Putting on a radiotherapy mask that covers your face, stretches over your shoulders and fastens to a treatment bed to hold you in place can be a claustrophobic experience for most adults. It’s worse if you are a child unable to understand the vital importance of staying still for targeted treatment.
“The masks are quite scary looking, so in the past when I got them out, the [children’s] first reaction would always be, ‘I don’t need one of those’,” says Lobke Marsden, a play specialist in the radiotherapy department at Leeds children’s hospital.
Now Marsden, working with a small team including a clinical nurse specialist, a paediatric radiographer and two oncologists, has transformed the once traumatic radiotherapy treatment with her specially painted masks.
She has painted masks ranging from superheroes such as Batman and Iron Man to My Little Pony, a pizza mask, a “queen of radiotherapy” mask – and one for a girl who wanted her hair painted on like it was before chemotherapy caused it to fall out.
Marsden came up with the idea several years ago when she looked online and saw a hospital in the US doing something similar. When it was proposed to the team, however, there were concerns that the paint might affect treatment.
Marsden painted offcuts of the plain masks with water-based acrylic in every hue and thickness for testing. Each sample was passed through the Linac machine used for treatment to ensure it would not be detrimental to patients.
Marsden works closely with patients so the designs are exactly how they want them, and masks can take from one hour to two days to complete. She describes the children’s reactions: “They often smile or laugh. They can’t believe that something that’s quite cold-looking can be turned into something that they might want to wear, especially the little ones. When it’s painted, they often just want to put it on and dress up.”
“There are quite a few parents who go out and buy the outfit for them, to match the mask,” says Marsden, referring to one boy who came dressed as Batman every day and would only respond to the name of the superhero.
“Treating children and adults is surprisingly similar in lots of ways,” says Lucy Hume, a paediatric radiographer working with Marsden.
“The same fears and anxieties come from adults and children, but obviously children don’t have an understanding of what’s going on. The adults will have been well informed about their diagnosis and what’s going to happen at each stage and they can understand that . But the children can’t – and a lot of the information is given to their parents,” she says.
The masks keep children entertained. “It’s all about distraction,” says Hume.
If the children can’t stay still for their targeted treatment, which can last between 20 minutes and an hour, the only alternative is to have a general anaesthetic for every session, which can be challenging over several weeks.
The team uses other techniques, such as “magic string”, where the child tugs on one end from the treatment room and the parent tugs on the other so they remain connected. There is also an iPod arm that attaches to the bed to show a favourite TV show, and Marsden often uses Barbie dolls and a miniature Linac machine to demonstrate what will happen during treatment.
The masks are the biggest hit, however. “This is a fantastic initiative, a perfect example of an individual applying her creative skills to improve the healthcare experience for children and their families,” says Anne Stanton, head of nursing for Leeds children’s hospital. “Play specialists’ work helps to fulfil the emotional, social and developmental needs of children and young people – and to alleviate emotional trauma within families.”
“Children have the opportunity to become their heroes and favourite characters and this empowers them and makes them feel special,” adds Stanton. “[Marsden’s] work affords children an element of control and choice in what can be an otherwise scary and overwhelming situation.”
For Marsden, her role is clear. “To make the radiotherapy journey the least stressful possible. We find that children are much more willing to cooperate. Before, we might have struggled to get them in the mask and wear it for the treatment – and now they often want to, which is great. I hope that it’s made the experience a lot nicer. Not just for the children, but for the parents as well.”
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