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Rosenberg AR, Bradford MC, Junkins CC, Taylor M, Zhou C, Sherr N, Kross E, Curtis JR, Yi-Frazier JP. Effect of the Promoting Resilience in Stress Management Intervention for Parents of Children With Cancer (PRISM-P): A Randomized Clinical Trial. JAMA Netw Open 2019; 2:e1911578. [PMID: 31532518 PMCID: PMC6751761 DOI: 10.1001/jamanetworkopen.2019.11578] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE Parents of children with serious illness, such as cancer, experience high stress and distress. Few parent-specific psychosocial interventions have been evaluated in randomized trials. OBJECTIVE To determine if individual- or group-based delivery of a novel intervention called Promoting Resilience in Stress Management for Parents (PRISM-P) improves parent-reported resilience compared with usual care. DESIGN, SETTING, AND PARTICIPANTS This parallel, phase 2 randomized clinical trial with enrollment from December 2016 through December 2018 and 3-month follow-up was conducted at Seattle Children's Hospital. English-speaking parents or guardians of children who were 2 to 24 years old, who had received a diagnosis of a new malignant neoplasm 1 to 10 weeks prior to enrollment, and who were receiving cancer-directed therapy at Seattle Children's Hospital were included. Parents were randomized 1:1:1 to the one-on-one or group PRISM-P intervention or to usual care. Data were analyzed in 2019 (primary analyses from January to March 2019; final analyses in July 2019). INTERVENTIONS The PRISM-P is a manualized, brief intervention targeting 4 skills: stress management, goal setting, cognitive reframing, and meaning making. For one-on-one delivery, skills were taught privately and in person for 30 to 60 minutes approximately every other week. For group delivery, the same skills were taught in a single session with at least 2 parents present. MAIN OUTCOMES AND MEASURES Participants completed patient-reported outcome surveys at enrollment and at 3 months. Linear regression modeling evaluated associations in the intention-to-treat population between each delivery format and the primary outcome (Connor-Davidson Resilience Scale scores, ranging from 0 to 40, with higher scores reflecting greater resilience) and secondary outcomes (benefit finding, social support, health-related quality of life, stress, and distress) at 3 months. RESULTS In total, 94 parents enrolled, were randomized to 1 of the 3 groups, and completed baseline surveys (32 parents in one-on-one sessions, 32 in group sessions, and 30 in usual care). Their median (interquartile range) ages were 35 to 38 (31-44) years across the 3 groups, and they were predominantly white, college-educated mothers. Their children had median (interquartile range) ages of 5 to 8 (3-14) years; slightly more than half of the children were boys, and the most common cancer type was leukemia or lymphoma. One-on-one PRISM-P delivery was significantly associated with improvement compared with usual care in parent-reported outcomes for resilience (β, 2.3; 95% CI, 0.1-4.6; P = .04) and for benefit finding (β, 0.5; 95% CI, 0.2-0.8; P = .001). No significant associations were detected between either platform and other parent-reported outcomes. CONCLUSIONS AND RELEVANCE When delivered individually, PRISM-P was associated with improved parent-reported resilience and benefit finding. This scalable psychosocial intervention may help parents cope and find meaning after their child receives a diagnosis of a serious illness. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02998086.
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Affiliation(s)
- Abby R. Rosenberg
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle
- Division of Bioethics/Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
| | - Miranda C. Bradford
- Children’s Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Courtney C. Junkins
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Mallory Taylor
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington
- Division of General Pediatrics, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Nicole Sherr
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Erin Kross
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle
| | - J. Randall Curtis
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle
| | - Joyce P. Yi-Frazier
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
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Jong MC, Lown A, Schats W, Otto HR, Jong M. Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review. BMJ Open 2019; 9:e030544. [PMID: 31481374 PMCID: PMC6731868 DOI: 10.1136/bmjopen-2019-030544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Long-term childhood cancer survivors are at risk for frailty and have significant health-related issues in adulthood. Various health promotion interventions have been proposed to enhance quality of life including wilderness therapy, which applies the impact of nature on health in a therapeutic context. Previous studies have described positive outcomes linked with various wilderness-related therapies for cancer survivors. However, there is no clarity on the role these therapies play in childhood cancer. The current scoping review aims to systematically map the concept, content and outcome of wilderness therapy for childhood cancer survivors. METHODS AND ANALYSIS This review will be guided by the Joanna Briggs Institute Reviewers' manual for scoping reviews. A systematic literature search using medical subject headings (MeSH) and text words related to wilderness therapy and childhood cancer survivors will be performed in EMBASE, ERIC, Medline, Psycinfo, CINAHL, Scopus, Web of Science, SPORTDiscus and Svemed+, Sociological Abstracts, supplemented by grey literature searches. Eligible quantitative and qualitative studies will be screened, included, assessed for quality and extracted for data by two reviewers independently. Results will be described in a narrative style, reported in extraction tables and diagrams, and where appropriate in themes and text. ETHICS AND DISSEMINATION This study describes a protocol for a scoping review that will undertake secondary analysis of data already published in literature and is therefore exempt from medical ethical review. The scoping review will inform understanding of the benefits and risks of wilderness therapy for childhood cancer survivors, their families, practitioners, clinicians and researchers, and will help elucidate the steps necessary for building its evidence base going forward. Results will be published in a peer-reviewed scientific journal.
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Affiliation(s)
- Miek C Jong
- Department of Health Sciences, Mid Sweden University, Campus Sundsvall, Sundsvall, Sweden
- The Arctic University of Norway, National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, Tromsø, Norway
| | - Anne Lown
- Department of Social Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Winnie Schats
- Scientific Information Service, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Mats Jong
- Department of Health Sciences, Mid Sweden University, Campus Sundsvall, Sundsvall, Sweden
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Robert R, Stavinoha P, Jones BL, Robinson J, Larson K, Hicklen R, Smith B, Perko K, Koch K, Findley S, Weaver MS. Spiritual assessment and spiritual care offerings as a standard of care in pediatric oncology: A recommendation informed by a systematic review of the literature. Pediatr Blood Cancer 2019; 66:e27764. [PMID: 31033210 DOI: 10.1002/pbc.27764] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/05/2019] [Accepted: 04/06/2019] [Indexed: 12/22/2022]
Abstract
Children with cancer and their families experience shifts in spiritual wellness from diagnosis through treatment and survivorship or bereavement. An interdisciplinary team conducted a systematic review of quantitative and qualitative research on spiritual assessments, interventions, and outcomes in childhood cancer following PRISMA guidelines using a PROSPERO registered protocol. Thirty-nine well-designed studies were included in the final analysis. The findings from this systematic review indicate the need for early spiritual assessment with offering of continued support for the spiritual functioning of children with cancer and their families as a standard of care.
