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Child life meets the distinct needs of young patients, promoting effective
Even the tiniest babies can benefit from techniques such as infant massage and comfort positioning.
The American Academy of Paediatrics affirms that child life is “an essential component of quality paediatric health care”, and child life services have become a standard in most children’s hospitals in resource-rich countries. However, child life is virtually unknown in resource-limited settings.
In the management of retinoblastoma in resource-limited settings, child life approaches can:
ease a child’s fear and anxiety through role play and recreational activities;
encourage understanding and cooperation through medical play in preparation for medical procedures;
foster cooperation during medical procedures through distraction play and comfort positioning;
reduce the need for potentially dangerous (and often unavailable) sedatives and pain medications through non-pharmacological pain management techniques;
support children and their families confronting grief and bereavement issues, such as the loss of an eye, through self expression activities and printed resources.
Increased cooperation from young patients can also help reduce medical costs by:
eliminating the need for anaesthesia during procedures such as lumbar puncture or radiotherapy;
decreasing the number of nurses required to complete painful procedures such as inserting an IV;
minimizing the use of expensive pain medications.
In addition, improving a child's treatment experience and psychosocial wellbeing will increase the chances for successful integration into society and school.
Certified Child Life Specialists (CCLS) are university trained professionals. However, essential child life methods can be employed by physicians, nurses, social workers, teachers, parents and others to help children effectively manage stress and overcome challenging life events.
Pilot Training Projects
During a pilot project in Kisumu in 2007, and training week in Eldoret in 2008, Canadian Certified child life specialist, Morgan Livingstone shared basic skills with nurses, auxiliary staff and parents. She demonstrated the value of approaches such as:
the use of simple language to explain procedures and reassure children;
comfort positioning to reduce a child’s anxiety and increase co-operation during painful procedures;
therapeutic massage to control pain;
use of cloth dolls to enable self-expression in non-verbal and distressed children; and
use of cloth dolls by medical staff to explain medical procedures in a non-threatening way..
Morgan is a member of our KNRbS team. She has extensive experience of resource-limited child life implementation through her work with Operation Smile.
Building A Child Life Progam
To achieve systemic introduction of child life support in Kenya, we are:
fidentifying child life leaders in each of the main treatment centres (Nairobi, Eldoret and Mombasa);
developing a formal child life training syllabus in collaboration with medical staff, child life leaders and parents;
facilitating a series of practical in-job training courses for medical professionals and auxiliary staff from across Kenya; and
overseeing development of educational resources to help children, their families and the wider community to understand surgical eye removal, other aspects of retinoblastoma, and the continued capacity of children who have undergone enucleation to be active members of society.
We will also train women from several credit union cooperative groups across Kenya to produce the simple cloth dolls used in self-expression and medical preparation play with retinoblastoma patients. We will provide start-up materials to enable the women’s groups to produce low-cost dolls for sale to hospitals and families undergoing treatment.
ntroducing child life into retinoblastoma care in Kenya will:
enable young patients to effectively manage stress and actively cooperate with their medical care;
reduce costs associated with treatment;
reduce stigma which currently impedes take-up of curative therapy and hinders post-operative psychological healing.
Achieving cure for children with retinoblastoma requires both elimination of the cancer and care of the patient’s social and emotional well-being. Child life support is not an optional extra, but an integral part of the child’s medical care package.
We aim to ensure that the whole child is cared for, enabling each child to move forward through life as a happy, confident individual.
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