The Efficacy of Procedural Support Interventions on Coping and Distress for Children With Newly Diagnosed Leukemia: A Prospective Pilot Study

Introduction Acute leukemia is the most prevalent pediatric cancer diagnosis in the United States and treatment requires intravenous access weekly or monthly for two to three years. Recurrent medical procedures have been associated with worse emotional functioning for children while receiving care and into adulthood. Therefore, psychosocial interventions that address children’s procedural distress early in treatment have the potential to positively impact emotional functioning while on treatment and as long-term survivors. This pilot study aimed to evaluate serial comprehensive procedural support interventions provided by a certified child life specialist (CCLS) on mood, distress, and pain ratings during Infusaport access procedures for children newly diagnosed with leukemia. Method Children ( n = 21) received procedural support for their first 10 Infusaport access procedures with five follow-up procedures over a 12-month period. Assessment of mood, distress behaviors, and pain rating were conducted via self-report measures, and behavioral coding data was obtained from video recordings of the procedures. Results Decreased distress was demonstrated at both group and individual levels with 86% of children demonstrating a statistically and clinically significant reduction in distress behaviors. No child demonstrated significant behavioral deterioration after demonstrating significant improvement. Pain ratings also significantly decreased during the study period. Repeated measures correlations demonstrated distress behaviors, pain rating, and mood were all significantly correlated within participants across time. Discussion This study provides preliminary evidence that serial procedural support interventions provided by CCLS may be associated with reduced distress behaviors and lower pain ratings.