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Affiliation(s)
- Rhonda Robert
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Pete Stavinoha
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Barbara L Jones
- Steve Hicks School of Social Work and Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Jacob Robinson
- Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska
| | - Kara Larson
- Division of Spiritual Ministry and Chaplaincy, Children's Hospital Medical Center, Omaha, Nebraska
| | - Rachel Hicklen
- The Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Blake Smith
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas
| | - Kathleen Perko
- Bridges Palliative Care Program, Doernbecher, Children's Hospital, Oregon Health and Science University, Portland, Oregon
| | - Kendra Koch
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas
| | - Stephen Findley
- Department of Spiritual Care and Education, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Meaghann S Weaver
- Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska
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Bakula DM, Sharkey CM, Perez MN, Espeleta HC, Gamwell KL, Baudino M, Delozier AM, Chaney JM, Matt Alderson R, Mullins LL. Featured Article: The Relationship Between Parent and Child Distress in Pediatric Cancer: A Meta-Analysis. J Pediatr Psychol 2019; 44:1121-1136. [DOI: 10.1093/jpepsy/jsz051] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 05/18/2019] [Accepted: 06/02/2019] [Indexed: 12/20/2022] Open
Abstract
Abstract
Objective
Parents and children affected by pediatric cancer are at risk for psychological distress, including depression, anxiety, and post-traumatic stress. A link is believed to exist between parent and child distress; however, no systematic analysis of this relationship has occurred. A meta-analysis was conducted to assess the relationship between parent and child distress among families affected by pediatric cancer.
Methods
A systematic review and meta-analysis was conducted using EBSCO (searching PsycINFO, MEDLINE, Academic search Premiere, and Health Source: Nursing/Academic Edition) and PubMed. The initial search yielded a total of 29,118 articles. Inclusion criteria were that studies assessed the relation between parent and child distress in the context of pediatric cancer, were written in English, and were published in peer-reviewed journals. 28 articles met inclusion criteria.
Results
A statistically significant association was found between overall parent and child distress (r = .32, p < .001), such that increased parent-reported distress was associated with increased distress in their children. Significant relationships were also present among each type of parental distress (i.e., depression, anxiety, post-traumatic stress, and global distress; rs = .31–.51, ps < .001) and overall child distress. Moderation analyses via meta-regression indicated that parent proxy-report of child symptoms was associated with a stronger relationship between parent and child distress than child self-report of their own distress.
Conclusions
Aligned with the social–ecological framework, familial factors appear to be highly relevant in understanding distress following pediatric cancer diagnosis. Indeed, greater parent distress was associated with greater child distress.
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Yun H, Romero SAD, Record B, Kearney J, Raghunathan NJ, Sands S, Mao JJ. Utilization of integrative medicine differs by age among pediatric oncology patients. Pediatr Blood Cancer 2019; 66:e27639. [PMID: 30706689 PMCID: PMC6866674 DOI: 10.1002/pbc.27639] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE Coping with symptoms related to cancer treatment is challenging for pediatric patients with cancer and their caregivers. Additionally, caring for pediatric patients requires specialized expertise to incorporate age-appropriate interventions to improve outcomes. Despite the increase in pediatric inpatient integrative medicine (IM) therapies, there is a paucity of knowledge about whether the utilization of IM therapies differs by patient age. METHODS We conducted a retrospective analysis on IM utilization among pediatric inpatients between 2008 and 2016 in a tertiary urban cancer center using electronic medical records. Multivariable logistic regression models examined the relationship between age and specific type of IM utilization, adjusting for specific demographic factors. RESULTS Between 2008 and 2016, the pediatric inpatient IM service had 20 686 visits and treated 1877 unique patients. A significant age difference (P < 0.001) by modality was noted: dance therapy (mean age ± standard deviation: 5.9 ± 5.3 years), music therapy (8.0±7.0 years), mind-body therapies (13.0 ± 7.7 years), massage (14.5 ± 7.8 years), and acupuncture (20.0 ± 7.9 years). In multivariable analysis, the association between age and use of specific IM therapies remained significant (P < 0.001 for all). CONCLUSION Specific types of inpatient IM therapy usage significantly differed by the age of pediatric patients with cancer; therefore, designing and providing age-appropriate IM interventions with consideration for developmental stage are needed to ensure that the most appropriate and effective therapies are provided to children with cancer.
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Affiliation(s)
- Hyeongjun Yun
- Memorial Sloan Kettering Cancer Center New York New York
| | | | | | - Julia Kearney
- Memorial Sloan Kettering Cancer Center New York New York
| | | | - Stephen Sands
- Memorial Sloan Kettering Cancer Center New York New York
| | - Jun J. Mao
- Memorial Sloan Kettering Cancer Center New York New York
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Harrington RL, Qato DM, Antoon JW, Caskey RN, Schumock GT, Lee TA. Multimorbidity and healthcare utilization among early survivors of pediatric cancer. Pediatr Blood Cancer 2019; 66:e27655. [PMID: 30740866 DOI: 10.1002/pbc.27655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/27/2018] [Accepted: 01/22/2019] [Indexed: 01/08/2023]
Abstract
Early survivors of pediatric cancer are at increased risk of experiencing chronic conditions; however, little is known about the morbidity burden in this population. In this observational cohort study of commercially insured pediatric cancer survivors in the United States (2009-2014), we find that 22.5% of survivors had one chronic condition, and 36.3% had multiple. Compared with survivors without chronic conditions, the presence of multiple conditions significantly increased the odds of an emergency department visit by 70% (odds ratios [OR], 1.7; 95% confidence interval [CI], 1.4-2.1) and of a hospitalization almost four-fold (OR, 3.8; 95% CI], 2.5-5.5). Findings are important for informing pediatric survivorship care plans in the years following completion of therapy.
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Affiliation(s)
- Rachel L Harrington
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
| | - Dima M Qato
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
| | - James W Antoon
- Children's Hospital, Department of Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Rachel N Caskey
- Departments of Pediatrics and Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Glen T Schumock
- University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
| | - Todd A Lee
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
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Schepers SA. Commentary: Fifty Years of Development in Pediatric Psycho-Oncology Research and Practice: How Far Have we Come? J Pediatr Psychol 2019; 44:761-763. [DOI: 10.1093/jpepsy/jsz043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Samsel C, Tapsak S, Thomson K, McKenna K, McGregor K, Forbes P, Ibeziako P. Psychotropic medication use trends in a large pediatric and young adult solid organ transplant population. Pediatr Transplant 2019; 23:e13380. [PMID: 30786113 DOI: 10.1111/petr.13380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/08/2019] [Accepted: 01/18/2019] [Indexed: 01/30/2023]
Abstract
INTRODUCTION This study describes psychotropic medication use in a pediatric and young adult solid organ transplant population. METHODS We conducted a retrospective review of the lifetime incidence of psychotropic medication use and associated characteristics in patients seen over a 6-year period at a large pediatric transplant center utilizing univariate and multivariate statistical analyses. RESULTS The lifetime incidence of psychotropic medication use was 36.5% in 393 patients. Transplant psychiatry provided psychopharmacological consultation to 21.9% of patients. Controlling for age and sex, there were significant associations between psychotropic use and thoracic organ disease (heart/lung) (AOR = 2.14; 95% CI: 1.2-3.8; P = 0.01), White race (P = 0.0002), histories of depressive/mood disorders (AOR = 3.68; 95% CI: 1.8-7.7; P = 0.0005), attention/learning disorders (AOR = 3.30; 95% CI: 1.6-6.9; P = 0.001), acute and post-traumatic stress disorders (AOR = 10.54; 95% CI: 2.6-42.8; P = 0.001), and experiencing bullying (AOR = 2.16; 95% CI: 1.03-4.55; P = 0.04). In unadjusted tests, significant associations were found between lifetime psychotropic usage and patient anxiety history (OR = 2.26; 95% CI: 1.5-3.5; P = 0.0002), end-of-life disease progression (OR = 3.04; 95% CI: 1.7-5.4; P = 0.0002), family psychiatric history (OR = 2.17; 95% CI: 1.4-3.4; P = 0.0007), and adherence concerns (OR = 2.67; 95% CI: 1.7-4.1; P < 0.0001). DISCUSSION The lifetime incidence of psychotropic medication use among pediatric and young adult transplant patients is substantial. Patients with thoracic organ disease, end-of-life illness, individual/family psychiatric histories, trauma, and bullying histories have particularly high rates. Integrating child psychiatry as part of pediatric transplant teams should be an important consideration for the care of these patients.
