Parent-child communication patterns during the first year after a parent's cancer diagnosis

Gender differences in the relationships between parental phubbing and adolescents' depressive symptoms: The mediating role of parent-adolescent communication

Phubbing, as a common phenomenon in modern society's communication, describes the act of using one's phone in face-to-face interactions. In recent years, parental phubbing has attracted the attention of researchers, and it is imperative to explore the relationship between father phubbing (Fphubbing), mother phubbing (Mphubbing) and adolescent development. Therefore, this study investigated 4213 adolescents (mean age = 16.41, SD = 0.77, 52.5% were boys) and explored the relationship between Fphubbing and Mphubbing and adolescents' depressive symptoms. Our single-group path analysis showed that both Fphubbing and Mphubbing were positively associated with adolescents' depressive symptoms. These positive associations were mediated by father-adolescent communication and mother-adolescent communication. Furthermore, multiple-group path analysis revealed that, compared to male adolescents, the relationship between Fphubbing and father-adolescent communication, and the relationship between Mphubbing and mother-adolescent communication were stronger in female adolescents. These findings offer a more ecological and comprehensive understanding of how parental phubbing associates with parent-adolescent communication and adolescents' depressive symptoms.

The Impact of Cancer on the Mental Health of Patients Parenting Minor Children: A Systematic Review of Quantitative Evidence

OBJECTIVE

To provide an overview of quantitative data on the impact of cancer on the mental health of patients parenting minor children. We focused on mental health outcomes, their levels and prevalence and applied measurement tools.

METHODS

MEDLINE, CINAHL, PsycInfo and Web of Science were searched up to March 2021. We included quantitative studies, published in a peer-reviewed journal and reporting outcomes on the mental health (e.g., depression, anxiety) of cancer patients parenting minor children (≤ 21 years). Study quality was assessed based on the NIH assessment tool for observational studies. This study is registered on PROSPERO (CRD42019141954).

RESULTS

A total of 54 articles based on 36 different studies were included in this systematic review. Studies differ markedly regarding study and sample characteristics (e.g., outcome measures, sample size, parental health status). Depression and anxiety levels range from normal to abnormal, according to applied measurement tools. 7%-83% of parents with cancer have depression scores indicating probable depression and 19%-88% have anxiety scores indicating anxiety disorder.

CONCLUSIONS

This review reveals the dimension of mental burden affecting cancer patients parenting minor children. To identify, address and timely treat potentially arising mental health problems and support needs, affected parents should be closely monitored by healthcare professionals and referred to specialized support offers, if necessary. In the context of a comprehensive patient- and family-oriented care, it is highly relevant to integrate mental health (including parental) issues routinely into oncological care by proactively asking for the patient's psychosocial situation and the family status. This article is protected by copyright. All rights reserved.

Effect of time on quality of parent-child communication in pediatric cancer

BACKGROUND

A diagnosis of childhood cancer results in new parent-child communication challenges. Little is known about how communication changes over time after diagnosis or relapse. The objective of this study was to determine the effect of time since diagnosis and relapse on quality of parent-child communication. We hypothesized that there would be a positive correlation between time and quality of parent-child communication.

METHODS

Cross-sectional study in children (7-17 years) with relapsed/refractory cancer and their caregivers, who spoke English, were not cognitively impaired, and had internet access. Parents were recruited through Facebook ads. Parents and children completed the Parent-Adolescent Communication Scale (PACS), a 20-item measure of communication quality, with openness and problem subscales. Spearman's rho (r_s ) coefficients assessed correlations between PACS scores and time since diagnosis/relapse.

RESULTS

There was a statistically significant negative correlation between parent PACS scores and time since child's cancer diagnosis (r_s  = -0.21, p = .02), indicating a tendency for overall worsening communication as time since diagnosis increased. There was a positive correlation between the parent PACS problem scores and time since diagnosis (r_s  = +0.22, p = .01), indicating more problematic communication as time since diagnosis increased. Correlations of time since relapse and PACS scores were small and not statistically significant.

CONCLUSION

Parent-child communication worsens over time following a child's cancer diagnosis with more communication problems, contrary to our hypothesis. Future studies are needed to evaluate intervention timing to best support parent-child communication beyond the new-diagnosis period.

