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Published online April 23, 2007
PEDIATRICS Vol. 119 No. 5 May 2007, pp. e1159-e1166 (doi:10.1542/peds.2005-1514)
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ARTICLE

Predicting Pediatric Distress During Radiation Therapy Procedures: The Role of Medical, Psychosocial, and Demographic Factors

James L. Klosky, PhDa, Vida L. Tyc, PhDa,b, Xin Tong, MPHc, Deo Kumar Srivastava, PhDc, Mindy Kronenberg, PhDa, Alberto J. de Armendi, MDb,d, Thomas E. Merchant, DO, PhDb,e

a Divisions of Behavioral Medicine
d Anesthesiology and Departments of
e Radiation Oncology
c Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee
b Department of Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee

OBJECTIVES. The purpose of this work was to identify demographic, medical, and psychosocial variables that predict radiation therapy–related distress among pediatric patients with cancer.

PATIENTS AND METHODS. Seventy-nine children between the ages of 2 and 7 years were consecutively enrolled in the study. Radiation therapy–related distress was measured by rates of anesthesia, observed behavioral distress, and heart rate.

RESULTS. Younger age and higher observed behavioral distress predicted the use of anesthesia, higher baseline heart rate predicted lower initial observed behavioral distress, and prone treatment position was associated with increases in both observed behavioral distress and heart rate relative to baseline.

CONCLUSIONS. Modifiable treatment and psychological variables directly relate to pediatric radiation therapy–related distress. Implementation of developmentally appropriate and cost-effective interventions to reduce procedural radiation therapy distress is warranted.

Key Words: pediatric distress • radiation therapy • noninvasive medical procedures

Abbreviations: RT—radiation therapy • HR—heart rate • OBD—observed behavioral distress • ECOG—Eastern Cooperative Oncology Group • OSBD—Observation Scale of Behavioral Distress

Accepted Nov 1, 2006.


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