Anna E. van Asselt, Robert C. Gibler, Meghan Tokala, Meredith L. Dreyer Gillette, Kimberly L. Klages, Renee Gilbert, Jacee Weber, Carolyn R. Bates
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引用次数: 0
Abstract
Background
Engaging in physical activity (PA) throughout cancer treatment offers many benefits, but may be challenging due to cancer-related pain. Pain research in pediatric cancer has primarily focused on procedural pain, with fewer studies exploring how pain affects PA. The current study qualitatively investigated the impact of pain on PA in youth with acute lymphoblastic leukemia (ALL) using a biopsychosocial framework.
Procedure
As part of a larger study, caregivers (N = 17) of a child diagnosed with ALL and on treatment for less than 1 year completed a semi-structured interview about perceptions of their child's health behaviors during ALL treatment. This secondary analysis focused specifically on discussions about pain and its impact on PA. We followed Braun and Clarke's (2006) six-step thematic analysis framework to identify themes of pain-related barriers to PA.
Results
Key pain-related barriers endorsed by caregivers included: interactions among pain and treatment effects, caregiver distress around seeing their child in pain, and fear of interfering with medical equipment. Despite these barriers, caregivers found creative solutions to adapt activities for their child. Caregivers were reassured by PA advice from their medical team; however, advice varied between teams.
Conclusion
The relationship between pain and PA during ALL treatment is influenced by an intricate system of biological (e.g., treatment effects), psychological (e.g., parental distress), and social (e.g., communication among families and medical teams) factors. Future directions include identifying evidence-based PA recommendations and exploring family–team communication dynamics. This study also highlights a need to prioritize ALL pain management and involve caregivers in behavioral treatment protocols to improve PA.
背景:在整个癌症治疗过程中参加体育活动(PA)有很多好处,但由于癌症相关的疼痛,参加体育活动可能具有挑战性。儿科癌症疼痛研究主要集中在治疗过程中的疼痛,很少有研究探讨疼痛如何影响体力活动。本研究采用生物-心理-社会框架,定性研究了疼痛对急性淋巴细胞白血病(ALL)青少年 PA 的影响:作为一项大型研究的一部分,被诊断为急性淋巴细胞白血病且接受治疗不到一年的患儿的照顾者(N = 17)完成了一项半结构化访谈,内容涉及对其患儿在急性淋巴细胞白血病治疗期间的健康行为的看法。本次二次分析特别关注有关疼痛及其对 PA 影响的讨论。我们遵循 Braun 和 Clarke(2006 年)的六步主题分析框架,确定了与疼痛相关的 PA 障碍主题:结果:护理人员认可的与疼痛相关的主要障碍包括:疼痛与治疗效果之间的相互作用、护理人员因看到孩子疼痛而感到痛苦,以及害怕干扰医疗设备。尽管存在这些障碍,但照顾者还是找到了创造性的解决方案来调整孩子的活动。医疗团队提供的 PA 建议让照顾者感到放心;但是,不同医疗团队提供的建议各不相同:结论:在 ALL 治疗期间,疼痛和 PA 之间的关系受到生物(如治疗效果)、心理(如父母的痛苦)和社会(如家庭和医疗团队之间的沟通)因素等复杂系统的影响。未来的研究方向包括确定以证据为基础的 PA 建议和探索家庭与团队之间的沟通动态。本研究还强调了优先考虑 ALL 疼痛管理和让护理人员参与行为治疗方案以改善 PA 的必要性。
期刊介绍:
Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.