Impact of Coping Skills Training on the Quality of Life Among the Daughters of Mothers with Breast Cancer

Background

Cancer affects the quality of life (QoL) of patients and their families. The purpose of this study was to determine the effect of coping skills training on the QoL among daughters of mothers with breast cancer.

Methods

In this quasi-experimental pre-test/post-test design, data were collected from 70 participants (35 in each of the control and education groups) from January 2016 to July 2017 in Imam Khomeini and Rasole-e-Akram Hospitals in Tehran. The education group participated in a workshop and group discussion (groups of 5 to 8 participants) with the presence of a pediatric psychiatrist and two pediatric nurses, and then a follow up program was performed. The Pediatric Quality of Life Inventory version 4.0 was used in this study in two stages of pre-test (before education) and post-test (four weeks later). Data were analyzed through SPSS, version 21 using independent t-test and paired t-test for comparison of the mean scores of the two groups, with the significance level of 0.05.

Results

After the education, there were significantly improved scores of the QoL in the dimensions of physical functioning (P<0.001), emotional functioning (P<0.001), and school functioning (P<0.001) in the study group compared to the control group. The social functioning did not show a significant change (P<0.083).

Conclusion

The findings of the study confirm that coping skills training can lead to the improvement of QoL in adolescent daughters of mothers with breast cancer. Healthcare professionals must provide the mothers and daughters with information about breast cancer and instruments to handle their situation to promote the daughters' QoL.

To disclose or not to disclose? Communication between mothers with cancer and their young children

Objective: Understand how mothers with cancer communicate about the disease with their children. Method: We used qualitative methods. Ten mothers participated in a semi-structured interview about their experiences of disclosing the disease to their young children. The interviews were audio recorded and transcribed. Results: Two main themes emerged, including three sub-themes for the second theme: 1) The cancer was disclosed to the children; 2) The cancer was not disclosed to the children; 2.1 Did not tell her child and has no intention to do so; 2.2 Did not tell her child but plans to do so in the future; and 2.3 Did not tell her child but believes her child knows about the disease. Mothers who succeed in maintain a sincere dialogue with their children show a strong affective closeness with their children. Conclusions: The findings may be useful for understanding and planning communication strategies that favor the mother-child bond and that positively contribute to the treatment of mothers with cancer.

Cancer patients' experiences with and opinions on the process 'Screening of Distress and Referral Need' (SDRN) in clinical practice: A quantitative observational clinical study

Objective

This observational clinical study investigated patients’ experiences with and opinions on the Dutch ‘Screening of Distress and Referral Need’ (SDRN) process implemented in oncology practice. Insight into these can guide improvement of the SDRN process.

Methods

Patients from hospitals that had implemented SDRN for at least a year completed questions on experiences with essential SDRN process steps (1: completion of the Distress Thermometer and Problem List as screening instrument (DT&PL), 2: information on SDRN+DT&PL, 3: information on referral options, 4: discussing DT&PL responses, 5: referral when needed), and on opinions about SDRN and DT&PL. Descriptive and univariate analyses were conducted.

Results

Of the 498 participants (response = 54%), 81% completed a DT&PL, of whom 86–87% was exposed to steps 2–3 and 76% discussed responses; only three needing care were not offered referral. Sixty-one percent encountered all SDRN steps and 78% would recommend SDRN to others. Recommending SDRN is related to more frequent DT&PL completion (t = -2.5; p≤0.01), receipt of information on SDRN+DT&PL and referral options (X² = 4.9; p≤0.05 and X² = 5.9; p≤0.05 respectively), discussion of responses (X² = 10.2; p≤0.001), and fuller exposure to SDRN process steps (X² = 14.8; p≤0.01). Percentages (strongly) agreeing were highest on the DT&PL being useful (90%) and suitable (88%), and lowest on burdensome (31%) and time-consuming (28%).

Conclusion

The majority of participating patients encountered the steps of the SDRN process considered essential, with 3/5 having encountered all steps. Referral is largely targeted to patients’ need. Patients’ perceived benefit of SDRN increases with fuller exposure to all process steps. Therefore, improvements, particularly in DT&PL completion and discussion of responses should be made.

Parent-Child Communication and Adjustment Among Children With Advanced and Non-Advanced Cancer in the First Year Following Diagnosis or Relapse

Objectives

To examine parent-child communication (i.e., openness, problems) and child adjustment among youth with advanced or non-advanced cancer and comparison children.

