title: Play-based procedural preparation and support intervention for cranial radiation.
abstract: The primary objective of this study was to examine the relationship between play-based procedural preparation and support intervention and use of sedation in children with central nervous system (CNS) tumors during radiation therapy. The secondary objective was to analyze the cost-effectiveness of the intervention compared to costs associated with daily sedation.
  
  
  
  A retrospective chart review was conducted, and 116 children aged 5-12 years met criteria for inclusion. Outcome measures included the total number of radiation treatments received, the number of treatments received with and without sedation, and the type and duration of interventions, which consisted of developmentally appropriate play, education, preparation, and distraction provided by a certified child life specialist.
  
  
  
  The results of univariate analyses showed that age, tumor location, and total number and duration of interventions were significantly associated with sedation use during radiation therapy. Multivariate analyses showed that, after adjustment for age, tumor location, and craniospinal radiation, a significant relationship was found between the total number and duration of the interventions and sedation use. The implementation of a play-based procedural preparation and support intervention provided by a certified child life specialist significantly reduced health-care costs by decreasing the necessity of daily sedation.
  
  
  
  Support interventions provided by child life specialists significantly decreased both sedation use and the cost associated with daily sedation during cranial radiation therapy in children with CNS tumors. This study supports the value of the child life professional as a play-based developmental specialist and a crucial component of cost-effective healthcare.
authors.affiliation: Child Life Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 121, Memphis, TN, 38105, USA. shawna.grissom@stjude.org.
authors.forename: Shawna
authors.initials: S
authors.lastname: Grissom
authors.affiliation: Child Life Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 121, Memphis, TN, 38105, USA.
authors.forename: Jessika
authors.initials: J
authors.lastname: Boles
authors.affiliation: Child Life Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 121, Memphis, TN, 38105, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Bailey
authors.affiliation: University of Massachusetts, 100 Morrissey Blvd., Boston, MA, 02125, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Cantrell
authors.affiliation: Child Life Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 121, Memphis, TN, 38105, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Kennedy
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 723, Memphis, TN, 38105, USA.
authors.forename: April
authors.initials: A
authors.lastname: Sykes
authors.affiliation: Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS738, Memphis, TN, 38105, USA.
authors.forename: Belinda N
authors.initials: BN
authors.lastname: Mandrell
mesh_terms: D016543:Central Nervous System Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D002648:Child; D003362:Cost-Benefit Analysis; D016371:Cranial Irradiation / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010989:Play Therapy / Q000379:methods*; D012189:Retrospective Studies
keywords: Child life; Cost-effectiveness; Play; Procedural support; Radiation therapy; Sedation