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Affiliation(s)
- Chase Samsel
- Boston Children's Hospital Department of Psychiatry, Boston, Massachusetts.,Boston Children's Hospital Pediatric Transplant Center, Boston, Massachusetts.,Dana-Farber Cancer Institute Department of Psychosocial Oncology and Palliative Care, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Sara Tapsak
- Boston Children's Hospital Department of Psychiatry, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Katharine Thomson
- Boston Children's Hospital Department of Psychiatry, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Kristine McKenna
- Boston Children's Hospital Department of Psychiatry, Boston, Massachusetts.,Boston Children's Hospital Pediatric Transplant Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Kerry McGregor
- Boston Children's Hospital Department of Psychiatry, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Peter Forbes
- Boston Children's Hospital Clinical and Translational Research Program, Boston, Massachusetts
| | - Patricia Ibeziako
- Boston Children's Hospital Department of Psychiatry, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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Maslak K, Favara-Scacco C, Barchitta M, Agodi A, Astuto M, Scalisi R, Italia S, Bellia F, Bertuna G, D'Amico S, La Spina M, Licciardello M, Lo Nigro L, Samperi P, Miraglia V, Cannata E, Meli M, Puglisi F, Parisi GF, Russo G, Di Cataldo A. General anesthesia, conscious sedation, or nothing: Decision-making by children during painful procedures. Pediatr Blood Cancer 2019; 66:e27600. [PMID: 30604464 DOI: 10.1002/pbc.27600] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Following diagnosis, children with cancer suddenly find themselves in an unknown world where unfamiliar adults make all the important decisions. Children typically experience increasing levels of anxiety with repeated invasive procedures and do not adapt to the discomfort. The aim of the present study is to explore the possibility of asking children directly about their medical support preferences during invasive procedures. PROCEDURE Each patient was offered a choice of medical support on the day of the procedure, specifically general anesthesia (GA), conscious sedation (CS), or nothing. An ad hoc assessment tool was prepared in order to measure child discomfort before, during, and after each procedure, and caregiver adequacy was measured. Both instruments were completed at each procedure by the attending psychologist. RESULTS We monitored 247 consecutive invasive procedures in 85 children and found that children in the 4 to 7 year age group showed significantly higher distress levels. GA was chosen 66 times (26.7%), CS was chosen 97 times (39.3%), and nothing was chosen 5 times and exclusively by adolescents. The child did not choose in 79 procedures (32%). The selection of medical support differed between age groups and distress level was reduced at succeeding procedures. CONCLUSIONS Offering children the choice of medical support during invasive procedures allows for tailored support based on individual needs and is an effective modality to return active control to young patients, limiting the emotional trauma of cancer and treatment.
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Affiliation(s)
- Karolina Maslak
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Cinzia Favara-Scacco
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | | | - Antonella Agodi
- Department "GF Ingrassia", University of Catania, Catania, Italy
| | - Marinella Astuto
- Intensive Care Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Rita Scalisi
- Intensive Care Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Simona Italia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Francesco Bellia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Gregoria Bertuna
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Salvatore D'Amico
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Milena La Spina
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Maria Licciardello
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Luca Lo Nigro
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Piera Samperi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Vito Miraglia
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Emanuela Cannata
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy
| | - Mariaclaudia Meli
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Federica Puglisi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giuseppe Fabio Parisi
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanna Russo
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Di Cataldo
- Pediatric Hemato-Oncology Unit, Azienda Policlinico Vittorio Emanuele, Catania, Italy.,Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Pai ALH, Swain AM, Chen FF, Hwang WT, Vega G, Carlson O, Ortiz FA, Canter K, Joffe N, Kolb EA, Davies SM, Chewning JH, Deatrick J, Kazak AE. Screening for Family Psychosocial Risk in Pediatric Hematopoietic Stem Cell Transplantation with the Psychosocial Assessment Tool. Biol Blood Marrow Transplant 2019; 25:1374-1381. [PMID: 30878608 DOI: 10.1016/j.bbmt.2019.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 03/08/2019] [Indexed: 12/29/2022]
Abstract
Family psychosocial risk screening is an important initial step in delivering evidence-based care in hematopoietic stem cell transplantation (HCT). Establishing an evidence-based screening approach that is acceptable, reliable, and valid is an essential step in psychosocial care delivery. This is a 3-institution multimethod study. In part 1, caregivers of children about to undergo HCT (n = 140) completed the Psychosocial Assessment Tool-Hematopoietic Cell Transplantation (PAT-HCT), a brief parent report screener adapted for HCT, and validating questionnaires. Families received feedback on their risks identified on the PAT-HCT. In part 2, 12 caregivers completed a semistructured interview about their perceptions of the PAT and the feedback process. The reliability and validity of the PAT-HCT total and subscale scores were tested using Kuder-Richardson-20 (KR-20) and Pearson correlations. Thematic content analysis was used to analyze the qualitative interview data. Internal consistency for the total score (KR-20 = .88) and the Child Problems, Sibling Problems, Family Problems, and Stress Reactions subscales were strong (KR-20 >.70). Family Structure, Social Support, and Family Beliefs subscales were adequate (KR-20 = .55 to .63). Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. Feedback was provided to 97.14% of the families who completed the PAT-HCT, and the mean rating of acceptability was >4.00 (on a 5-point scale). The qualitative data indicate that families appreciate the effort to provide screening and feedback. The PAT-HCT is a psychometrically sound screener for use in HCT. Feedback can be given to families. Both the screener and the feedback process are acceptable to caregivers.
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Affiliation(s)
- Ahna L H Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine
| | - Avi Madan Swain
- Division of Pediatric Hematology-Oncology, Children's of Alabama; Department of Pediatrics, University of Alabama at Birmingham
| | - Fang Fang Chen
- Center for Healthcare Delivery Science, Nemours Children's Health System; Sidney Kimmel Medical School at Thomas Jefferson University
| | - Wei-Ting Hwang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine of the University of Pennsylvania
| | - Gabriela Vega
- Center for Healthcare Delivery Science, Nemours Children's Health System
| | - Olivia Carlson
- Center for Healthcare Delivery Science, Nemours Children's Health System
| | | | - Kimberly Canter
- Center for Healthcare Delivery Science, Nemours Children's Health System; Sidney Kimmel Medical School at Thomas Jefferson University
| | - Naomi Joffe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine
| | - E Anders Kolb
- Sidney Kimmel Medical School at Thomas Jefferson University; Center for Cancer and Blood Disorders, Nemours Children's Health System
| | - Stella M Davies
- Department of Pediatrics, University of Cincinnati College of Medicine; Cancer and Blood Diseases Institute, Cincinnati Children's Hospital
| | - Joseph H Chewning
- Division of Pediatric Hematology-Oncology, Children's of Alabama; Department of Pediatrics, University of Alabama at Birmingham
| | - Janet Deatrick
- Department of Family and Community Health, University of Pennsylvania School of Nursing
| | - Anne E Kazak
- Center for Healthcare Delivery Science, Nemours Children's Health System; Department of Pediatrics, Sidney Kimmel Medical School at Thomas Jefferson University.