Methods

Families (n = 125) were recruited after a child's diagnosis/relapse and stratified by advanced (n = 55) or non-advanced (n = 70) disease. Comparison children (n = 60) were recruited from local schools. Children (ages 10-17) reported on communication (Parent-Adolescent Communication Scale) with both parents, while mothers reported on child adjustment (Child Behavior Checklist) at enrollment (T1) and one year (T2).

Results

Openness/problems in communication did not differ across groups at T1, but problems with fathers were higher among children with non-advanced cancer versus comparisons at T2. Openness declined for all fathers, while changes in problems varied by group for both parents. T1 communication predicted later adjustment only for children with advanced cancer.

Conclusions

Communication plays an important role, particularly for children with advanced cancer. Additional research with families affected by life-limiting conditions is needed.

Telling the Truth…With Kindness: Retrospective Evaluation of 12 Years of Activity of a Support Group for Children and Their Parents With Cancer

BACKGROUND

Cancer in a parent can have harmful effects on a child's ability to cope with the situation, in particular if communication about the disease is limited.

OBJECTIVE

The aim was to evaluate whether the parent-child group run by a psychoanalyst and a doctor at the hospital helps facilitate communication about the disease with a child and helps to sooth the child and his/her symptoms.

METHODS

This qualitative retrospective study conducted among 61 families (71 adults, 19 children) using semidirected interviews made it possible to identify the expectations and benefits perceived by the parents and children.

RESULTS

The main expectations of the parents were to meet professionals who would help them to speak about the disease and to help the children understand it better in order to reduce their symptoms. The parents' expectations were largely satisfied. As far as the children are concerned, they expressed more benefits (better understanding of the disease, reduction of symptoms, meeting similar others) than expectations.

CONCLUSIONS

The group is a resource that helps both parents and children. Meeting similar others made it possible to justify each participant's own experiences and promote better communication during the continued course of the disease.

IMPLICATIONS FOR PRACTICE

The benefits brought about by this group testify to the need to offer such support to a greater number of parents with cancer. Improvements to the way in which the group is organized are discussed.

Parents' reactions to children's stuttering and style of coping with stress

PURPOSE

The aim of the research was to determine: (a) how parents react to their child's stuttering, (b) what stress coping strategies they utilise, as well as (c) whether stress coping style depends on parents' reaction to their child's stuttering.

METHODS

The research involved 23 mothers and 23 fathers of children who stutter (CWS) at the age of three to six years old. The Reaction to Speech Disfluency Scale (RSDS), developed by the authors, was used in the research. To determine the parents' coping the Coping Inventory in Stressful Situations (CISS) by N.S. Endler and D.A Parker was applied.

RESULTS

The strongest reactions are observed on the cognitive level. Stronger cognitive, emotional and behavioural reactions are observed in the mothers towards their disfluently speaking sons and in the fathers towards their daughters. Having analysed the profiles of coping styles, it can be noticed that the task-oriented coping is most frequently adapted by the fathers. The mothers most often use the avoidance-oriented coping. No relevant correlation was observed between the fathers' coping style and their reactions to the child's disfluent speech. As far as the mothers are concerned, it has been proved that an increase in behavioural reactions correlates with the avoidance-oriented coping.

CONCLUSION

The cognitive reactions of the parents' towards their child's stuttering were most frequent, while the emotional ones were the least frequent. Confronted with a stressful situation, the fathers most often adapt the task-oriented coping, whereas the mothers use the avoidance-oriented coping.

EDUCATIONAL OBJECTIVES

the reader will be able to (1) learn what the key reactions of parents to their children's stuttering are, (2) describe stuttering as a stress factor for the parents, (3) describe the factors which influence parents' reactions to their child's stuttering and their coping style.

The well-being of children impacted by a parent with cancer: an integrative review

PURPOSE

This paper reviewed the peer-reviewed scientific literature on well-being of children impacted by a parent with cancer.

METHOD

An integrative review of peer-reviewed literature between 2000 and 2015 regarding parental cancer and its impact on families was conducted by searching relevant databases using predefined key search terms. A thematic analysis was undertaken on literature that met inclusion criteria.

