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Raches D, Gajjar A, Robinson GW, Ashford JM, Bryndziar M, Huggins A, Lockett S, Harris A, Taylor H, Bursi E, Conklin HM. Intensive Interdisciplinary Rehabilitation in the Pediatric Hematology/Oncology Setting: Feasibility and Perceived Benefit of the Acute Neurological Injury Service. Cancers (Basel) 2024; 16:2999. [PMID: 39272857 PMCID: PMC11393926 DOI: 10.3390/cancers16172999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024] Open
Abstract
(1) Background: Intensive interdisciplinary rehabilitation services more effectively promote recovery from acquired brain injury than a single discipline approach. However, research literature is lacking regarding the perceived feasibility and utility of an interdisciplinary approach across disciplines for patients within a tertiary care pediatric hematology/oncology setting. (2) Methods: The Acute Neurological Injury (ANI) service applied an acquired brain injury/inpatient rehabilitation interdisciplinary approach to a pediatric hematology/oncology population, with a focus on interdisciplinary communication, shared goal setting, and coordinated transition planning. Caregivers whose children received coordinated ANI program care were interviewed regarding the perceived feasibility and utility of ANI program components. (3) Results: An interdisciplinary approach to a pediatric hematology/oncology population is feasible for caregivers and for providers of rehabilitation and psychosocial services within a tertiary care cancer hospital setting. Parents perceived benefits from aspects of this approach including coordinated interdisciplinary care planning, the implementation of an interdisciplinary goal, parent brain injury education, neuropsychological assessment reports, and weekly cognitive intervention sessions. Parents were interested in both having a peer mentor while managing new cancer diagnoses and later serving in a mentor role for a newly diagnosed family. (4) Conclusions: An interdisciplinary acquired brain injury approach to a pediatric hematology/oncology population is feasible with perceived benefits to families managing new cancer diagnoses.
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Affiliation(s)
- Darcy Raches
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Amar Gajjar
- Division of Neuro-Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Giles W Robinson
- Division of Neuro-Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Jason M Ashford
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Martina Bryndziar
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - April Huggins
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Sherry Lockett
- Department Rehabilitation Services, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Allison Harris
- Department Rehabilitation Services, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Hannah Taylor
- Department Rehabilitation Services, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Ellen Bursi
- Department Rehabilitation Services, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Heather M Conklin
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
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Qureshi SP, Judson E, Cummins C, Gadoud A, Sanders K, Doherty M. Resisting the (re-)medicalisation of dying and grief in the post-digital age: Natural language processing and qualitative analysis of data from internet support forums. Soc Sci Med 2024; 348:116517. [PMID: 38593612 DOI: 10.1016/j.socscimed.2023.116517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 04/11/2024]
Abstract
In the mid-twentieth century, the social movement of death revivalism sought to resist the medicalisation of dying and grief through promotion of the dying person retaining autonomy, and societal openness toward death and bereavement. Despite this advocacy, present-day dying in high income countries is largely institutionalised, with value placed on control over the body and emotions. These phenomena are at odds with the ambitions of death revivalism, and demonstrate the re-medicalisation of dying and grief. Furthermore, contemporary society is continually advancing into the post-digital age, reflected in digital technologies being a tacit part of human existence. Within this framework, this study aims to investigate how people living with life-limiting illness and their loved ones experience, negotiate, and resist medicalisation of dying and grief through online internet forums. We collected posts through web-scraping and utilised Natural Language Processing techniques to select 7048 forum posts from 2003 to 2020, and initially categorise data, before utilising Inductive Thematic Analysis, which generated two major themes. The theme of 'Comfort' describes online forums facilitating psychosocial support which was often used to compensate for systemic deficiencies, especially during the Covid-19 pandemic. Common sources of comfort included animal companions and spirituality, in stark contrast with the medicalised model. The theme of 'Capability' describes online forums acting as solutions for people facing disempowering care systems, including providing information on legal rights and benefits which may not be otherwise easily available, and facilitating collective advocacy. Our findings indicate that community-led online forums can play an effective and sustainable role in democratising care and retaining agency when facing life-limiting illness and grief. Future palliative and bereavement care research must focus on how online forums can be integrated into existing systems, made transparent and accessible, be adequately funded and structured, and be optimised, including compensating for service disruption encountered during future pandemics.
