Table 1.
A summary of research studies included in the review.
| Author, year and country | Design | Sample | Symptom (measurement) | Intervention | Symptom(s) related outcomes |
|---|---|---|---|---|---|
| Alemi et al., 2016 [24] Iran |
Quasi-experiment, 8-week, pre-post test | 11 pediatric cancer patients (aged 7–12), cancer types not reported, from two hospitals. Experiment group (n = 6): social robot-assisted therapy; Control group (n = 5): psychotherapy. |
Reported by patients Anxiety（Multidimensional Anxiety Children Scale） Depression（Children’s Depression Inventory） Anger（Children’s Inventory of Anger） |
Social humanoid robot-assisted therapy: 8 scenarios | Experimental group experienced greater reductions in anxiety, depression and anger than control group (all P < 0.05). |
| Campo et al., 2017 [26] USA |
One group, pre-post test | 25 young adult cancer survivors (aged 18–29), all types of cancer, 2.6 years since treatment completion | Reported by patients Anxiety（PROMIS--Anxiety v1.0 short-form） Depression（PROMIS--Depression v1.0 short-form） |
Telehealth: mindful self-compassion videoconference intervention, group-based, 90-min videoconference sessions, held weekly over 8 weeks, with audio-supplemented home practice | Anxiety and depression level demonstrated significant reduction (P < 0.001), with large effect sizes (Cohen’s d 1.24, 0.99, separately). |
| Gershon et al., 2004 [20] USA |
RCT, three arms parallel, 8-week, pre-post test | 59 pediatric cancer patients (aged 7–19), with all types of cancer, need port access, from at an outpatient oncology. Experiment group (n = 22): Virtual Reality; Distraction group (n = 22): non–Virtual Reality distraction; Control group (n = 15): usual care. |
Reported by patients, parents, nurses Pain（VAS） Anxiety（VAS） |
eHealth: Virtual Reality, immersive Virtual Reality distraction technique | Only nurse reported pain for the experimental and distraction groups were significantly reduced, compared to the control group at posttest (P < 0.05). Younger children experienced more distress with this procedure than older children. |
| Hooke et al., 2016 [27] USA |
One group, three time points: baseline, after 2 weeks (i.e. before the steroid pulse), and after 5 days of steroids | 17 pediatric patients (aged 6–18) with ALL receiving a cycle of maintenance chemotherapy that included full doses of a corticosteroid (dexamethasone or prednisone) | Reported by patients Fatigue（Childhood Fatigue Scale for children ages 6–12; Fatigue Scale for Adolescents in adolescents 13–18 years） |
Wearable technology: Fitbit tracker as a pedometer-based intervention with daily coaching for 2 weeks before a maintenance steroid pulse | No significant differences observed for fatigue at posttest (P > 0.05). Higher steps were associated with lower fatigue (r = −0.563, P = 0.029) |
| Huang et al., 2014 [21] USA |
RCT, two arms parallel, 4-month, pre-post, stratified by age | 38 pediatric cancer survivors with ALL (aged 8–18) with BMI≥85%. Experiment group (n = 19): Fit4Life; Control group (n = 19): printed weight management materials. |
Reported by patients Depression（Children’s Depression Inventory） |
mHealth: a WMI tailored for childhood ALL survivors (Fit4Life), 4-month web, phone, and text message-delivered WMI tailored for cancer survivorship | Experimental group reported reduced depression compared to control at posttest (P = 0.02). |
| Jibb et al., 2017 [28] Canada |
One group, pre-post test | 40 pediatric cancer patients (aged 12–18) with all types of cancer undergoing cancer treatment | Reported by patients Pain intensity（Brief Pain Inventory） Pain interference（PROMIS Pediatric Pain Interference Short-form Scale） |
mHealth: Pain Squad + APP, electronic monitoring with real-time self-management recommendations | Change scores showed each pain intensity item improved over the course of Pain Squad + use (All P < 0.05). Less pain interference post intervention as compared to baseline with a small effect size (Cohen’s d = 0.38; P = 0.039). |
| Kunin-Batson et al., 2016 [22] US |
RCT, two arms parallel, 12-month, pre-post test | 52 AYA cancer survivors (aged 15–29) with all types of cancer. Experiment group (n = 26): web-based information provision; Control group (n = 26): standard of care. |
Reported by patients Anxiety（State Trait Anxiety Inventory） |
eHealth: receive access to personalized health history, late effects information, and resources via a password-protected web portal. | No significant differences on anxiety between groups (P > 0.05). |
| Li et al., 2011 [25] China |
Quasi-experiment, two arms, pre-post test | 122 pediatric cancer patients (aged 8–18) with all types in treatment. Experiment group (n = 52): therapeutic play; Control group (n = 70): routine nursing care. |
Reported by patients Anxiety（Chinese Version of the State Anxiety Scale for Children） Depressive symptoms（Center for Epidemiologic Studies Depression Scale for Children） |
eHealth: therapeutic play, using Virtual Reality computer games: conducted by research nurse and implemented in small group with maximum four children in one group in a playroom of the oncology unit. | Experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7 (P = 0.02). No differences in children’s anxiety scores between the two groups on day 7 (P = 0.07). |
| Sander et al., 2002 [23] USA |
RCT, two arms post test | 30 adolescents (aged 10–19), with all types in treatment during lumbar punctures. Experiment group (n = 17): Virtual Reality; Control group (n = 13): standard care. |
Reported by patients Pain（VAS） |
eHealth: Virtual Reality, wore Virtual Reality glasses and watched a video | Pain scores were not statistically different between the two groups (P = 0.77). Pain scores tended to be lower in the Virtual Reality group (median score of 7.0, range 0–48) than in the control group (median score of 9.0, range 0–59). |
| Schneider et al., 1999 [29] USA |
An interrupted time series design, one group | 11 children (aged 10–17) with all types of cancer receiving chemotherapy. | Reported by patients Symptom distress（Symptom Distress Scale） Anxiety（State-Trait Anxiety Inventory for Children） |
eHealth: Virtual Reality, wore a Virtual headset with one of three CD ROM-based scenarios, during a single intravenous chemotherapy treatment | Symptom distress score during the initial chemotherapy treatment decreased during subsequent treatments (P = 0.02). State anxiety levels were not influenced by the Virtual Reality intervention (P = 0.11). |
| Seitz et al., 2014 [30] Germany |
One group, 3-month, pre-post test | 20 cancer survivors (aged 20–36) with all types of cancer. | Reported by patients Anxiety, depression（Hospital Anxiety and Depression Scale） Fear（Short form of the Fear of Progression and Relapse Questionnaire） |
eHealth: web based therapist guided, cognitive behavioral intervention: 10 writing sessions containing standardized text messages and instructions | Significant decreases in anxiety (t = 3.44; P = 0.003), fear of relapse/progression (t = 2.14; P = 0.046), and depression (t = 5.69; P < 0.001). |
Note: ALL = acute lymphoblastic leukemia. AYA = adolescent and young adult. PROMIS = Patient-Reported Outcomes Measurement Information System. VAS = Visual Analog Scale. WMI = weight management intervention.