Background and Aims

Aromatherapy using essential oils is a popular integrative medicine practice. Despite protocols with a list of approved hospital-provided oils for inhalation, many families on the Cancer Transplant Unit at Primary Children’s Hospital (PCH) continue to use personal oils. Staff also identified a need for updated education and clarity regarding aromatherapy practices.

This project included a review of the literature and survey of other pediatric oncology programs in the United States to update hospital practices and staff/family education regarding essential oil aromatherapy.

Methods

Sources published between 2010-20 with attention to aromatherapy to reduce nausea, pain and anxiety among pediatric and oncology populations were identified. A survey regarding hospitals' essential oil policies, mode of distribution, approved oils, documentation, and staff education was posted on the Association of Pediatric Hematology/Oncology Nurses discussion board. An industrial hygiene specialist was consulted to discuss the safety of inpatient diffusers.

Results

The literature review yielded 10 articles and a textbook chapter. Studies suggested aromatherapy is effective to reduce nausea, anxiety and pain among hospitalized children. Two authors noted the need for studies with larger sample sizes. 
Nurse educators, managers and aromatherapists from 20 inpatient pediatric oncology units completed the survey. All reported allowing at least one essential oil, most frequently lavender. Five reported using QueaseEASE personal nasal inhalers (PNI) with favorable responses. Five hospitals allowed diffusers; hospitals that prohibited diffusers cited concerns maintaining low-microbial, scent-free, and safe environments. Eight hospitals train nurses in the use of essential oils and require documentation of any oil administration. Eleven respondents indicated direct inhalation as the preferred method of administration, with 7 prohibiting all other methods. 

Conclusions

The PCH aromatherapy policy has been updated to prohibit diffusers hospital-wide. A PNI blend promoting digestive ease was added to PCH supply. Staff and family educational materials are being updated using FDA-approved language. PCH is collaborating with the hospital aromatherapist and unit educators to train staff on essential oil administration, including PNIs and nontransdermal patches.

Background and Aims

Complementary health approaches (CHA), such as herbs and yoga, are commonly used by children with cancer (CWC) globally. Recently, our team published a systematic review of CHA questionnaires in pediatrics, and 35 questionnaires were identified. None of these questionnaires were thoroughly validated, but the “Which Health Approaches and Treatments are you using?” (WHAT) questionnaire had evidence of initial validation and could be adapted for CWC. A sequential 4-phased approach is now being used to validate the WHAT questionnaire. The current study is the first phase and aims to reach consensus on the content of the WHAT questionnaire for CWC.

Methods

An electronic Delphi survey was conducted to reach consensus on the domains and items of the WHAT questionnaire for CWC. We invited CWC, their parents, health care providers (HCP), CHA providers and researchers. Parents and CWC were recruited from SickKids and the Ontario Parents Advocating for Children with Cancer group. HCP and CHA providers and researchers were recruited from the International Society of Pediatric Oncology working groups, and Pediatric Complementary and Alternative Medicine Research and Education Network. Based on previous similar research, the target response rate was 17%.

Results

Sixty participants completed the survey (14 CWC, 13 parents, 21 HCP, and 12 CHA providers/researchers). The response rates for CWC/parents, and HCP/CHA providers and researchers were 61% and 31%, respectively. Consensus was reached on all domains and items of the WHAT questionnaire after one Delphi cycle. The domains found to be the most relevant were CWC use of CHA, factors associated with CHA use, perceived impact of CHA use, and communication about CHA use.

Conclusions

Consensus was reached by CWC, parents, HCP, CHA providers and researchers on the content of the WHAT questionnaire. Next steps are further development and then psychometric testing of the adapted WHAT questionnaire in pediatric oncology.

Background and Aims

The use of social robots is increasing in pediatric oncology. Research suggests potential positive effects of social robots for children, but it is unknown how health care providers think about this innovation. We aimed to describe the opinions of health care providers in pediatric oncology regarding social robots and to examine differences in their opinions based on their background characteristics and experience with social robots.

Methods

Health care providers working in pediatric oncology care were approached globally to participate in an online survey. We reported frequencies of answers to multiple choice questions and a thematic approach was used to determine themes in open-end questions. Differences in opinions were studied using logistic regression analyses.

Results

Health care providers’ (n = 286) first thoughts about social robots were mostly positive (81.0%). They saw value in social robots (83.6%), mostly during hospitalization or procedures and when used for distraction. They were willing to use one (67.8%), but also expected difficulties (67.1%), mainly concerning technical errors. Psychosocial staff members less often saw value in social robots, more often expected difficulties and were less willing to use a social robot than other health care providers (ps < 0.05). No other differences were found.

Conclusions

Social robots may be a promising addition to standard care, since health care providers in pediatric oncology were generally positive about this innovation. However, psychosocial staff members were more reluctant. Important potential barriers were defined that should be addressed when wanting to implement social robots in pediatric oncology care.