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Affiliation(s)
- Shaun Peter Qureshi
- Centre for the Art of Dying Well, Faculty of Business and Law, St Mary's University Twickenham, London, TW1 4SX, United Kingdom.
| | - Ellen Judson
- Centre for the Analysis of Social Media, Demos, 15 Whitehall, London, SW1A 2DD, United Kingdom.
| | - Ciaran Cummins
- Centre for the Analysis of Social Media, Demos, 15 Whitehall, London, SW1A 2DD, United Kingdom.
| | - Amy Gadoud
- Lancaster Medical School, Lancaster University, Sir John Fisher Drive, LA1 4AT, United Kingdom; Trinity Hospice, Low Moor Road, Blackpool, FY2 OGB, United Kingdom.
| | - Karen Sanders
- Centre for the Art of Dying Well, Faculty of Business and Law, St Mary's University Twickenham, London, TW1 4SX, United Kingdom.
| | - Margaret Doherty
- Centre for the Art of Dying Well, Faculty of Business and Law, St Mary's University Twickenham, London, TW1 4SX, United Kingdom.
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Dias N, Floyd A, Ramkumar R, Horvick S, Haberstroh A, Hendricks-Ferguson VL, Fasolino T. A Review of Parental Bereavement Interventions: Implications for Clinical Practice, Research, and Policy. J Hosp Palliat Nurs 2024; 26:60-67. [PMID: 38227778 DOI: 10.1097/njh.0000000000001016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
The untimely death of a child is an incredibly traumatic experience for parents and their loved ones. It uproots every aspect of their life, leading the bereaved parents to be far more likely to have poorer physical and mental health outcomes. This traumatic form of bereavement should have comprehensive grief-focused, high-quality interventions available for parents and extended family members. The purpose of this rapid review was to explore and describe the bereavement interventions available for parents and family that have been published within the past 5 years. Records identified 123 full-text articles that were reviewed, and 14 of those were included for data extraction and synthesis, using Cochrane Rapid Reviews Methods Group with the addition of keyword searches. The 14 articles were analyzed by evaluating description of bereaved parents, accessibility of interventions, who delivered interventions, and the type and delivery time of interventions. Four types of interventions were identified, including Web-based, community-based, hospital-based, and psychotherapy interventions. This rapid review has implications for clinical practice, research, and health care policy that can increase the availability of support and quality of interventions for bereaved parents and family members.
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Fisher RS, Dattilo TM, DeLone AM, Basile NL, Kenney AE, Hill KN, Chang HF, Gerhardt CA, Mullins LL. The study of psychosocial outcomes of parents bereaved by pediatric illness: a scoping review of methodology and sample composition. J Pediatr Psychol 2024; 49:207-223. [PMID: 38423530 DOI: 10.1093/jpepsy/jsae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE Parents of children who died of a medical condition experience a range of psychosocial outcomes. The current scoping review aims to summarize the outcomes assessed, methodology, and sample characteristics of recent psychosocial research conducted with this population. METHODS Included studies were limited to peer-reviewed, psychosocial outcomes research published between August 2011 and August 2022, written in English, and including caregiver study participants of children who died of a medical condition. Data sources were scholarly journal articles from 9 electronic databases, including Scopus, Web of Science, Academic Search Primer, ProQuest Research Library, PubMed, Embase, PsycINFO, Psychology & Behavioral Sciences Collection, and Health Source: Nursing/Academic Edition. The Mixed Methods Appraisal Tool-2018 evaluated methodological quality. RESULTS The study sample included 106 studies, most of which were either qualitative (60%) or quantitative (29%). Mixed-methods studies (8%) and randomized clinical trials (2%) were also identified. Study quality was variable, but most studies met all quality criteria (73%). Studies primarily represented cancer populations (58%), White participants (71%), and mothers (66%). Risk-based psychosocial outcomes (e.g., grief) were more commonly assessed than resilience-based outcomes. CONCLUSIONS The current scoping review revealed that recent research assessing the psychosocial outcomes of bereaved parents is limited in the representation of diverse populations, primarily qualitative, of broadly strong methodological quality, and oriented to psychosocial risk. To enhance the state of the science and inform evidence-based psychosocial services, future research should consider varied methodologies to comprehensively assess processes of risk and resilience with demographically and medically diverse populations.
