KEY POINTS
- This qualitative study explored how children and parents experience proton therapy with or without anaesthesia at the Danish Centre for Particle Therapy, with the goal of designing support that may make awake treatment more feasible.
- Interviews included five children aged 4-8 years and eight parents from six families. One child had received all treatment under anaesthesia, three experienced both anaesthetized and awake treatment, and one completed the full course awake.
- Anxiety was central for both groups but took different forms. Children described concrete fears related to the treatment room, immobilization mask, sensory experiences and being alone, while parents focused more on separation, uncertainty and the consequences of repeated anaesthesia.
- Anxiety itself did not appear to make awake treatment impossible. The analysis identified four recurring needs that seemed to make treatment more manageable: control, predictability, information, and care through relationships and continuity.
- Practical examples of control included hand signals, familiar coping tools and opportunities for the child to participate actively. Predictable routines, knowing how many fractions remained and consistent communication reduced uncertainty for both children and parents.
- These findings were translated into three intervention domains: preparation and information, exposure and training, and care and continuity. Proposed tools include picture books, department tours, home practice lying still, play-gantry sessions, hospital-clown support, designated treatment teams and individualized distraction.
- The intervention is currently being feasibility-tested; this study does not demonstrate that these strategies reduce anaesthesia use. The dataset came from only six families at one centre, interviews occurred 1-5 months after treatment, and recall and social-desirability bias are possible.
CLINICAL TAKEAWAY
Avoiding anaesthesia in young children may depend less on eliminating anxiety than on making the treatment environment understandable, predictable and controllable. The framework is clinically intuitive and directly implementable, but its ability to reduce anaesthesia use still needs prospective testing.
SOURCE
Technical Innovations & Patient Support in Radiation Oncology