Treatment on Time - Person-centred symptom management for children with cancer - advancing mHealth and mapping care approaches for prioritised symptoms

Abstract

Background: Children (up to 17y) undergoing cancer treatment experiences multiple symptoms. Prioritised core symptoms are anxiety, fatigue, nausea and vomiting, pain, sadness/depression and sleep disturbances. Person-centred care emphasises listening to childrenʼs perspectives and supporting participation in decisions. However, children are not always given opportunities to have their voice heard despite their legal right to participate. Digital tools may facilitate symptom management and support person-centred care by strengthening childrenʼs participation. Overall aim: To strengthen person-centred symptom management for children treated for cancer through mHealth and mapping of care approaches. Methods: Study I had a mixed method design including 102 children (8-17y) to evaluate the content validity of an electronic assessment scale using hypothetical pain and think aloud interviews. Study II had a quantitative design including 86 children (8-17y) to evaluate construct validity for an electronic assessment scale using repeated postoperative pain assessments. Study III had a triangulation design combining qualitative and quantitative data and included 14 children (6-17y), 5 parents of the included children and 6 nurses to evaluate access to an mHealth tool in settings outside hospital. Study IV was a systematic scoping review of studies published between 2015-2025 on care approaches to relieve prioritised symptoms in paediatric cancer. Findings: Studies I-II showed that an electronic assessment scale may be used to assess pain. Study III demonstrated that an mHealth tool has the potential to support more person-centred symptom assessment and management. Reported barriers included motivational factors and limited support. Study IV identified care approaches targeting prioritised core symptoms. The most common interventions were approaches involving psychological or cognitive processes influencing physical symptoms (for example, virtual reality) to manage anxiety and pain. Conclusion: A validated assessment scale, an accessible mHealth tool and identified care approaches may strengthen person-centred symptom management by making childrenʼs symptoms visible, understood and managed.