Reduction of distress associated with paediatric bone marrow transplant: complementary health promotion interventions

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Abstract
Despite numerous medical advances in stem cell/bone marrow transplantation (BMT) for children with malignancies or other catastrophic disorders, BMT remains a prolonged and physically demanding procedure that can be associated with high levels of distress for patients and their families. This paper reviews work from our laboratory that documents the high levels of somatic distress and mood disturbance experienced by patients undergoing the procedure, and points to the need for the development of novel interventions to reduce BMT-related distress. Issues of instrumentation and methodology for outcomes assessment are highlighted. Research is reviewed to support the potential benefits of a number of techniques from the field of complementary medicine (relaxation/imagery; massage, humour therapy, expressive therapy) for reduction of transplant-related distress. Finally, we described a series of studies in which complementary health promotion techniques were assessed in pilot trials. Based on patient and parent perception of helpfulness, two complementary treatments, massage and humour therapy, emerged as the most promising approaches for use in the BMT setting and are now the focus of a randomized clinical trial.

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