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Lövgren M, Kreicbergs U, Udo C. Family talk intervention in paediatric oncology: a pilot study protocol. BMJ Paediatr Open 2019; 3:e000417. [PMID: 30815590 PMCID: PMC6361369 DOI: 10.1136/bmjpo-2018-000417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION There is evidence that families with a child diagnosed with cancer need psychosocial support throughout the illness trajectory. Unfortunately, there is little research into psychosocial interventions for such families, especially interventions where the entire family is involved. The aim of this pilot study is therefore to evaluate a psychosocial intervention, the family talk intervention (FTI), in paediatric oncology in terms of study feasibility and potential effects. METHODS AND ANALYSIS This pretest/post-test intervention pilot study is based on families with a child diagnosed with cancer. All families that include at least one child aged 6-19 years (ill child and/or sibling) at one of the six paediatric oncology centres in Sweden between September 2018 and September 2019 will be asked about participation. The intervention consists of six meetings with the family (part of the family or the entire family), led by two interventionists. The core elements in the intervention are to support the families in talking about the illness and related subjects, support the parents in understanding the needs of their children and how to support them and support the families in identifying their strengths and how to use them best. Mixed methods are used to evaluate the intervention (web-based questionnaires, interviews, field notes and observations). Self-reported data from all family members are collected at baseline, directly after the intervention and 6 months later. Study outcomes are family communication, knowledge about the illness, resilience, quality of life and grief. ETHICS AND DISSEMINATION The study has been approved by the Regional Ethical Review Board in Stockholm (Dnr 2018/250-31/2 and 2018/1852-32). Data are processed in coded form, accessible only to the research team and stored at Ersta Sköndal Bräcke University College in a secure server. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03650530, registered in August 2018.
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Affiliation(s)
- Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,The Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,The Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - Camilla Udo
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,School of Education, Health and Society, Dalarna University, Falun, Sweden
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Samsel C, Kearney J, Meadows AL, Abrams A, Hirst JM, Muriel AC. Olanzapine for chemotherapy-induced nausea: Lessons learned from child and adolescent psychiatry. Pediatr Blood Cancer 2018; 65:e27289. [PMID: 29932280 DOI: 10.1002/pbc.27289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Chase Samsel
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Julia Kearney
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Amy L Meadows
- Department of Psychiatry and Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky
- Kentucky Children's Hospital, Lexington, Kentucky
| | - Annah Abrams
- Harvard Medical School, Boston, Massachusetts
- Department of Pediatric Psychosocial Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeremy M Hirst
- Department of Psychiatry and Palliative Care, University of California San Diego School of Medicine, San Diego, California
| | - Anna C Muriel
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Supporting Parent Caregivers of Children with Life-Limiting Illness. CHILDREN-BASEL 2018; 5:children5070085. [PMID: 29949926 PMCID: PMC6069074 DOI: 10.3390/children5070085] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 06/20/2018] [Indexed: 11/17/2022]
Abstract
The well-being of parents is essential to the well-being of children with life-limiting illness. Parents are vulnerable to a range of negative financial, physical, and psychosocial issues due to caregiving tasks and other stressors related to the illness of their child. Pediatric palliative care practitioners provide good care to children by supporting their parents in decision-making and difficult conversations, by managing pain and other symptoms in the ill child, and by addressing parent and family needs for care coordination, respite, bereavement, and social and emotional support. No matter the design or setting of a pediatric palliative care team, practitioners can seek to provide for parent needs by referral or intervention by the care team.
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Woodford J, Wikman A, Cernvall M, Ljungman G, Romppala A, Grönqvist H, von Essen L. Study protocol for a feasibility study of an internet-administered, guided, CBT-based, self-help intervention (ENGAGE) for parents of children previously treated for cancer. BMJ Open 2018; 8:e023708. [PMID: 29903802 PMCID: PMC6009624 DOI: 10.1136/bmjopen-2018-023708] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION A subgroup of parents of children previously treated for cancer report long-term psychological distress after end of treatment. However, needs for psychological support are commonly unmet and there is a lack of evidence-based treatments tailored to the specific needs of this population. An internet-administered, guided, cognitive-behavioural therapy-based, self-help intervention (ENGAGE) for parents of children previously treated for cancer may provide a solution. The aim is to examine the feasibility and acceptability of the intervention ENGAGE and the study procedures for a future controlled trial. METHODS AND ANALYSIS The study has an uncontrolled within-group design with an embedded qualitative and quantitative process evaluation. Potential participants are parents of children previously treated for cancer, living in Sweden, recruited via their child's personal identification number (via the Swedish Childhood Cancer Registry and the Swedish Tax Agency). Parents are invited randomly with information packs sent to home addresses. Further interest in participating can be registered via information on relevant websites. The study aims to recruit 50 parents who will receive the intervention ENGAGE which is designed to be delivered over a 10-week period, and comprises one introductory chapter followed by up to 10 intervention modules addressing key concerns identified for the population. Consistent with feasibility study objectives, primary outcomes relate to recruitment, attrition, data collection, study resources, intervention delivery and acceptability. Clinical outcomes (post-traumatic stress, depression, anxiety, fear of cancer recurrence, psychological inflexibility and experiential avoidance, depressed inactivity, fatigue, quality of life and self-compassion) will be measured at baseline, post-treatment (12 weeks) and 6-month follow-up. ETHICS AND DISSEMINATION The Regional Ethical Review Board in Uppsala, Sweden has granted approval for the study (Dnr: 2017/527). Results will be disseminated to relevant healthcare and patient communities, in peer-reviewed and popular science journals, and at scientific and clinical conferences. TRIAL REGISTRATION NUMBER ISRCTN57233429; Pre-results.
