Talking to Children and Families about Chronic Pain: The Importance of Pain Education-An Introduction for Pediatricians and Other Health Care Providers.

Chronic pain in children and adolescents is a common and debilitating health problem. This narrative review will give a brief overview on what pediatric chronic pain is and what treatment options there are for children and adolescents. The specific emphasis will be on pediatric chronic pain education and communication: this narrative review aims to show how important a good patient-health care provider relationship is-it builds the foundation for successful communication-and how this relationship can be established. In addition, we will present five steps that health care providers can perform to explain pediatric chronic pain to patients and their parents and what to keep in mind in their clinical routine. Our review is intended for pediatricians and other health care providers who treat pediatric patients with chronic pain but might feel uncertain on how to best communicate with them.

A two-session psychological intervention for siblings of pediatric cancer patients: a randomized controlled pilot trial.

BACKGROUND: Since siblings of pediatric cancer patients are at risk for emotional, behavioral, and social problems, there is considerable interest in development of early psychological interventions. This paper aimed at evaluating the effectiveness of a two-session psychological intervention for siblings of newly diagnosed pediatric cancer patients. METHODS: Thirty siblings age 6-17 years were randomly assigned to an intervention group or an active control group with standard psychosocial care. The manualized intervention provided to siblings in the first 2 months after the cancer diagnosis of the ill child included medical information, promotion of coping skills, and a psychoeducational booklet for parents. At 4 to 6 weeks, 4 months, and 7 months after the diagnosis, all siblings and their parents completed measures (from standardized instruments) of social support, quality of life, medical knowledge, posttraumatic stress symptoms, and anxiety. RESULTS: At follow-up siblings in the intervention group showed better psychological well-being, had better medical knowledge, and reported receiving social support from more people. However, the intervention had no effects on posttraumatic stress symptoms and anxiety. CONCLUSIONS: The results of this pilot trial suggest that a two-session sibling intervention can improve siblings' adjustment, particularly psychological well-being, in the early stage after a cancer diagnosis. TRIAL REGISTRATION: ClinicalTrials.gov NCT00296907.

How siblings of pediatric cancer patients experience the first time after diagnosis: a qualitative study.

BACKGROUND: Siblings of pediatric cancer patients have a higher risk of developing emotional, behavioral, and social problems. However, little is known about specific experiences of this population in the first time after diagnosis. OBJECTIVE: The purpose of this qualitative study was to describe the experiences of siblings of pediatric cancer patients in different areas of life in the first half-year after the cancer diagnosis. METHODS: Semistructured interviews were conducted with 7 siblings of pediatric cancer patients (ages 11-18 years). Siblings were asked about their experiences in the hospital, in school, in their family, with peers, and with the ill child. Content analysis was used to derive important themes from the interviews. RESULTS: Twenty-three categories of siblings' experiences were identified from the data. CONCLUSIONS: In all areas of life, siblings reported difficulties, such as absence of parents, dealing with the ill child's or other patients' suffering and appearance, or impaired school achievement. But the siblings also mentioned important resources such as peer relationship, helpful coping strategies, and increased family cohesion. IMPLICATIONS FOR PRACTICE: The results of the present study lead to a list of important topics in different areas of life that might be helpful for healthcare professionals to have in mind when meeting with siblings of cancer patients. Integration of these findings should serve to improve sibling support and develop standardized sibling interventions.

Psychological interventions with siblings of pediatric cancer patients: a systematic review.

OBJECTIVE: Siblings of pediatric cancer patients have been shown to be at risk for developing emotional, behavioral, and social problems. There is a need for psychological interventions in this population. Several researchers have previously documented and evaluated their interventions with siblings. This paper aimed at reviewing the existing reports of evaluated psychological interventions with siblings of pediatric cancer patients and at outlining future directions. METHODS: Research was conducted on several online bibliographic databases. Articles were selected on the basis of predefined criteria. If possible, effect sizes (ES) were calculated. RESULTS: Fourteen studies representing 11 different sibling interventions met criteria for inclusion. One individual intervention, three camps, and seven groups were found. Objectives of interventions concentrated mainly on enhancing siblings' coping and improving their medical knowledge. In terms of outcome measures, most of the studies focused on psychological adjustment variables. Findings showed significant improvements in siblings' depression symptomatology, medical knowledge, and health-related quality of life. Findings were inconsistent with regard to anxiety, behavioral problems, social adjustment, self-esteem, and posttraumatic stress symptoms. Depending on the outcome variables, small to large ES were found. Satisfaction with the intervention was high in both siblings and parents. CONCLUSION: There is tentative evidence that psychological interventions with siblings of childhood cancer patients can effectively reduce psychological maladjustment and improve medical knowledge about cancer. However, the number of studies is small, and several methodological shortcomings have to be noted. In future, more randomized controlled trials need to be conducted in larger samples to extend the evidence base.

Prospective study of the effectiveness of coping in pediatric patients.

Findings about the influence of coping on psychological adjustment in children with different medical conditions are inconsistent and often based on cross-sectional data. This prospective study evaluated the effect of various coping strategies on children's post-traumatic stress symptoms and behavioral problems 1 month and 1 year after an accidental injury or the diagnosis of a chronic disease in 161 pediatric patients 6-15 years of age. Only minor positive effects of coping on psychosocial adjustment were found: Religious coping reduced post-traumatic stress symptoms. Active coping strategies had negative effects on internalizing and externalizing behavioral problems. Support seeking strategies, distraction, and avoidance had no impact on long-term psychosocial adjustment.