Morwenna and some former members of EST (Michael, Darren) recently published a systematic review and meta-analysis of non-pharmacological interventions to reduce the distress and anxiety that children and young people experience when undergoing treatments for cancer. The paper found some promise for hypnosis interventions, but ultimately calls for much more in the way of high quality randomised controlled trials.

The broad idea for the review came about as a result of findings in our #tlc4ltc Long Term Conditions project. We became aware of a batch of studies looking at what we called ‘procedural anxiety’ in young people with cancer, but which didn’t meet the inclusion criteria for that particular review. The idea was honed and turned into reality through the enthusiasm and interest of an undergraduate medical student, Dominic Mayhew.

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Dominic discussed the idea with Tamsin Ford, one of the members of the #tlc4ltc project team, and submitted a successful application to the PenCLAHRC INSPIRE Studentship, for a placement in the summer of 2016. The INSPIRE Studentship scheme  offers funding for a research placement for a medical or dental undergraduate, in order to provide experience of academic research. INPSIRE is a scheme run by University of Exeter Medical School and funded by the Wellcome Trust, administered via the Academy of Medical Sciences.

Dominic had little research experience at the start of the project, and even less understanding of the processes involved in conducting a systematic review. However, Darren and Michael worked closely with Dominic to train and develop his skills, fostering decision making and working with him throughout all stages of the review. As a result, Dominic was heavily involved in the conception of the review, writing the protocol, defining inclusion/exclusion criteria, screening, data extraction and quality appraisal, data synthesis and authorship of the final paper.

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The placement was originally for seven weeks during the summer of 2016, a period in which Dominic worked quite intensively on the project. However, as is often the way with systematic reviews, time ran on into 2017. Dominic was keen to remain involved with the project however, and enjoyed the flexibility to dip in and out of project work, alongside his busy undergraduate schedule. There was also the opportunity to submit conference abstracts, and Dominic presented posters at the Student Paediatrics Conference in Brighton in April 2017 and the Royal College of Psychiatrists International Congress in Edinburgh in June 2017.

The project team also included Christine Curle, a child psychologist at Devon Integrated Children’s Service in Exeter, so was a very well-informed collaborative piece where all team members contributed and learned from one another.

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We completed the review and submitted it for publication in August 2017. The peer review process was quite lengthy, but at the end of April 2018 we had a published paper. While the length of this process this was a bit of an eye-opener for Dominic, we wouldn’t want him to think the academic experience was TOO positive!

Publication of the review was accompanied by some media attention. Hopefully the paper will prompt some researchers to action, as it has inspired one of the new breed of medics to get involved with research, and have a better understanding of what systematic reviews do and don’t tell you. Dominic was a pleasure to work with, and clearly enjoyed his involvement. He reflects upon the experience here. If you would like to know more about the project, Michael talks about the paper in the first EST Research Snapshot podcast.

Thanks for reading; we hope you are inspired as a student or researcher to get involved with this sort of rewarding, collaborative effort!

 

Nunns M, Mayhew, D, Ford T, Rogers M, Curle C, Logan S, Moore D. Effectiveness of non-pharmacological interventions to reduce procedural anxiety in children and adolescents undergoing treatment for cancer: A systematic review and meta-analysis. Psycho-Oncology Apr 30 2018. https://doi.org/10.1002/pon.4749