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Affiliation(s)
- Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Anna Wikman
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Martin Cernvall
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Gustaf Ljungman
- Paediatric Oncology, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Amanda Romppala
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Reflections on the Emotional Hazards of Pediatric Oncology Nursing: Four Decades of Perspectives and Potential. J Pediatr Nurs 2018; 40:63-73. [PMID: 29776481 DOI: 10.1016/j.pedn.2018.03.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/10/2018] [Accepted: 03/11/2018] [Indexed: 12/16/2022]
Abstract
THEORETICAL PRINCIPLES Pediatric oncology nurses are particularly vulnerable to emotional distress. Responsible for the oversight of a child's care, these nurses sustain close interactions with multiple patients and families over time, many of whom are coping with life-limiting diagnoses. The world of pediatric oncology nurses is one where tragedy is routinely witnessed thus demanding self-care and healing across a continuum. PHENOMENON ADDRESSED The aim of this article is to outline and review the emotional sequelae of pediatric oncology nurses' work and to suggest interventions to support well-being in light of prolonged caregiving. Three major categories that are addressed include the aspects of clinical practice that influence caregiving, the risks of burnout, compassion fatigue, moral distress and grief, and interventions to counteract these phenomena. RESEARCH LINKAGES Future-nursing research should focus upon the development of validated, psychometrically sound measurement tools to assess nurse-specific variants of burnout, compassion fatigue, moral distress, and nurse grief. Qualitative research should investigate the relationship between personal variables, workplace and team characteristics, age and experience, and their influence on the predominance of burnout, compassion fatigue, moral distress, and nurse grief. Lastly, the phenomena of resiliency demands further study.
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Viola A, Taggi-Pinto A, Sahler OJZ, Alderfer MA, Devine KA. Problem-solving skills, parent-adolescent communication, dyadic functioning, and distress among adolescents with cancer. Pediatr Blood Cancer 2018; 65:e26951. [PMID: 29316232 PMCID: PMC5867217 DOI: 10.1002/pbc.26951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/17/2017] [Accepted: 12/05/2017] [Indexed: 12/20/2022]
Abstract
Some adolescents with cancer report distress and unmet needs. Guided by the disability-stress-coping model, we evaluated associations among problem-solving skills, parent-adolescent cancer-related communication, parent-adolescent dyadic functioning, and distress in adolescents with cancer. Thirty-nine adolescent-parent dyads completed measures of these constructs. Adolescents were 14-20 years old on treatment or within 1 year of completing treatment. Better problem-solving skills were correlated with lower adolescent distress (r = -0.70, P < 0.001). Adolescent-reported cancer-related communication problems and dyadic functioning were not significantly related to adolescent distress (rs < 0.18). Future work should examine use of problem-solving interventions to decrease distress for adolescents with cancer.
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Affiliation(s)
- Adrienne Viola
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | | | - Melissa A. Alderfer
- Nemours Children’s Health System, Wilmington, Delaware,Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
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Peikert ML, Inhestern L, Bergelt C. Psychosocial interventions for rehabilitation and reintegration into daily life of pediatric cancer survivors and their families: A systematic review. PLoS One 2018; 13:e0196151. [PMID: 29672608 PMCID: PMC5908186 DOI: 10.1371/journal.pone.0196151] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/07/2018] [Indexed: 11/18/2022] Open
Abstract
Background The survival rate of childhood cancer patients increased over the past decades. However, even after successful treatment the transition back to normalcy is often a major challenge for the whole family. Therefore, this study aims to provide an overview of psychosocial interventions for childhood cancer survivors and their families in the first years after the end of cancer treatment. Methods We conducted a systematic review following the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO registration number: CRD42017059782). In November 2016 and September 2017, we searched the databases CINAHL, MEDLINE, PSYNDEX, and Web of Science. We included studies investigating psychosocial interventions for childhood cancer survivors diagnosed under the age of 21, their family members or the family as a whole. Further, we summarized the study characteristics and conducted a narrative synthesis of the results. Finally, we assessed the study quality with the Effective Public Health Practice Project Quality Assessment Tool. Results We identified a total of 8215 records based on our database searches and 17 additional records through hand searches. We included 33 articles in the qualitative synthesis. Most of the studies described interventions for the cancer survivor (n = 15). Nine studies investigated interventions for the whole family, and two studies interventions for siblings. The interventions mainly take place in an outpatient group setting (n = 15). Overall, most of the studies reported a significant psychosocial benefit of the interventions. However, the quality of the included studies was limited. Conclusion In summary, we identified a broad range of different interventions and thus could give a comprehensive overview of existing interventions for childhood cancer survivors and their families. However, there is a necessity for high quality studies. The results may help to optimize health care services that support families with the re-entry into daily life.
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Affiliation(s)
- Mona Leandra Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wikman A, Kukkola L, Börjesson H, Cernvall M, Woodford J, Grönqvist H, von Essen L. Development of an Internet-Administered Cognitive Behavior Therapy Program (ENGAGE) for Parents of Children Previously Treated for Cancer: Participatory Action Research Approach. J Med Internet Res 2018; 20:e133. [PMID: 29669710 PMCID: PMC5932329 DOI: 10.2196/jmir.9457] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/05/2018] [Indexed: 12/28/2022] Open
Abstract
Background Parenting a child through cancer is a distressing experience, and a subgroup of parents report negative long-term psychological consequences years after treatment completion. However, there is a lack of evidence-based psychological interventions for parents who experience distress in relation to a child’s cancer disease after end of treatment. Objective One aim of this study was to develop an internet-administered, cognitive behavior therapy–based, psychological, guided, self-help intervention (ENGAGE) for parents of children previously treated for cancer. Another aim was to identify acceptable procedures for future feasibility and efficacy studies testing and evaluating the intervention. Methods Participatory action research methodology was used. The study included face-to-face workshops and related Web-based exercises. A total of 6 parents (4 mothers, 2 fathers) of children previously treated for cancer were involved as parent research partners. Moreover, 2 clinical psychologists were involved as expert research partners. Research partners and research group members worked collaboratively throughout the study. Data were analyzed iteratively using written summaries of the workshops and Web-based exercises parallel to data collection. Results A 10-week, internet-administered, cognitive behavior therapy–based, psychological, guided, self-help intervention (ENGAGE) was developed in collaboration with parent research partners and expert research partners. The content of the intervention, mode and frequency of e-therapist support, and the individualized approach for feedback were modified based on the research partner input. Shared solutions were reached regarding the type and timing of support from an e-therapist (eg, initial video or telephone call, multiple methods of e-therapist contact), duration and timing of intervention (eg, 10 weeks, 30-min assessments), and the removal of unnecessary support functions (eg, removal of chat and forum functions). Preferences for study procedures in future studies testing and evaluating the intervention were discussed; consensus was not reached for all aspects. Conclusions To the best of our knowledge, this study is the first use of a participatory action research approach to develop a psychological intervention for parents of children previously treated for cancer and to identify acceptable study procedures. Involvement of parents with lived experience was vital in the development of a potentially relevant and acceptable intervention for this population.
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Affiliation(s)
- Anna Wikman
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Laura Kukkola
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helene Börjesson
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Martin Cernvall
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Schleisman A, Mahon E. Creative Play: A Nursing Intervention for Children and Adults With Cancer. Clin J Oncol Nurs 2018; 22:137-140. [PMID: 29547615 DOI: 10.1188/18.cjon.137-140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pediatric patients undergoing treatment for oncology diagnoses are likely to experience stress, anxiety, and social isolation. One role of a pediatric oncology nurse is to incorporate play into daily hospital routines. By using medical and normative play, nurses can decrease distress and promote normal growth and development. However, the use of play is not limited to pediatric patients. Oncology nurses who work with adults can incorporate similar strategies within their patient populations to reduce anxiety and stress and to improve quality of life.
