title: Efficacy of therapeutic play for pediatric brain tumor patients during external beam radiotherapy.
abstract: OBJECTIVE
  External beam radiotherapy (EBRT) is frequently used to improve disease control for pediatric brain tumor patients. However, to facilitate the radiotherapy (RT) procedure, "forced" type interventions including conscious sedation or general anesthesia are frequently used to manage patients' fear and anxiety. The aim of this study was to investigate the effects of therapeutic play (TP) in reducing anxiety for pediatric brain tumor patients treated by EBRT.
  
  
  METHODS
  Between April 1st and September 30th, 2009, 19 young brain tumor patients, aged 3-15 years and recommended for RT, were recruited: ten to a control group and nine to the study intervention group. The study group was introduced with TP during EBRT. The Beck Youth Anxiety Inventory and the Faces Anxiety Scale were used to evaluate patients' psychological levels of anxiety. The heart rate variability and salivary cortisol concentrations were used to indicate the patients' physical levels of anxiety. Both the psychological and physiological tests were administered to all subjects before and after the RT procedure.
  
  
  RESULTS
  The study group had significantly lower anxiety scores and expressed fewer negative emotions than did the control group before EBRT.
  
  
  CONCLUSIONS
  TP can not only improve the quality of medical services but can also reduce costs and staffing demands. In addition, it can help lower young patients' anxiety and fear during medical procedures. As a result, it further decreases the potential negative impacts of hospitalization on these young patients.
authors.affiliation: Division of Radiation Oncology, Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yu-Li
authors.initials: YL
authors.lastname: Tsai
authors.affiliation: Graduate Institute of Transition and Leisure Education for Individuals with Disabilities, Taipei Physical Education College, Taipei, Taiwan.
authors.forename: Shiow-Chwen
authors.initials: SC
authors.lastname: Tsai
authors.affiliation: Division of Radiation Oncology, Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Sang-Hue
authors.initials: SH
authors.lastname: Yen
authors.affiliation: Division of Child and Adolescent Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Kai-Lin
authors.initials: KL
authors.lastname: Huang
authors.affiliation: Department and Institute of Nursing, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Pei-Fan
authors.initials: PF
authors.lastname: Mu
authors.affiliation: Division of Radiation Oncology, Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hueh-Chun
authors.initials: HC
authors.lastname: Liou
authors.affiliation: Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tai-Tong
authors.initials: TT
authors.lastname: Wong
authors.affiliation: Division of Radiation Oncology, Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: I-Chun
authors.initials: IC
authors.lastname: Lai
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Pin
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Lou
authors.affiliation: Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan.
authors.forename: I-Tsun
authors.initials: IT
authors.lastname: Chiang
authors.affiliation: Division of Radiation Oncology, Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan. chenyw@vghtpe.gov.tw.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. chenyw@vghtpe.gov.tw.|Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. chenyw@vghtpe.gov.tw.|Cancer Center, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, 112, Taiwan. chenyw@vghtpe.gov.tw.
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy; D016371:Cranial Irradiation / Q000379:methods / Q000523:psychology*; D003887:Desensitization, Psychologic; D005239:Fear / Q000523:psychology; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D010989:Play Therapy / Q000379:methods*; D057173:Recreation Therapy; D012054:Reinforcement, Psychology; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D006854:Hydrocortisone
keywords: Anxiety; Brain tumor; Quality of life; Radiotherapy; Sedation; Therapeutic play