Running head: PEDIATRIC SURGICAL ONCOLOGY 1

Pediatric Surgical Oncology and Nursing Care

Nurs422 – Adult Health II

Abigail Hansen
Running head: PEDIATRIC SURGICAL ONCOLOGY 2

Pediatric Surgical Oncology and Nursing Care

Pediatric surgical oncology is a specialized field that needs compassionate, patient, and

strong nursing care. When a child receives the diagnosis of cancer it can be devastating and

possibly the scariest thing that has happened to them in their short lifetime. Providing proper

psychosocial nursing care for pediatric cancer patients can change their life and give them the

hope that they may not have had before.

Psychosocial Care

Arguably one of the most important aspects of nursing care is the emotional support and

comfort that nurses can provide for a pediatric surgical patient that has been diagnosed with

cancer. During the long period of procedures and surgeries that the child may undergo the

patient may experience anxiety and distress (Cantrell et at., 2017). This anxiety can happen to

anyone going through cancer and surgery, but is imaginably even worse for the little humans

called children. Children are universally known to be sensitive and naïve. For these reasons it

would be a devastating experience for a child to go through surgical procedures while dealing

with cancer of any kind. Children who are younger than the age of five are at even greater risk

for anxiety because of their limited ability to communicate (Mechtel, M., & Stoeckle, A., 2017).

These young children are in great need of compassionate nursing care in order to make them feel

at ease before, during, and after their surgical operations.

Anxiety has been known to adversely affect many things in the clinical setting. When

children’s anxiety over surgical oncology procedures goes untreated it can impact the overall

healing of the child, including their cooperation with the healthcare team and displaying

undesirable behavior (Mechtel et al., 2017). When a child is scared it is very possible that they

will act out by fighting, screaming, and crying, as well as other behaviors that can make it
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extremely difficult for the healthcare team to properly take care of them. This anxiety and these

behaviors can greatly influence the outcomes and health-related quality of life in these children

(Cantrell et at., 2017). It is taught that one of the goals for each and every patient is a positive

outcome and a high health-related quality of life. It is the job of nurses to provide proper

psychosocial care and hopefulness in order to ensure positive outcomes and high quality of life

in pediatric oncology patients.

Patient Education

Patient education is an essential psychosocial nursing intervention for every disease

process but especially in surgical oncology. Patient education in the surgcial oncology setting

includes the use of developmentally appropriate education to the child that is going into surgery in

order to increase skills for coping and avoid major anxiety (Mechtel et al., 2017). Preparing the

appropriate education for the child’s age is extremely important. Using words that the child may

not understand can increase the anxiety in the patient and this, as discussed, can affect their healing

process. Nurses can use their assessment skills to determine the patient’s correct developmental

stage, emotional state, and readiness to learn. By being able to correctly identify the education

needed by the child the nurse can provide the best care possible for surgical oncology patients.

Not only is the education of the patient important, the education of the family surrounding

them is imperative. Parents generally want to be with their children during their most vulnerable

times to help support them and give them comfort. This is why it is important to not only educate

the child who are going into surgery, but also the parent who is at the bedside constantly looking

after their loved one. Parental temperament can vastly affect the child’s feelings of anxiety or

security (Yousef, Y., Drudi, S., Sant’Anna, A. M., & Emil, S., 2018). When a patient is anxious the
PEDIATRIC SURGICAL ONCOLOGY

child will recognize this and be anxious as well. If a parent is well educated on what is going to

happen to their child during surgery their anxiety can be reduces along with their child’s.

As discussed, education for a child going into surgery needs to be on their developmental

level. Explaining to the child before surgery what they might see, hear, and feel, as well as

encouraging them to verbally express any discomfort they might feel can help the child cope with

the chaos that they may be experiencing (Mechtel et al., 2017). Discussing all of this with the

parent at the bedside and using language that they understand will comfort the child and help them

feel less distressed. Allowing the child to participate in care by letting them make small choices,

such as what finger to put the pulse oximetry probe on, can also help with their understanding and

cooperation (Mechtel et al., 2017). Giving the child limited autonomy throughout the process of

preparing for surgery can truly help set them at ease. Educating each patient will increase coping

skills, decrease anxiety, and help build a trusing relationship between nurse and patient.