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Paltin I, Schofield HL, Baran J. Rehabilitation and Pediatric Oncology: Supporting Patients and Families During and After Treatment. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2018. [DOI: 10.1007/s40141-018-0181-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Scialla MA, Canter KS, Chen FF, Kolb EA, Sandler E, Wiener L, Kazak AE. Delivery of care consistent with the psychosocial standards in pediatric cancer: Current practices in the United States. Pediatr Blood Cancer 2018; 65:10.1002/pbc.26869. [PMID: 29080381 PMCID: PMC5766412 DOI: 10.1002/pbc.26869] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/21/2017] [Accepted: 09/21/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND With published evidence-based Standards for Psychosocial Care for Children with Cancer and their Families, it is important to know the current status of their implementation. This paper presents data on delivery of psychosocial care related to the Standards in the United States. PROCEDURE Pediatric oncologists, psychosocial leaders, and administrators in pediatric oncology from 144 programs completed an online survey. Participants reported on the extent to which psychosocial care consistent with the Standards was implemented and was comprehensive and state of the art. They also reported on specific practices and services for each Standard and the extent to which psychosocial care was integrated into broader medical care. RESULTS Participants indicated that psychosocial care consistent with the Standards was usually or always provided at their center for most of the Standards. However, only half of the oncologists (55.6%) and psychosocial leaders (45.6%) agreed or strongly agreed that their psychosocial care was comprehensive and state of the art. Types of psychosocial care provided included evidence-based and less established approaches but were most often provided when problems were identified, rather than proactively. The perception of state of the art care was associated with practices indicative of integrated psychosocial care and the extent to which the Standards are currently implemented. CONCLUSION Many oncologists and psychosocial leaders perceive that the delivery of psychosocial care at their center is consistent with the Standards. However, care is quite variable, with evidence for the value of more integrated models of psychosocial services.
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Affiliation(s)
- Michele A. Scialla
- Nemours Alfred I duPont Hospital for Children, Nemours Center for Cancer and Blood Disorders, Wilmington, Delaware
| | - Kimberly S. Canter
- Nemours Children’s Health System, Nemours Center for Healthcare Delivery Science, Wilmington, Delaware
| | - Fang Fang Chen
- Nemours Children’s Health System, Nemours Center for Healthcare Delivery Science, Wilmington, Delaware
- Sidney Kimmel Medical College of Thomas Jefferson University, Department of Pediatrics, Philadelphia, Pennsylvania
| | - E. Anders Kolb
- Nemours Alfred I duPont Hospital for Children, Nemours Center for Cancer and Blood Disorders, Wilmington, Delaware
| | - Eric Sandler
- Nemours Children’s Health System, Nemours Children's Specialty Care, Division of Hematology/Oncology, Jacksonville, FL
| | - Lori Wiener
- Center for Cancer Research, National Cancer Institute, Pediatric Oncology Branch, Bethesda, Maryland
| | - Anne E. Kazak
- Nemours Children’s Health System, Nemours Center for Healthcare Delivery Science, Wilmington, Delaware
- Sidney Kimmel Medical College of Thomas Jefferson University, Department of Pediatrics, Philadelphia, Pennsylvania
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Kukkola L, Hovén E, Cernvall M, von Essen L, Grönqvist H. Perceptions of support among Swedish parents of children after end of successful cancer treatment: a prospective, longitudinal study. Acta Oncol 2017; 56:1705-1711. [PMID: 28971717 DOI: 10.1080/0284186x.2017.1374554] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Most children survive childhood cancer, however parenting a child diagnosed with cancer is a major challenge. The main aim of the current study was to describe Swedish parents' need, opportunity and benefit of support from healthcare professionals and significant others after end of a child's successful cancer treatment. MATERIAL AND METHODS Data was collected from approximately one week after end of successful treatment/six months after transplantation (T4, n = 212) up to five years thereafter (T7, n = 137). Parents answered questions via telephone about need, opportunity and benefit of talking to psychologists, social workers, partners and friends. RESULTS The proportion reporting need of support from healthcare professionals varied between 73% (mothers' need of support from social workers, T4) and 7% (fathers' need of support from psychologists/social workers, T7). Need of support from significant others varied between 99% (mothers' and fathers' need of support from partners, T4) and 27% (fathers' need of support from friends, T7). The proportion reporting need of support decreased over time (p < .001), no decrease occurred from three months after end of treatment/nine months after transplantation (T5) to one year after end of treatment/18 months after transplantation (T6). More mothers than fathers reported need of support from friends at T5 (p < .001) and T7 (p < .05) and from psychologists at T7 (p < .05). Opportunities for support from healthcare professionals varied, most reported opportunity for support from significant others. Almost all reported benefit from received support. CONCLUSION A declining number reports a need of support over time, however subgroups report an unmet need and almost every parent perceive support from healthcare professionals as beneficial. More parents should get access to psychosocial support services after end of a child's cancer treatment/transplantation.
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Affiliation(s)
- Laura Kukkola
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Emma Hovén
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Martin Cernvall
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
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Ångström-Brännström C, Lindh V, Mullaney T, Nilsson K, Wickart-Johansson G, Svärd AM, Nyholm T, Lindh J, Engvall G. Parents' Experiences and Responses to an Intervention for Psychological Preparation of Children and Families During the Child's Radiotherapy. J Pediatr Oncol Nurs 2017; 35:132-148. [PMID: 29172925 DOI: 10.1177/1043454217741876] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to evaluate parents' experiences and responses to a systematic intervention for psychological preparation of children and families during the child's radiotherapy (RT) treatment. In this case-control study at 3 pediatric RT centers, an intervention with a preparatory kit, including age-adjusted information on tablets, gift of a stuffed toy or a pair of headphones, a parent booklet, and toy models of the computed tomography and RT machines was implemented. For evaluation, a mixed methods data collection was conducted. A total of 113 parents of children undergoing RT were included-n = 59 in the baseline group and n = 54 in the intervention group. Health-related quality of life was rated low, but parents in the intervention group expressed less anxiety after the RT compared with the baseline group. They found information suitable for their young children, siblings, and friends were involved and the toy models were used for play. Parents expressed positive feelings due to close interaction with staff and each other within the family. The solutions developed within a human-centered design approach and shaped as a systematic family-centered strategy contributed to parents understanding and coping with the child's RT.
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Scialla MA, Canter KS, Chen FF, Kolb EA, Sandler E, Wiener L, Kazak AE. Implementing the psychosocial standards in pediatric cancer: Current staffing and services available. Pediatr Blood Cancer 2017; 64:10.1002/pbc.26634. [PMID: 28544310 PMCID: PMC5719337 DOI: 10.1002/pbc.26634] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/14/2017] [Accepted: 04/14/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fifteen evidence-based Standards for Psychosocial Care for Children with Cancer and Their Families (Standards) were published in 2015. The Standards cover a broad range of topics and circumstances and require qualified multidisciplinary staff to be implemented. This paper presents data on the availability of psychosocial staff and existing practices at pediatric oncology programs in the United States, providing data that can be used to advocate for expanded services and prepare for implementation of the Standards. PROCEDURE Up to three healthcare professionals from 144 programs (72% response rate) participated in an online survey conducted June-December 2016. There were 99 pediatric oncologists with clinical leadership responsibility (Medical Director/Clinical Director), 132 psychosocial leaders in pediatric oncology (Director of Psychosocial Services/Manager/most senior staff member), and 58 administrators in pediatric oncology (Administrative Director/Business Administrator/Director of Operations). The primary outcomes were number and type of psychosocial staff, psychosocial practices, and identified challenges in the delivery of psychosocial care. RESULTS Over 90% of programs have social workers and child life specialists who provide care to children with cancer and their families. Fewer programs have psychologists (60%), neuropsychologists (31%), or psychiatrists (19%). Challenges in psychosocial care are primarily based on pragmatic issues related to funding and reimbursement. CONCLUSION Most participating pediatric oncology programs appear to have at least the basic level of staffing necessary to implement of some of the Standards. However, the lack of a more comprehensive multidisciplinary team is a likely barrier in the implementation of the full set of Standards.
