Effects of a behavioral intervention to improve the care of children with cancer

Abstract

Recent developments in medical treatment allow for approximately 70% of children with cancer to survive. In developing countries such as Mexico, however, the oncological disease still represents the two main causes of death in children 6 to 14 years old. Due to medication side-effects and the invasive nature of some medical procedures, cancer's development and treatment sharply decrease the quality of life of patients and their immediate relatives and may decrease the effectiveness of health care. The purpose of the present study was to examine the effects of a behavioral intervention aimed at establishing self-care behaviors, social skills to facilitate treatment and general improvement of quality of life. The intervention involved such procedures as modeling, shaping, positive reinforcement and behavioral essays. The experimental comparisons involved individual replications with six boys 5 to 15 years old and their immediate relatives. Measurement included a behavioral interview, medical treatment adherence, behavioral recording systems, and verbal measures such as a social satisfaction questionaire, evaluation of the treatment components, the Pediatric Quality of Life Inventory, and the Content Analysis of Verbatim Explanations. The intervention focused on the modifi cation or establishment of hygiene, nutrition and treatment related behaviors. Procedures also involved modifying intra verbal behaviors such as pessimistic thoughts into positive ones, as well as social skills training (assertive comunication and negotiation) and problem-solving skills. The intervention consisted of seven training units for the parents and six units for the children and their siblings. Results showed clinical and statistically significant changes in all target behaviors, and increased quality of life perception. Results are discussed in the context of scarcity of resources conditions usually prevalent in developing countries.