234 A.D. Gallo and K. Westhoff

20.4.5.3 Reactions

• Acute stress reactions

• Longer-term depressive developments, disorders of self-worth and body image

• Inability to tolerate or denial of disability, creation of taboo

• Lack of compliance with postoperative rehabilitation

20.4.5.4 Interventions

•Preoperative preparatory information (picture books, games, etc.)

•Support in pain management, interdisciplinary pain treatment

•Promotion of emotional processing of the physical change, impairment, or disability

•Support for rehabilitation measures

•Help in reintegration and obtaining aids

20.4.6 Radiotherapy

20.4.6.1 Problems

•Preparations for radiation (fitting and wearing aids, e.g. face masks; simulation)

•Unfamiliar treatment team and strange environment

•Unfamiliar “machines”

•Forms of treatment that are difficult to comprehend (nothing to feel or hear)

•Sedation or narcosis of young children

•Side effects (dependent on dose and site, e.g., nausea and vomiting, dizziness, diarrhea, skin irritation, fatigue)

•Delayed effects (particularly neuropsychological impairments following irradiation of the head)

20.4.6.2 Requirements

•Cooperation with the treatment team

•Lying immobile, sometimes in an uncomfortable position

•Adapting to being alone during irradiation

•Dealing with possible delayed effects

20.4.6.3 Reactions

•Fear of isolation, panic

•Helplessness and defenselessness

20.4.6.4 Interventions

•Information and preparation (visits to the radiotherapy department, handling the apparatus, illustrated material)

•Practicing “lying still” during the radiation procedure during play (swapping roles, “irradiating” cuddly toys)

•Supportive measures (autosuggestion techniques)