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Affiliation(s)
| | | | | | | | | | - Lori Wiener
- Sidney Kimmel Medical College of Thomas Jefferson University
| | - Anne E. Kazak
- Nemours Children’s Health System,Sidney Kimmel Medical College of Thomas Jefferson University
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Samsel C, Ribeiro M, Ibeziako P, DeMaso DR. Integrated Behavioral Health Care in Pediatric Subspecialty Clinics. Child Adolesc Psychiatr Clin N Am 2017; 26:785-794. [PMID: 28916014 DOI: 10.1016/j.chc.2017.06.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Comorbid behavioral and physical health conditions are accompanied by troubling symptom burden, functional impairment, and treatment complexity. Pediatric subspecialty care clinics offer an opportunity for the implementation of integrated behavioral health (BH) care models that promote resiliency. This article reviews integrated BH care in oncology, palliative care, pain, neuropsychiatry, cystic fibrosis, and transplantation. Examples include integrated care mandates, standards of care, research, and quality improvement by child and adolescent psychiatrists (CAPs) and allied BH clinicians. The role of CAPs in integrated BH care in subspecialty care is explored, focusing on cost, resource use, financial support, and patient and provider satisfaction.
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Affiliation(s)
- Chase Samsel
- Department of Psychiatry, 300 Longwood Avenue, Boston Children's Hospital, Boston, MA 02115, USA; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, SW360A, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Monique Ribeiro
- Department of Psychiatry, 300 Longwood Avenue, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Anesthesiology, Perioperative and Pain Medicine, 333 Longwood Avenue, Boston Children's Hospital, Boston, MA 02115, USA
| | - Patricia Ibeziako
- Department of Psychiatry, 300 Longwood Avenue, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - David R DeMaso
- Department of Psychiatry, 300 Longwood Avenue, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
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Abstract
OBJECTIVE Most children with cancer are diagnosed in early childhood, potentially resulting in missed developmental opportunities. The most common diagnoses-brain tumors, leukemia-are also associated with increased risk of neurocognitive deficits. Unfortunately, research regarding the functioning of preschool-aged children with cancer is limited. Our objective is to describe the cognitive and psychosocial functioning of preschool-aged children with cancer who completed a clinical evaluation at a hospital-based psychology clinic. METHODS Assessment data from 98 preschool-aged children with cancer (M = 5.17 years old, SD = 0.54; 54.1% male) who completed clinically referred evaluations from 2011 to 2015 were abstracted. Because of variability in assessment measures used across clinicians, indicators of cognitive, adaptive, preacademic, and emotional/behavioral functioning were collapsed before analyses. RESULTS Children were 2.56 years from diagnosis (SD = 1.46, range 0-5.25 years) and most were off therapy (79.6%). Primary diagnostic categories were represented: brain tumor (68.4%), solid tumor (15.3%), and leukemia (16.3%). Mean IQ scores were significantly below expectations (t[80] = -7.95, p < .001). There were no differences based on diagnostic category, treatment status, or sex. Adaptive functioning (t[73] = -8.42, p < .001) and preacademic skills (t[77] = -6.20, p < .001) were also significantly below expectations. Mean scores on a measure of parent-reported emotional/behavioral functioning were in the average range. CONCLUSION Young children with cancer may be at significant risk of deficits in intellectual, adaptive, and preacademic functioning. Although our sample is biased by those who were referred for clinical evaluations, the severity of deficits highlights the potential vulnerability of young patients, even before most have entered formal school. Interventions-such as hospital-based preschool programs to increase preacademic skills-should be designed that explicitly target preschool-aged children and focus on a wide range of domains.
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77
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Mooney-Doyle K, Dos Santos MR, Szylit R, Deatrick JA. Parental expectations of support from healthcare providers during pediatric life-threatening illness: A secondary, qualitative analysis. J Pediatr Nurs 2017; 36:163-172. [PMID: 28888498 PMCID: PMC5659330 DOI: 10.1016/j.pedn.2017.05.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/26/2017] [Accepted: 05/28/2017] [Indexed: 11/30/2022]
Abstract
PURPOSES To explain parental expectations of support from healthcare providers for their parenting roles and goals during a child's life-threatening illness (LTI). DESIGN AND METHODS Qualitative interpretive study guided by the Family Adjustment and Adaptation Response Model. Thematic analyses were conducted with data from 31 semi-structured interviews of parents of children with LTI using systematic strategies to ensure rigor including audit trails and prolonged engagement. RESULTS We identified three themes and one meta-theme or overall theme: (1) "Help us survive this," (2) "Let's fight together: please fight with me, not against me, to care for my family," and (3) "Guide me through the darkness: I am suffering." Overall, the parents conveyed that they expect mutuality with the health care providers and system in order to keep Fighting together for my family survival. CONCLUSIONS In the daily work of caring for their families, parents of children with LTI consider survival on multiple levels. They consider the life, illness, and potential death of one child while considering the on-going survival and sustenance of family relationships. PRACTICE IMPLICATIONS Parents are distressed and grapple with conflicted feelings about managing competing needs of various family members. Relationships with health care providers can influence parents' management of the situation and be a source of support as their parenting role changes over the illness trajectory, time, and in response to adversity.
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Affiliation(s)
- Kim Mooney-Doyle
- University of Pennsylvania School of Nursing, Philadelphia, PA, United States.
| | | | - Regina Szylit
- University of Sao Paulo, School of Nursing, Sao Paulo, Brazil
| | - Janet A Deatrick
- University of Pennsylvania School of Nursing, Philadelphia, PA, United States
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Sison J, Tran H, Margol A, Tiwari N, Garcia KM, Cotter J, Kiehna E, Olch AJ, Wong K. Palliative Care Options for a Young Adult Patient with a Diffuse Intrinsic Pontine Glioma. Cureus 2017; 9:e1580. [PMID: 29057192 PMCID: PMC5647135 DOI: 10.7759/cureus.1580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Diffuse intrinsic pontine gliomas (DIPGs) are rare but devastating brain tumors that occur primarily in children. These gliomas have poor prognoses and present options focus on palliation of symptoms and prolongation of life. Here, we present a case of a 16-year-old female diagnosed with a DIPG whose age group has been mostly left out of discussions regarding psychosocial support options. This report is meant to start a conversation about the different support options available at our institution that have shown promising results in the literature for palliative care applications. These options can include camps for patients with brain tumors, psychological counseling, the Ronald McDonald House, and other psychosocial programs. Many of these programs can be tailored to meet the specific needs of adolescent and young adult (AYA) patients and will hopefully be integrated into a comprehensive palliative care regimen in future studies.
