Background and Aims

Due to COVID-19 pandemic and additional restrictions at the Department of Hemato-oncology of the Mother and Child Health Care Institute of Serbia, children and their parents did not have access to psychological support from the association. In order to provide online psychological support, with a special focus on empowerment of children and parents, the smartphone application “Feelmings” was created, which enables the creation of a personalized video with specific and individual content and messages for each patient.

Methods

The pilot study lasted two months, with participation of twenty-five children (aged 2-12) and their mothers. A personalized two minutes video was created for each child and contains favorite photos of the child, the child's favorite tune and with encouraging mother’s voice messages. The personalized video was shown to the children as a passive activity while the child performed other routine actions. Our assumption was that parents would notice reduced psychological negative reactions to medical interventions, as well as the importance of parent’s more frequent verbal encouragement of a child.

Results

Evaluation of the survey showed:

87% of mothers estimate that the use of video is a good method for providing support to children;

69% of mothers reported that their child seemed calmer in general;

42% of mothers believe that the psychological reaction of the child decreased prior to medical intervention;

91% of mothers reported that they pay much more attention to the importance of more frequent verbal encouragement of the child.

Conclusions

Parents reported that video had a positive effect on reducing the child's reaction to stress. Also, this type of empowerment positively influenced the parents to pay more attention to the verbal encouragement as the mother’s voice has a positive effect on the child’s emotional development and increases child’s capacity to cope with stress. This pilot project requires to be customized for teens.

Background and Aims

As part of the multi-fold strategies to cope with the unprecedented crisis of COVID-19, a number of hospitals in India were designated as COVID-only-hospitals by government of India. This posed unique challenges for pediatric-oncology units at these hospitals forcing them to discharge admitted patients at short notice. Cankids, a national society for change in childhood cancer in India stepped in to forge partnerships with other centers who were in a position to take over the ongoing treatments in a twinning-model.

Methods

As soon as a centers were designated as Covid-19-only-facility, a virtual-meeting was organised with a partner center willing to take over the ongoing care of these patients. Each case was discussed at-length and care transferred to the other centre. The transport of the patients was coordinated by Cankids. Where required arrangements were made for families at “Home-away-from-Home” managed by Cankids. The partner centres were requested to extend maximum discounts and support to these patients. The entire financial burden was borne by the organization.

Results

A total of 58 patients from six-hospitals were supported from April-November 2020. No patient abandoned treatment. The median age was 8 years and their hospital of origin are in Bihar, Uttar Pradesh, West Bengal, and Delhi. The expenditure incurred for this exercise was INR 6,183,249 ($ 84129.04), at an average of INR 41,465 ($) per patient. 291 trips for the transport were arranged a cumulative stay of 174 days was facilitated at “Home away from Home”. The patients were transferred back to the primary center as and when it was feasible for them. One patient was succumbed during the study period due to refractory disease.

Conclusions

The twinning model allowed continuing delivery of optimal care at no additional financial burden to the family. It has also paved the way for future partnership between the involved centers.

Background and Aims

In Chile, 500 children are diagnosed with cancer every year. Treatment is granted for all of them through public health policies and NGO collaboration. To address the acute and long-term consequences of treatment and the disease, the Oncological Rehabilitation Center Fundación Nuestros Hijos (CROFNH) provides a multidisciplinary approach to the rehabilitation needs for children and adolescents with cancer. Here, we report the experience of the CROFNH, its multidisciplinary approach, and the successful telerehabilitation strategy implemented in response to the emergency situation of the Covid-19 pandemic during 2020.

Methods

Direct data of the clinical specialties and coverage indicators of the CROFNH are used to offer a view of the scope of services available.

Results

The services offered in the CROFNH include kinesiology, occupational therapy, neuropsychology, speech therapy, physiatry, special education, nutrition, psycho-oncology, and dentistry. From September 2014 to December 2020, 53,481 sessions were given to more than 480 patients on active treatment (79%), follow-up (17%), and palliative care (4%). Specialties of kinesiology, occupational therapy, neuropsychology, and speech therapy count for 75% of the sessions. As lockdown and restricted mobility were in place during the Covid-19 pandemic, a program of synchronous telerehabilitation was implemented on March 2020. The clinical specialists provided individual and/or group online therapy sessions of 45-60 minutes to the patients and their parents. As of December 2020, a total of 8,549 synchronous telerehabilitation sessions have been granted to 194 children and adolescents including: special education, physiatry, speech therapy, kinesiology, neuropsychology, nutrition, psychology, and occupational therapy.

Conclusions

With its integrated services in the medical treatment of children and adolescents with cancer, the CROFNH helps to reduce the impact of treatment-related side effects in children’s daily lives, improves their quality of life, and contributes to maximizing their possibilities of becoming independent and functional adults up to the maximum of their capacities.