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Procedural pain in lumbar punctures and the impact of preparation in pediatric cancer patients

Sinha, Sudha ; Marczak, Magdalena ; Jacob, Jean ; Palat, Gayatri ; Brun, Eva LU ; Wiebe, Thomas LU ; Schyman, Tommy and Segerlantz, Mikael LU (2019) In Indian Journal of Medical and Paediatric Oncology 40(2). p.182-192
Abstract

Aim: Childhood cancer patients are subjected to recurring painful medical procedures. In low- and middle-income countries (LMIC), where the majority of the world's childhood cancer patients live, pain management is often unsatisfactory due to limited resources. This study aimed to evaluate the possibility of conducting a preprocedural preparation for lumbar punctures (LPs) at a pediatric oncology unit in a LMIC and to assess whether this intervention would decrease procedural pain and fear. Methods: Patients aged 5-18 who underwent LPs between February 25, 2017, and April 12, 2017, were eligible and invited to participate. Included patients were interviewed to assess the procedural pain and fear in conjunction with the LP and the... (More)

Aim: Childhood cancer patients are subjected to recurring painful medical procedures. In low- and middle-income countries (LMIC), where the majority of the world's childhood cancer patients live, pain management is often unsatisfactory due to limited resources. This study aimed to evaluate the possibility of conducting a preprocedural preparation for lumbar punctures (LPs) at a pediatric oncology unit in a LMIC and to assess whether this intervention would decrease procedural pain and fear. Methods: Patients aged 5-18 who underwent LPs between February 25, 2017, and April 12, 2017, were eligible and invited to participate. Included patients were interviewed to assess the procedural pain and fear in conjunction with the LP and the patients' understanding of why an LP was done. Closest caregivers and the medical staff were interviewed to compare the perceptions of pain. The study was conducted in two separate phases; patients included in the period of February 25-March 9 underwent LP according to routines without preparation while patients included in the period of March 10-April 12 received procedural preparation with information. Results from the interviews from the two study groups were compared. Results: Out of 79 patients who met the inclusion criteria, 76 were included and preparation was successfully implemented for 25 of them. The pain decreased significantly (P = 0.022) after preparation. The physicians underestimated the patients' pain (P < 0.0001). The understanding of the reason for the LP increased significantly among patients (P = 0.0081) and their caregivers (P < 0.0001). Conclusions: Preparation by preprocedural information, created to fit the situation at a state-run hospital in a LMIC, is feasible and efficient.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Low/middle-income countries, pediatric oncology, preprocedural preparation, procedural pain
in
Indian Journal of Medical and Paediatric Oncology
volume
40
issue
2
pages
182 - 192
publisher
Wolters Kluwer
external identifiers
  • scopus:85073724844
ISSN
0971-5851
DOI
10.4103/ijmpo.ijmpo_58_18
language
English
LU publication?
yes
id
4ddd0807-0b41-428f-b141-9631eec1eb95
date added to LUP
2019-10-31 09:14:58
date last changed
2023-11-13 16:12:38
@article{4ddd0807-0b41-428f-b141-9631eec1eb95,
  abstract     = {{<p>Aim: Childhood cancer patients are subjected to recurring painful medical procedures. In low- and middle-income countries (LMIC), where the majority of the world's childhood cancer patients live, pain management is often unsatisfactory due to limited resources. This study aimed to evaluate the possibility of conducting a preprocedural preparation for lumbar punctures (LPs) at a pediatric oncology unit in a LMIC and to assess whether this intervention would decrease procedural pain and fear. Methods: Patients aged 5-18 who underwent LPs between February 25, 2017, and April 12, 2017, were eligible and invited to participate. Included patients were interviewed to assess the procedural pain and fear in conjunction with the LP and the patients' understanding of why an LP was done. Closest caregivers and the medical staff were interviewed to compare the perceptions of pain. The study was conducted in two separate phases; patients included in the period of February 25-March 9 underwent LP according to routines without preparation while patients included in the period of March 10-April 12 received procedural preparation with information. Results from the interviews from the two study groups were compared. Results: Out of 79 patients who met the inclusion criteria, 76 were included and preparation was successfully implemented for 25 of them. The pain decreased significantly (P = 0.022) after preparation. The physicians underestimated the patients' pain (P &lt; 0.0001). The understanding of the reason for the LP increased significantly among patients (P = 0.0081) and their caregivers (P &lt; 0.0001). Conclusions: Preparation by preprocedural information, created to fit the situation at a state-run hospital in a LMIC, is feasible and efficient.</p>}},
  author       = {{Sinha, Sudha and Marczak, Magdalena and Jacob, Jean and Palat, Gayatri and Brun, Eva and Wiebe, Thomas and Schyman, Tommy and Segerlantz, Mikael}},
  issn         = {{0971-5851}},
  keywords     = {{Low/middle-income countries; pediatric oncology; preprocedural preparation; procedural pain}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{2}},
  pages        = {{182--192}},
  publisher    = {{Wolters Kluwer}},
  series       = {{Indian Journal of Medical and Paediatric Oncology}},
  title        = {{Procedural pain in lumbar punctures and the impact of preparation in pediatric cancer patients}},
  url          = {{http://dx.doi.org/10.4103/ijmpo.ijmpo_58_18}},
  doi          = {{10.4103/ijmpo.ijmpo_58_18}},
  volume       = {{40}},
  year         = {{2019}},
}