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Affiliation(s)
- Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Taylor M Dattilo
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Ansley E Kenney
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Kylie N Hill
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Hui-Fen Chang
- William E. Brock Memorial Library, Oklahoma State University, Stillwater, OK, United States
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, United States
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Gundry A, Elvidge N, Donovan L, Bunker K, Herbert A, Bradford N. Parent and Provider Perspectives of a Hospital-Based Bereavement Support Program in Pediatric Palliative Care. J Pain Symptom Manage 2023; 65:388-399.e9. [PMID: 36775110 DOI: 10.1016/j.jpainsymman.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023]
Abstract
CONTEXT Bereavement is an individuated, nuanced experience, and its expression is different for each parent who has cared for a dying child. Evidence highlights support is valuable to navigate this loss. OBJECTIVES To evaluate a Bereavement Support Program from the perspectives of both families and service providers. METHODS A cross-sectional study design explored the experiences and perspectives of the benefits of various program components. Respondents were asked about accessing program components, their expectations, and parents were asked to rate the impact of program components on their grief on a scale from one, (no impact) to 100 (positive impact). Space for free text was provided throughout for additional feedback. SETTING/ PARTICIPANTS The survey was distributed through mailing lists of parents known to the service, referring service providers, and advertised in the program newsletter. RESULTS One hundred two respondents completed the survey and provided detailed comments about their experiences. Most interactions and program components were reported helpful by both parents and service providers. Parents (N = 60) reported a positive impact on grief across all program components (median impact on grief range 81-98, Interquartile range 68.5-99). There were, however, a considerable number of respondents who were unaware of some components. CONCLUSION Bereavement care to navigate the devastating loss of a child is of paramount importance and can offer significant and beneficial resources for families. Findings have supported service development in a major tertiary paediatric hospital facilitating improved access for families, particularly for those in regional and rural locations.
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Affiliation(s)
- Alyson Gundry
- Paediatric Palliative Care Service, Oncology Services Group (A.G., L.D., A.H.), Children's Health Queensland Hospital and Health Service, South Brisbane, Australia; School of Nursing (N.E., N.B.), Queensland University of Technology, Kelvin Grove, Australia; Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research (A.H., N.B.), Queensland University of Technology, South Brisbane, Australia.
| | - Norah Elvidge
- Paediatric Palliative Care Service, Oncology Services Group (A.G., L.D., A.H.), Children's Health Queensland Hospital and Health Service, South Brisbane, Australia; School of Nursing (N.E., N.B.), Queensland University of Technology, Kelvin Grove, Australia; Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research (A.H., N.B.), Queensland University of Technology, South Brisbane, Australia
| | - Leigh Donovan
- Paediatric Palliative Care Service, Oncology Services Group (A.G., L.D., A.H.), Children's Health Queensland Hospital and Health Service, South Brisbane, Australia; School of Nursing (N.E., N.B.), Queensland University of Technology, Kelvin Grove, Australia; Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research (A.H., N.B.), Queensland University of Technology, South Brisbane, Australia
| | - Kristy Bunker
- Paediatric Palliative Care Service, Oncology Services Group (A.G., L.D., A.H.), Children's Health Queensland Hospital and Health Service, South Brisbane, Australia; School of Nursing (N.E., N.B.), Queensland University of Technology, Kelvin Grove, Australia; Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research (A.H., N.B.), Queensland University of Technology, South Brisbane, Australia
| | - Anthony Herbert
- Paediatric Palliative Care Service, Oncology Services Group (A.G., L.D., A.H.), Children's Health Queensland Hospital and Health Service, South Brisbane, Australia; School of Nursing (N.E., N.B.), Queensland University of Technology, Kelvin Grove, Australia; Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research (A.H., N.B.), Queensland University of Technology, South Brisbane, Australia
| | - Natalie Bradford
- Paediatric Palliative Care Service, Oncology Services Group (A.G., L.D., A.H.), Children's Health Queensland Hospital and Health Service, South Brisbane, Australia; School of Nursing (N.E., N.B.), Queensland University of Technology, Kelvin Grove, Australia; Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research (A.H., N.B.), Queensland University of Technology, South Brisbane, Australia
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