Developing trials of animal-assisted activities for youth with cancer

描述（由申请人提供）：本研究的长期目标是帮助儿童癌症患者科普疾病及其治疗引起的痛苦和焦虑。这与国家癌症研究所改善癌症护理的目标是一致的。动物辅助活动（AAA），如参观宠物项目，可以减少痛苦，帮助儿童科普医疗环境。它们可能特别有益于那些经历严重，漫长和经常痛苦治疗的儿科癌症患者。由于这些干预措施对这一人群的安全性和有效性尚不清楚，因此必须通过严格的随机对照试验（RCT）进行研究。在儿科肿瘤学中设计AAA的RCT需要了解这些环境和患者特有的障碍和机会。我们的目标是确定如何设计儿科癌症患者AAA的RCT。我们将：1）通过对临床工作人员的访谈和焦点小组以及对患者和家长的调查，确定住院和门诊儿科肿瘤环境中AAA的障碍和促进因素; 2）确定在儿科肿瘤环境中可行的AAA干预措施; 3）设计和试点测试儿科肿瘤中的AAA干预措施，为更大的RCT做准备。太平洋西北部的两个大型区域儿科癌症中心（西雅图儿童医院和俄勒冈州健康与科学大学）将参与其中。与肿瘤学工作人员的四个焦点小组以及与相关部门和项目（例如，肿瘤学、感染控制、风险管理、儿童生活、行为健康），并在研究的第一年进行录音和转录。对这些成绩单的定性内容分析将确定与儿科肿瘤学环境中实施和评估AAA相关的重要主题。此外，对大约80名患者（8-18岁）和130名父母的调查将为未来的干预和研究提供更多关于障碍和机会的信息。在第二年，我们将根据第一年的结果设计和试点一个大约10名患者的小型干预措施。本可行性研究的结果将为未来关于AAA减少儿童和青少年肿瘤患者痛苦的有效性的大规模RCT的设计和实施提供信息。如果安全有效，AAA干预措施可以提供一种低成本的方式来提高护理质量和生活质量，特别是癌症患者及其家庭的弱势群体。

DESCRIPTION (provided by applicant): The long-term goal of this research is to help pediatric cancer patients cope with distress and anxiety caused by their illness and its treatment. This is consistent with the National Cancer Institute's goal of improving cancer care. Animal-assisted activities (AAA), such as visiting pet programs, may reduce distress and help children cope in medical settings. They may be especially beneficial to pediatric cancer patients who undergo serious, lengthy, and often painful treatments. Because the safety and effectiveness of such interventions for this population is unknown, they must be investigated through rigorous randomized controlled trials (RCTs). Designing RCTs of AAA in pediatric oncology requires understanding the barriers and opportunities unique to these settings and patients. Our objective is to determine how to design a RCT of AAA in pediatric cancer patients. We will: 1) identify barriers to and facilitators of AAA in inpatient and outpatient pediatric oncology settings through interviews and focus groups of clinical staff, and surveys of patients and parents; 2) identify AAA interventions that would be feasible in pediatric oncology settings; and 3) design and pilot test an AAA intervention in pediatric oncology in preparation for a larger RCT. Two large regional pediatric cancer centers in the Pacific Northwest (Seattle Children's Hospital and Oregon Health and Science University) will participate. Four focus groups with oncology staff and approximately 20 individual interviews with selected leaders in relevant departments and programs (e.g., oncology, infection control, risk management, child life, behavioral health) will be conducted, audio-taped, and transcribed in the first year of the study. Qualitative content analysis of these transcripts will identify important themes related to both implementing and evaluating AAA in pediatric oncology settings. In addition, surveys of approximately 80 patients (aged 8-18) and 130 parents will provide additional information on barriers and opportunities for future interventions and research. In the second year, we will design and pilot a small intervention with approximately 10 patients based on our results from the first year. The results from this feasibility study will inform the design and implementation o a future large-scale RCT on the effectiveness of AAA to reduce distress in pediatric and adolescent oncology. If safe and effective, AAA interventions could provide a low-cost way of improving quality of care and of life for a particularly vulnerable population of cancer patients and their families.