate
- Symptom clusters
pain and anxiety |
- VAS†
- Wong-Baker FACES® Pain Scale
- The Children's Fear Scale
- Children's Anxiety and Pain Scale |
All mean scores of the outcome variables (pain, anxiety, heart, and respiratory rate) decreased after treatment with the two Reiki sessions. Significant reductions in pain during treatment 1 in non-verbal children (p = .063) and for respiratory rate of treatment 2 in verbal children (p = .009). The size of Cohen's effects was medium and high for most outcome measurements. |
Weekly et al. 2019(4444 Weekly T, Riley B, Wichman C, Tibbits M, Weaver M. Impact of a massage therapy intervention for pediatric palliative care patients and their family caregivers. J Palliat Care. 2019;34(3):164-7. doi: 10.1177/0825859718810727
https://doi.org/10.1177/0825859718810727...
)
USA |
To explore the impact of therapeutic massage on symptom overload and use of medication in pediatric patients undergoing palliative care, describe the impact of therapeutic massage on the suffering of the family caregiver and report the perception of the nursing team of the impact of therapeutic massage for the children and their families |
53 patients
(17 girls and 36 boys)
Age: 6 months to 8 years
(mean age: 3.8 years old) |
Use of therapeutic massage /
The massage intervention occurred during a scheduled period of 30 minutes in the participant's hospital room. The massage was performed by a certified pediatric massage therapist, with a focus on hands, feet, arms, scalp, head, and shoulders of the participants. Relaxing music was used during the intervention to minimize the noise from the hospital ward. The family caregivers were encouraged to watch the intervention. The mean duration of a massage was 10.5 minutes, with a minimum duration of 3 minutes and maximum duration of 22 minutes. |
- Clinical outcomes: use of pain medication "if necessary"
- Symptom clusters pain, anxiety, dyspnea, and nausea |
- NCCN§ Distress Thermometer Scale
- FACES Pictorial Scale
- BARF|| Pictorial Scale
- Dalhousie Dyspnea Scale
- McMurtry Anxiety Scale
- FLACC¶ Scale |
The difference in the scale face, legs, activity, cry, and child consolation (FLACC¶) was significant (p <0.0001) with a median (interquartile interval - IQI) before the FLACC¶ score being 2 (1-3) and after the FLACC¶ score 0 (0-1). The difference in use of medication for pain "if necessary" in the 24 hours before and after the massage was statistically significant (p =.0477). The mean difference for the level of suffering of the family caregiver with massage was 3.0 (IQI = 2.0, p <0.0001). All nurses reported that massage is a significant way of providing care to patients and families. |
Ofir et al., 2019(4545 Ofir R, Bar-Sela G, Ben-Arush MW, Postovsky S. Medical marijuana use for pediatric oncology patients: single institution experience. Pediatr Hematol Oncol. 2019;36(5):255-66. doi: 10.1080/08880018.2019.1630537
https://doi.org/10.1080/08880018.2019.16...
)
Israel |
To analyze the short-term efficacy and safety of Cannabis sativa (marijuana) (M)†† in pediatric oncology patients undergoing palliative care |
50 patients
(19 girls and 31 boys)
Age: 7 months to 19 years
(mean age: 13 years old) |
Use of marijuana /
The first dose of marijuana for all patients was 20 grams per month (cannabis through dry inflorescence) used for inhalation / smoking or a basis for oil production.
Marijuana (M)†† was offered to 30 patients through oil drops (60%) and to 11 through smoking (22%), followed by vaporization, capsules, or combination of various routes |
- Clinical outcomes: quality of life
- Symptom clusters
nausea and vomit, loss of appetite, mood, sleep disorders, and pain |
- VAS†
- NRS**
- FLACC¶ |
Positive effects were reported by children and parents in 80% of the cases related to the symptoms nausea and vomit, sleep disorders, pain, appetite, and mood. Five (10%) patients who smoked reported burning throat and anxiety attacks; 4% reported stomach pain, but it was not clear whether these complaints were caused by marijuana (M)†† or by the children's medical conditions. |
Genik et al. 2020(4646 Genik ML, McMurtry MC, Marshall S, Rapoport A, Stinson J. Massage therapy for symptom reduction and improved quality of life in children with cancer in palliative care: a pilot study. Complement Ther Med. 2020;48:102263. doi: 10.1016/j.ctim.2019.102263
https://doi.org/10.1016/j.ctim.2019.1022...
)
Canada |
To perform an intervention of therapeutic massage to determine the acceptability of the intervention and its initial effects on pain classification, reduction of worry, and quality of life |
8 patients
(3 girls and 5 boys)
Age: 10 to 17 years
(mean age= 14.5 years) |
Use of therapeutic massage /
The MT‡‡ intervention consisted of four weekly massages performed by a massage therapist with experience in palliative care services. The massages were performed in the hospital or at home, abiding by the contract between the massage therapist and the hospital's palliative care service. Each massage had approximately 60 minutes in duration. A balance between intervention and individualization was attempted. For example, special considerations or alterations were applied to the MT‡‡ session when these were related to physical care and the child's well-being, such as cancer type, site of metastases, adverse reactions to treatments, skin fragility, edema, and pressure or inflammation lesions. |
- Clinical outcomes: quality of life
- Symptom clusters
pain and worry |
-PedsQL§§-Cancer Module
-PainSquad app
- FPS-R||||
- CFS¶¶ |
The participants reported significant pain reductions after two MT‡‡ sessions (p = 0.03) and in worry after one session (p = 0.03). No statistically significant differences were found for symptoms pain and quality of life between baseline and follow-up (p>0.05) |
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