Location: Royal Children's Hospital, Monash Children's Hospital & Regional centres
Funding Requirement: $230,000 per annum RCH
$80,000 MCH
$10,000 Regional Centres
Funding Period: (Year): Annual and ongoing.
Aim of Project:
Children with cancer commonly experience distress and anxiety associated with their cancer-related medical procedures. Procedural pain is often perceived as the most distressing part of a child’s cancer treatment and may manifest in symptoms of significant distress and/or anticipatory anxiety. Some children may experience symptoms such as sleep disturbance prior to coming to the hospital, vomiting or feeling ill prior to or upon arrival at the hospital, significant distress before during and/or after procedures, needle phobia, withdrawal or lowered mood and even refusal of treatment. There is now ample research evidence supporting the effectiveness of non-pharmacological pain management techniques for children and adolescents with cancer. The Comfort First Procedural Pain Program was established in response to identified need from both staff and families regarding the management of the distress and anxiety commonly associated with cancer treatments.
Program Aims
- To minimize fear and distress associated with repeated medical procedures in newly diagnosed cancer patients.
- To make pain more tolerable by teaching pain management/coping strategies to new cancer patients and their parents/caregivers
- To respond early (i.e., newly diagnosed patients) and thereby potentially reduce the long term impact of procedural distress such as anticipatory anxiety and needle phobia.
- To instruct parents in techniques and include them as active participants in their child’s treatment.
- To give the child and family a sense of control over their situation by teaching them skills to manage their pain during procedures
- To skill staff in effective ways of managing their patients’ pain and to encourage a consistent approach amongst all staff and a high standard of professional practices in line with Paediatric (RACP) guidelines.
The program involves;
1) Direct clinical care with Comfort First clinicians (Clinical Psychologists, Educational Play Therapists or allied health clinicians) provide assessments and “comfort plans” for all new patients and working with both patients and families to teach coping strategies aimed at reducing distress, anxiety and pain. The Comfort First clinician’s work closely with the nursing and medical staff to ensure an integrated pain management approach utilising both pharmacological and non-pharmacological techniques is achieved.
2) An educational component which involves a curriculum that has been rolled out across sites and, more recently, to regional PICS partners. The educational component is an ongoing process to continually raise awareness and skill staff in good procedural pain management.
The program is in the process of being rolled out to Monash Children's Hospital with funding provided by The Koala Foundation. This relatively new position at MCH has been responsible for the procedural pain service but also for the implementation of a play and education service to the outpatients of the CCC.