An integrative pediatric oncology program addressing parents' quality of life-related concerns.

Parents of children with cancer face bio-psycho-social-spiritual concerns which can significantly reduce quality of life (QoL). We examined the impact of an integrative oncology (IO) intervention on QoL-related concerns among parents of children in a pediatric hematology-oncology department. The study was prospective, controlled, non-randomized and patient-preferenced. Parents of children recently (≤ 6 weeks) diagnosed with cancer were assessed using the Measure Yourself Concerns and Wellbeing (MYCaW), Edmonton Symptom Assessment Scale (ESAS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). An IO consultation was provided, with training in daily relaxation-breathing and manual treatments, and guidance on herbal medicine. Parents in both groups were re-assessed after three weeks. Of 68 parents consenting to participate, 37 (54%) underwent the intervention with 31 serving as controls. Multivariate analysis found the IO intervention group to contain more Hebrew-speakers (OR=5.96, 95% CI=1.3-27.3, P=0.022); females (OR=5.23, 95% CI=1.1-24.8, P=0.038); and report pain (OR=1.2, 95% CI=1.0-1.4, p=0.045) and impaired appetite on ESAS (OR=1.23, 95% CI=1.01-1.48, p=0.034) when compared to controls. Only the intervention group showed increased baseline-to-3-week scores for physical functioning (p<0.001), cognitive functioning (0=0.018) and fatigue on EORTC (p<0.001); and for ESAS appetite (p<0.001) and anxiety (p=0.02). ESAS sleep increased only in controls (p=0.029). IO interventions in pediatric hematology-oncology addressing QoL-related concerns among parents are feasible, potentially increasing predominantly physical symptoms and functioning. Further research is needed to confirm these "real-world" clinical outcomes, and the role of IO in "Caring for the Caregiver".

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Conflict of interests All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that they have received no support from any organization for the submitted work; have no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work.