An evaluation study of the perceptions of oncology staff on the problems and solutions in care of children undergoing radiotherapy.

Abstract

PURPOSE:To establish, by means of an analytical descriptive study, what problems are encountered by oncology staff when dealing with children undergoing radiotherapy, in order to assess their opinions on the appointment of a pediatric radiographer as one way of improving the quality of care for these category of patients. METHOD:A survey questionnaire was used to obtain data pertaining to the experiences and opinions of staff in a busy oncology department at a large tertiary hospital in the Western Cape. The responses were analysed and evaluated to determine the scope of the problems and solutions suggested. RESULTS:Fifty-two questionnaires were returned out of a total of 62, a response rate of 84%. The majority of respondents had encountered some children showing high apprehension on the machines at the beginning of their radiation therapy (98%), followed by planning (96%), clinics (93%), mould room (93%), with the least apprehension shown towards the end of their radiation therapy. The time when parents and radiographers leave the treatment room was reported to be a particularly anxious period for the child as 83% felt some children are not relaxed during the radiation treatment, which may impact on treatment accuracy. Encounters with fearful children had at times been experienced by 46% of the respondents while 58% had encounters with depressed parents. The study also established that at times these problems require sedation being given to the child; 67% of the respondents felt the current methods used to calm children in the department were not very effective compared to 33% who felt they were quite effective (p = 0.001). A high majority (83%) acknowledged mock treatment set-ups after the conclusion of radiation planning would be of benefit. Seventy-three percent of respondents recommended that a post of pediatric radiographer should be created versus 23% that were against this idea. CONCLUSION:For children undergoing radiotherapy and their parents, a pediatric radiographer may be one method to relieve anxiety and stress during this difficult time in their lives. Given that children visiting the oncology department are from different socio-cultural backgrounds and may vary in their developmental stage, no one solution can be deemed ultimate in dealing with this complex situation. Further efforts are needed to achieve workable solutions to this problem depending on the circumstances and situation.