Research Project Grants

Trish Dryden and Sabine Moritz
Co-investigator:
Sunita Vohra, Janet Kahn, Elizabeth Barberree, Helen Lee Robertson
Centennial College and Canadian Institute for Natural and Integrative Medicine
Project Title:
Teaching Parents to Massage their Child with Cancer to Decrease Parental Stress and Child's Pain
Abstract:
BACKGROUND:
                        Pediatric Cancer Prevalence and Mortality Rates: In Canadian children aged 0-19 the number of new cancer cases and death due to all cancers, from 1996-2000, was respectively on average 1,289 and 231 children per year.
                        Impact on Parents Caring for Children with Cancer: Parents of children with incurable cancer experience severe emotional distress including anxiety and depression. Parents require more support and skills to reduce their own anxiety and distress and to help alleviate suffering in their children.
                        Massage Therapy in Cancer Care: Massage therapists, a regulated profession that is trained in the safe use of different massage techniques, are increasingly involved in cancer care. Massage therapy has been shown to reduce physical and emotional symptoms for adults and children with cancer and to increase comfort in palliative care. A recent systematic review found consistent positive effects of massage therapy on mood, in particular anxiety. Simple massage therapy techniques have been taught successfully to lay people to allow them to care for loved ones with cancer. Interestingly, both the recipient and provider of the massage responded with reduced anxiety. Thus, teaching parents of children with incurable cancer a simple technique to massage their child has the potential to reduce parents' experience of anxiety and distress and to allow parents to contribute positively to their child's care.
                        OBJECTIVES: 1) To assess the feasibility of conducting a large trial on parental massage for children with cancer (participation and withdrawal rates, compliance, participant burden); 2) to obtain an estimate of the impact of parent delivered massage on distress and anxiety in the parent and child, and the child's physical symptoms of pain, nausea and fatigue to guide sample size estimation; 3) to obtain qualitative information from the participating families to guide refinement of the massage training and treatment approach and gain further insight into additional outcomes that may be affected by the intervention.
                        HYPOTHESES: It is hypothesized that parent administered massage or their child with incurable cancer will be associated with reduced anxiety for both the parent and the child, improved mood in the parent and improved quality of life for the child.
                        METHODS:
                        Study Design: This is a pilot study for a parallel group, randomized trial on parent administered massage therapy versus wait-list control for children with cancer. This study consists of an 8-week intervention period followed by an 8-week follow up phase. The pilot trial will be complemented by personal semi-structured interviews with participant families.
                        Study Population: Parents and their children with incurable cancer who are under the care of the Division of Oncology, Stollery Children's Hospital, Edmonton, Alberta, will be recruited for this study. Children aged 6 to 18 years with a life expectancy of at least 3 months will be eligible. For this pilot study a total of 10 children with their parents will be recruited.
                        Intervention: Parents will be taught basic soothing massage techniques: 1) by receiving a massage from a registered massage therapies who is an expert in massage therapy for pediatric cancer patients; 2) by attending two group classes on the 10 minute massage protocol; 3) by receiving written and visual materials on the protocol. Parents will be advised to use the protocol on a daily basis during the 8 week intervention period and as frequently as they and their child wish over the 8 week follow-up period.
                        Data Collection and Outcome Measures: Assessment of the following outcomes will take place at baseline, post-intervention and at the two month follow-up point: 1) anxiety levels in parents and children (State-Trait Anxiety Inventory for adults and children); 2) General mood in parents (Profile of Mood States); 3) Quality of life in children (Generic and cancer module of Pediatric Quality of Life Inventory). Parents will also complete study diaries on massage administration throughout the study. Semi-structured interviews with participating families will be conducted post the intervention period.
                        Primary Study Endpoint and Data Analysis: Parent and child anxiety will serve as primary study endpoints while parent mood and child quality of life will serve as secondary outcomes. Analysis of variance and t-tests for independent samples will be used for group comparisons and content analysis to analyze the qualitative interview data.
12 Feb 06