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known to continue in some patients for
years after the completion of anticancer
treatment.
3,4
Pain is a complex and multifaceted experience.
A comprehensive assessment of pain requires
variables such as cognitions, behaviors,
emotions, physiological reactions, and context
to be evaluated and addressed adequately.
5(p23)
Conventional management of painful and invasive
cancer-related procedures in children
varies worldwide. In the United Kingdom, for
example, the National Institute for Clinical Excellence
(NICE) draft
Service Guidelines for Improving
Outcomes in Children and Young People
with Cancer
emphasize the need for regular
painful procedures such as LP and bone marrow
biopsy; they highlight the importance of effective
pain management for young cancer
patients, emphasizing that most children require
general anesthesia (points 255--277).
6
The NICE guidelines acknowledge the role
imagination can play in a child’s ability to cope
with painful procedures by recommending that
children in hospital have daily access to play
specialists or activity coordinators to assist in
preparation for painful procedures. Furthermore,
access to formal psychology support
and techniques such as relaxation and visualization
should be available (point 280).
6