Illustration: a health care worker and a child

Sisom Cancer

Supporting Patient Communication and Symptom Management in Childhood Cancer

Project period

2005 - 2011

Funding

Research Fund Rikshospitalet 2005-2006

Norwegian Research Council (NFR) Grant 175389/V50 2006 - 2011

Abstract

To adequately help children with cancer, care providers need to elicit symptoms and problems children are experiencing, to tailor patient care to each child. However, children often have problems communicating their symptoms and problems, at the risk that many problems remain under-diagnosed and treated. SiSom is an interactive assessment and communication tool to help children with cancer express symptoms and problems through sound, animations, pictures and spoken text, and to assist clinicians in communicating and addressing their problems. This study tested effects of SiSom in routine consultations on: number of symptoms/problems addressed, child participation in consultations, and clinicians’ communication style.

Methods: Videotapes of 26 consultations were coded and analyzed, 10 for the pretest “usual care” control group; 16 for the posttest intervention group where children used SiSom prior to the consultation. The resulting assessment summary was given to their physicians and nurses who were told that they could use it in the consultation as they liked.

Results: Six boys and seven girls age 8-12 undergoing cancer treatment participated in 1-3 control or intervention consultations; Fifteen physicians in 1-5 consultations each. There were significant group differences (p<0.05) in favor of the intervention group in number of symptoms addressed; level of child participation; and number of times the physician directly addressed the child. When physicians used the assessment summary in 9 of 16 intervention group consultations compared to the control group and those who did not, p-values for these variables improved to p<0.01. Furthermore, physicians asked significantly more probing questions, provided more explanations and expressed more empathy more often (p<0.05

Conclusion: Despite the small sample, this study demonstrated that SiSom can significantly improve patient-provider communication and patient care for children with cancer. SiSom was easily adopted and used in clinical practice, even without specific instructions for its use.