Utilizing the psychosocial risk assessment in pediatrics to inform child life prioritization for children with cancer undergoing lumbar punctures with nitrous oxide sedation



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Childhood cancer is a rare, life-threatening disease. Every day, there are 43 children diagnosed with cancer (American Cancer Society, 2019). More than 40,000 children undergo cancer treatment annually and the significant psychosocial impact on the children and their families during treatment, through survivorship, and end-of-life, is well understood. The purpose of this study was to explore the utility of a standardized psychosocial risk assessment tool in order to assist Certified Child Life Specialists in prioritizing and identifying patients who are at the highest risk and need procedural support during lumbar punctures with nitrous oxide sedation. The predictor variable was the psychosocial risk assessment score (PRAP) of a low to moderate risk with dependent variable being the presence of adverse event. A total of 102 children with cancer who had a lumbar puncture with nitrous oxide sedation were included in this study. A binary logistic regression was conducted and the model was found not to be significant. The PRAP score did not predict an adverse event in children undergoing lumbar punctures with nitrous oxide sedation. A CCLSs ability to proactively identify the children who are at increased psychosocial risk has the potential to have significant impact on the patient’s emotional wellbeing and clinical care. For future studies, the cofounding factors need to be further explored.



Child life, Certified child life specialist, Child life specialist, Assessment, Psychosocial risk screening, Nitrous oxide