Token economy for managing behaviors of pediatric cancer inpatients
Description
Background: Hospitalization for treatment of diseases including cancer amongst children may lead to developmental and behavioral disorders (Petersen, Kube, Whitaker, Graff & Palmer, 2009). This may result in decreased socialization and impairment in performance of activities of daily living (ADL), including grooming, personal hygiene, eating and drinking. Not adhering to these ADLs may make things complicated for cancer patients as their immunity is already compromised, thus making them vulnerable to developing bloodstream infections and oral complications, resulting in prolonged hospital stay. They may further exhibit behavioral problems which may not be present at the time of admission but appear gradually due to hospitalization and the treatment. Thus the aim of this study to explore efficacy of token economy (TE) in managing behaviors in paediatric inpatients diagnosed with leukaemia. Methodology: The study adopted a quasi-experimental post assessment study design with control to assess the impact of TE on activities of daily living, social interactions, adaptation to treatment and participation in engaging activities amongst paediatric cancer inpatients with leukaemia over a period of 29 days. Patients meeting the inclusion criteria were alternatively assigned to control and experimental groups. Author based semi-structure interview was used to collect data post intervention. Results: Thirty patients participated in the study. The experimental group performed better on all dimensions of ADL assessed in this study (bathing, eating, oral hygiene and grooming) and social interaction. However, the changes in treatment adaptation and participation in engaging activities did not improve significantly. Conclusion: Behavioral difficulties were present in majority of the children diagnosed with leukaemia at the time of admission. Token economy as an intervention was effective in management of ADLs and social interaction in paediatric cancer inpatients diagnosed with leukaemia.