Therapeutic Play

Children are known for being playful and happy. Although some children may have

different temperaments, they almost always love to play with certain toys or children of their

choosing. Therapeutic play is a nursing intervention that consists of a structured activity that can

increase the psychosocial well-being of a child and that is appropriate for the child’s health status

and developmental age (Mechtel et al., 2017). Therapeutic play can consist of many different

activities because each patient in the pediatric surgical oncology floor will have different likes and

interests. Parents are also a good source for determining the child’s interests. Parents tend to know

what helps their child, their interests, and comfort items (Yousef et al., 2018). It is the responsibility

of the nurse to gather this information from the parents and the child in order to help the child
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preparing for surgery pick an appropriate activity that will be beneficial for the patient’s

psychosocial well-being.

Therapeutic play can help increase the health status of a child that is dealing with the stress

of cancer and the thought of going into an unknown surgery. Through therapeutic play the child

can learn important coping skills that will help to decrease anxiety before entering surgery

(Mechtel et al., 2017). According to Mechtel et al therapeutic play not only decreased anxiety but

it also help to promote the child’s cooperative behavior, and decreased the expression of behaviors

like screaming, demanding, and fighting the health care team. Teaching coping skills so young

could possibly help these individuals in the future when dealing with trials or even other surgeries.

Coping with therapeutic play can be very beneficial for pediatric surgical oncology patients.

It was found that as many as 59% of children participate in therapeutic play when they are

hospitalized (Mechtal et al., 2017). That is more than half of the children who are hospitalized. On

a pediatric surgical oncology floor it is the nurse’s duty to implement this important intervention

for psychosocial care. By continuing to implement appropriate therapeutic play the health care

team can decrease children’s anxiety over surgery, help implement coping skills for the children

to use now and in the future, and provide quality nursing care throughout the hospital stay.

Art-Based Therapy

Art-based therapy is a universally used intervention used with children throughout

hospitals. Art-based therapy includes the use of music, drawing, painting, and other arts in order

to help children with cancer cope with their diagnosis and procedures (Mechtal et al., 2017). Many

of these art-based therapies are very simple and easy to provide to most hospitals. Many children

enjoy playing instruments, coloring, or other performing arts. There are so many different ways a
PEDIATRIC SURGICAL ONCOLOGY

child can use art-therapy. Since there are so many ways to incorporate art-therapy into children’s

care, this therapeutic intervention can help many children who are struggling.

Finding ways to cope with the stress that comes with cancer and surgery is important for

everyone’s health. In the research done by Mechtal et al, creative art therapy in children from 2 to

13 years of age helped the children with a positive outlook and resiliency. This intervention acts

much in the same way as therapeutic play, when a child does something that they enjoy they cope

better and have decreased anxiety. Allowing the children to choose music, to color, paint, and do

artisitic things that they love can vastly improve their attitude towards cancer and their sugical

procedures. The nurse’s role in all of this is to provide these much needed interventions throughout

the surgical process. By doing this the nurse will help provide the best psychosocial care possible

for these scared patients’ well-being.

Conclusion

Psychosocial care of the pediatric surgical oncology patient is of the utmost importance.

The nurse has so many responsibilities in this setting but it is important to implement the

interventions of patient education, therapeutic play, or art-based therapy so that these young

patients can find ways to cope. Executing these interventions can allow the nurse to establish

trust with the patient and family, help the patient understand, and allows the nurse to provide

some much needed social support (Cantrell et al., 2017). Each of these are going to decrease the

patient’s anxiety and further help in the healing process, both mentally and phyically, and before

and after surgery. There are so many things that a nurse can do to help a small child that is

struggling with cancer and the surgical procedures that may come along with the diagnosis. It is

the beautiful responsibility of nurses on the pedicatric surgical oncology unit to provide the best
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care they possibly can and the author of this paper believes that one of the best ways they can do

that is by providing excellent psychosocial care.

PEDIATRIC SURGICAL ONCOLOGY

References

Cantrell, M. A., Conte, T. M., Hudson, M. M., Ruble, K., Herth, K., Shad, A., & Canino, S.

(2017). Developing the evidence base in pediatric oncology nursing practice for

promoting health-related quality of life in pediatric oncology patients. Journal Of

Pediatric Oncology Nursing: Official Journal Of The Association Of Pediatric Oncology

Nurses, 34(2), 90-97. doi:10.1177/104345416669678

Yousef, Y., Drudi, S., Sant’Anna, A. M., & Emil, S. (2018). Parental presence at induction of

anesthesia: perceptions of a pediatric surgical department before and after program

implementation. Journal Of Pediatric Surgery, doi:10.1016/j.jpedsurg.2018.01.007

Mechtel, M., & Stoeckle, A. (2017). Psychosocial care of the pediatric oncology patient

undergoing surgical treatment. Seminars in Oncology Nursing, 33(1), 87-97.

doi:10.1016/j.soncn.2016.11.009