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Affiliation(s)
| | - Hung Tran
- Children's Center for Cancer and Blood Diseases, Children's Hospital of Los Angeles
| | - Ashley Margol
- Children's Center for Cancer and Blood Diseases, Children's Hospital of Los Angeles
| | - Nishant Tiwari
- Pathology and Laboratory Medicine, Children's Hospital of Los Angeles
| | - Karla M Garcia
- Clinical Social Work, Children's Hospital of Los Angeles
| | - Jennifer Cotter
- Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, Ca
| | - Erin Kiehna
- Department of Neurosurgery, Children's Hospital of Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, Ca
| | - Arthur J Olch
- Department of Radiation Oncology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Kenneth Wong
- Department of Radiation Oncology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
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Morrison CF, Pai ALH, Martsolf D. Facilitators and Barriers to Self-Management for Adolescents and Young Adults Following a Hematopoietic Stem Cell Transplant [Formula: see text]. J Pediatr Oncol Nurs 2017; 35:36-42. [PMID: 28786302 DOI: 10.1177/1043454217723864] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Adolescents and young adults who experience hematopoietic stem cell transplant are at risk for self-management difficulties based on development, psychological comorbidities, and the complexity of the care regimen. Recommendations for practice change were designed to address facilitators and barriers to self-management for adolescents and young adults following hematopoietic stem cell transplant. As part of a grounded theory research study, 30 participants (17 adolescents and young adults and 13 of their caregivers) were individually interviewed and asked about facilitators and barriers to managing care and advice for health care providers. Participant responses were coded into categories, which were named with terms used by the participants. The number of participants who provided data per category was recorded. Self-management is generally characterized only in the ability to follow a prescribed care regimen. Participants indicated mental and emotional experiences as a result of treatment were indistinguishable from self-management activities. Facilitators included having a positive attitude, social support, organization, motivation, and information. Barriers included physical and psychological symptoms, isolation, difficulties with the medication regimen, single parenting, and having a bad attitude. Advice for health care providers included communicating effectively, treating patients holistically, and providing social support.
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Affiliation(s)
- Caroline F Morrison
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,2 University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Ahna L H Pai
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,3 University of Cincinnati, College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Donna Martsolf
- 2 University of Cincinnati, College of Nursing, Cincinnati, OH, USA
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Tackling psychosocial maladjustment in Parkinson's disease patients following subthalamic deep-brain stimulation: A randomised clinical trial. PLoS One 2017; 12:e0174512. [PMID: 28399152 PMCID: PMC5388322 DOI: 10.1371/journal.pone.0174512] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 03/08/2017] [Indexed: 01/10/2023] Open
Abstract
Background Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for the motor and non-motor signs of Parkinson’s disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN-DBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption. Methods Nineteen PD patients and carers were included in a randomised single blind study. Social adjustment scale (SAS) scores from patients and carers that received the psychoeducation programme (n = 9) were compared, both 1 and 2 years after surgery, with patients and carers with usual care (n = 10). Depression, anxiety, cognitive status, apathy, coping, parkinsonian disability, quality-of-life, carers’ anxiety and burden were also analysed. Results Seventeen patients completed the study, 2 were excluded from the final analysis because of adverse events. At 1 year, 2/7 patients with psychoeducation and 8/10 with usual care had an aggravation in at least one domain of the SAS (p = .058). At 2 years, only 1 patient with psychoeducation suffered persistent aggravated social adjustment as compared to 8 patients with usual care (p = .015). At 1 year, anxiety, depression and instrumental coping ratings improved more in the psychoeducation than in the usual care group (p = .038, p = .050 and p = .050, respectively). No significant differences were found between groups for quality of life, cognitive status, apathy or motor disability. Conclusions Our results suggest that a perioperative psychoeducation programme prevents social maladjustment in PD patients following STN-DBS and improves anxiety and depression compared to usual care. These preliminary data need to be confirmed in larger studies.
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Brand S, Wolfe J, Samsel C. The Impact of Cancer and its Treatment on the Growth and Development of the Pediatric Patient. Curr Pediatr Rev 2017; 13:24-33. [PMID: 27848890 PMCID: PMC5503788 DOI: 10.2174/1573396313666161116094916] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/08/2016] [Accepted: 12/12/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cancer treatment can have profound effects on the growth and development of pediatric patients. Different models of psychosocial development and behavioral treatment approaches aid children receiving medical treatment. Providing education, anticipatory guidance, and individualized support to child and their families is a psychosocial standard. OBJECTIVE Clarify the different models of psychosocial development and applicable psychosocial interventions to better prepare and tailor cancer treatment to pediatric patients. METHODS Authors reviewed existing evidenced-based literature in oncology, psychology, developmental, and psychiatric while drawing on case examples and expert knowledge to illustrate the impact of cancer treatment on pediatric patients, analyze developmentally individualized needs, and describe facilitative interventions. RESULT Pediatric patients of all ages cope and adjust better to all phases of treatment when their care is delivered in a developmentally-informed and psychosocially thoughtful way. CONCLUSION Providers can comprehensively prepare their patients and families for treatment better by utilizing a psychosocially- and developmentally-informed framework while meeting individualized unique needs of patients. An integrated multidisciplinary psychosocial support team is facilitative in anticipating and meeting the needs of pediatric cancer patients and has recently become a psychosocial standard of care.
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Affiliation(s)
- Sarah Brand
- Dana-Farber Cancer Institute, 450 Brookline Avenue, SW360E, Boston, MA 02115. United States
| | - Joanne Wolfe
- Department of Medicine, Boston Children`s Hospital, MA. United States
| | - Chase Samsel
- Harvard Medical School, Boston, MA. United States
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Wiener L, Kazak AE, Noll RB, Patenaude AF, Kupst MJ. Standards for the Psychosocial Care of Children With Cancer and Their Families: An Introduction to the Special Issue. Pediatr Blood Cancer 2015; 62 Suppl 5:S419-24. [PMID: 26397836 PMCID: PMC6397048 DOI: 10.1002/pbc.25675] [Citation(s) in RCA: 259] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 06/26/2015] [Indexed: 01/10/2023]
Abstract
Pediatric oncology psychosocial professionals collaborated with an interdisciplinary group of experts and stakeholders and developed evidence-based standards for pediatric psychosocial care. Given the breadth of research evidence and traditions of clinical care, 15 standards were derived. Each standard is based on a systematic review of relevant literature and used the AGREE II process to evaluate the quality of the evidence. This article describes the methods used to develop the standards and introduces the 15 articles included in this special issue. Established standards help ensure that all children with cancer and their families receive essential psychosocial care.
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Affiliation(s)
- Lori Wiener
- Pediatric Oncology Branch, National Cancer Institute,
Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - Anne E Kazak
- Nemours Children’s Health System, Sidney Kimmel
Medical School of Thomas Jefferson University, Philadelphia, PA
| | | | | | - Mary Jo Kupst
- Department of Pediatrics, Medical College of Wisconsin,
Milwaukee, Wisconsin
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