Stress Management Aids Children With Cancer In Hospital Setting

Main Category: Cancer / Oncology
Also Included In: Pediatrics / Children's Health;  Anxiety / Stress
Article Date: 03 Oct 2009 - 2:00 PST

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Being diagnosed with a new illness and going through treatment can be an overwhelming event. For children and teens with cancer at St. Jude Children's Research Hospital, a team of child life specialists work to manage the stress and anxiety that patients may experience in the hospital setting.

A child's normal development can be affected when battling a serious illness. Child life specialists coordinate closely with patients to provide non-threatening, age-appropriate explanations and preparations. This individualized education not only helps children understand what is happening, but also fosters trust and confidence so that they know what to expect during this time of many changes. The specialists also create therapeutic opportunities for play and expressive activities that promote patients' development, an outlet for feelings, peer interaction, a sense of mastery or developed coping.

"Children and teens might feel stressed with feelings of anxiousness, sadness or confusion about what is happening to them," said Jennifer Smith, St. Jude child life specialist. "By making the hospital environment less threatening, we can help patients cope better with treatment."

Coping refers to what a person does in order to avoid, remove or minimize a stressful situation and is the process of making adaptations to meet personal needs and to respond to the demands of the environment. The coping process uses personal resources to manage routines, frustrations and challenges of daily life in ways that seek to maintain or enhance feelings of well-being. The way a child copes in a hospital environment can be influenced by many things, including age, past medical experiences, family support, comprehension of diagnosis and hospitalization, developmental level and any other current stressors.

Appropriate coping skills exist within every child, but sometimes the stress of hospitalization causes the skills to be temporarily threatened or minimized. Coping strategies are unique, and skills that work for one person may be different from techniques that work for another.

Smith sites common coping techniques and common reactions children use to get through difficult situations

-- Anger or aggression: Although the frustration is derived from the uncontrollable situation, it can often be misplaced and directed at surrounding people.

-- Crying: This is a natural, emotional release.

-- Deep breathing or self-calming techniques: These techniques are intended to divert or distract attention from the stressful situation.

-- Denial: The overall disbelief and shock that the situation is actually happening. This can sometimes carry over to rejecting necessary medicine, procedures etc.

-- Escape: Similar to denial, focusing on a specific activity (for example, video games or play) in order to avoid or pretend the stressful situation doesn't exist.

-- Information seeking: Desire to know more about a situation in order to process or further understand. Some adults hesitate to allow their information-seeking children to be privy to more in-depth information, but when sought out by the child, allowing this access encourages their coping.

-- Play: Can be used as a release and distraction. Some children talk about feelings or reenact real-life situations in their play.

-- Rebelliousness: Reasserting their independence in an effort to gain some control.

-- Regression: Reverting to old routines or behaviors (for instance, being more clingy) may remind them of a time when life seemed easier. Newly learned skills like potty training may be temporarily abandoned while they are adjusting to the many changes in their routine.

-- Selective silence: Choosing not to talk reasserts their independence and is an overt sign of something they will always be able to control: with whom they choose to speak.

-- Submission: The child may react to challenges by becoming passive or withdrawn.

-- Use of fantasy: This can be helpful; for example, children may view themselves as "superheroes," which can be a great motivator especially during procedures. Parents should also be the child's "bridge to reality"; for example, when the child demands that superheroes do not do chores, etc.

St. Jude child life specialists assist patients and siblings in creating and developing positive coping skills, plans and techniques for events that will be challenging for them. Involving the child or teen in the process of choosing the positive method that works best for them gives them back the control they seek.

"Arriving at the hospital, families often find themselves in a situation that they never thought possible," Smith said. "Our goal is to provide support to patients and their families and make the hospital a less intimidating place."

St. Jude Children's Research Hospital

St. Jude Children's Research Hospital is internationally recognized for its pioneering work in finding cures and saving children with cancer and other catastrophic diseases. Founded by late entertainer Danny Thomas and based in Memphis, Tenn., St. Jude freely shares its discoveries with scientific and medical communities around the world. No family ever pays for treatments not covered by insurance, and families without insurance are never asked to pay. St. Jude is financially supported by ALSAC, its fundraising organization.

Source: St. Jude Children's Research Hospital