Children with cancer who undergo repeated, painful medical procedures, such as lumbar punctures and bone marrow aspirations have been shown to benefit from behavioral pain management skills. No studies, however, have shown that previously untrained professionals can effectively train children in the use of such skills. The goal of the project, """"""""Pediatric Pain Control: A Professional Course,"""""""" is to show that pediatric health professionals can be practically and efficiently trained to teach acute, pain management skills to children with cancer. The project's specific aims are to 1) carefully train pediatric professionals to be knowledgeable and skillful in the use of behavioral pain management skills, 2) thoroughly assess their knowledge and skills, 3) show that children, taught the skills, can reduce the pain and anxiety related to their medical procedures and 4) disseminate the pain management course. The course includes a weekend seminar, where professionals learn pain management skills, followed by small group sessions, where they teach the skills to children and their families. The skills involve breathing, relaxation, story telling and imagery. Skills will be modeled and practiced. Materials include a seminar manual, handbook, video and workbook. Teaching materials for the small group sessions will be developed. Course evaluation instruments* will assess the professional trainees satisfaction with the training program and parents' and children's satisfaction with the small group training. Professional trainees will be evaluated for knowledge acquisition using a pre-test, post-test design and for skill acquisition using a structured, skill-checklist. Skill acquisition by the children will be rigorously assessed. Fifty children, ages 5 - 12, attending St. Christopher's Oncology Clinic in Philadelphia will be randomly assigned to either a behavioral pain management group or a standard management group. Pain and anxiety during medical procedures will be assessed by the childrens' self reports and by trained observers under baseline, treatment and control conditions. Dissemination is inherent since one professional trainee can teach up to ten children in a small group setting. A needs assessment of oncology programs regarding behavioral pain management programs will be undertaken and results will be used to disseminate the course locally, regionally and nationally.