RESULTS

Forty-nine studies met the criteria for this review, and five major themes were established: impact of cancer, communication, coping strategies, parenting factors mediating impact, and support services. There was considerable variability in study design, methodological approaches, and findings. In the majority of studies, children were significantly impacted by the parent's cancer diagnosis and exhibited distress. Daughters appeared to experience worsened mental health, and sons experienced a greater totality of internalizing and externalizing problems. Children of all ages were impacted by their parent's cancer diagnosis and initiated a number of coping strategies in response. Despite this, a significant number of studies revealed that parents underestimated the impact that their cancer had on their children. Family functioning, as well as the ill parents' gender, coping strategies, cancer severity, and mental and physical health mediated their children's well-being. Parent-child communication was a key element in supporting children.

CONCLUSION

Parental cancer may impact children's long-term well-being. Further investigations are needed in this area. Additionally, review of support programs and interventions are warranted in terms of their uptake and impact on families affected by a parent's cancer.

Wonders & Worries: evaluation of a child centered psychosocial intervention for families who have a parent/primary caregiver with cancer

OBJECTIVE

Scant evidence exists to guide interventions for children who have a parent with cancer. This study evaluated the outcomes of a community based psychosocial intervention targeted to children dealing with parental or primary caregiver cancer. This curriculum provided an age-appropriate understanding of the illness, facilitated the expression of feelings, identified individual coping skills to help ease feelings related to parent's cancer, and enhanced the family's ability to communicate about the disease.

METHODS

Families whose children participated in the six-week curriculum-based intervention completed a questionnaire that included demographic information, a five-item assessment of changes in parenting abilities, and a nine-item assessment of changes in children's behavioral issues. The prevalence of each reported item was determined through a secondary analyses of cross-sectional data derived from a multi-year sample of these survey results.

RESULTS

A sample of 156 families responded to the survey between 2009 and 2014. A majority of families described improvement in all five areas of parenting abilities assessed including communication skills and confidence in parenting. Amelioration of multiple children's issues was reported including improved communication skills (87%), reduced anxiety (84%), increased feeling of security at home (90%), and improved school performance (73%).

CONCLUSIONS

The results reported here suggest that this child centered psychosocial intervention promoted positive adaptation by actively supporting families and children while a parent/primary caregiver coped with a cancer diagnosis. Future research is planned utilizing a randomized controlled study design to formally evaluate the effectiveness and preventative impact of this manualized six-week curriculum. Copyright © 2016 John Wiley & Sons, Ltd.

When a parent has cancer: challenges to patients, their families and health providers

At least 14% of cancer patients live with minor children. Being a parent with cancer has far-reaching consequences for individual treatment decision-making and quality of life in patients and their families. Even though the majority of children and adolescents do not show clinically relevant symptoms of psychopathology, worries about the survival of the parent and the future development of the family are present, and experienced as distressing, in most children. Open communication by parents and clinicians has been found to be of major importance for children and adolescents in adjusting to parental cancer. Support for parents with cancer on relevant parenting issues, starting in the diagnostic phase, should be acknowledged as an important facet of cancer care to reduce the psychosocial burden for cancer patients and their families.

The influence of mothers' and fathers' parenting stress and depressive symptoms on own and partner's parent-child communication

This study examines how parenting stress and depressive symptoms experienced by mothers and fathers influence their own (actor effects) and the partner's (partner effects) parent-child communication. Based on the Actor-Partner Interdependence Model, data from 196 families were analyzed, with both parents rating their parenting stress and depressive feelings, and parents as well as children rating the open parent-child communication. Actor effects were found between parenting stress and open parent-child communication, whereas partner effects were prominent between depressive symptoms and open parent-child communication. The results provide no evidence for gender differences in the strength of the pathways to open parent-child communication. Our findings demonstrate the need to include both parents in studies on parent-child communication to enhance our understanding of the mutual influence among family members.

Coping skills and mental health status in adolescents when a parent has cancer: a multicenter and multi-perspective study

OBJECTIVE

Parental cancer increases the risk of psychosocial problems in adolescents. We investigated the frequency and efficacy of adolescents' coping strategies and relationships between those strategies and mental health status. Age and gender differences regarding coping and mental health were also investigated.

METHODS

In total, 214 adolescents from 167 families participated in a cross-sectional, multicenter study. All participants were recruited from standard oncological care. Among the participants, 52% utilized a child-centered intervention program. Adolescents' coping skills were measured using KIDCOPE. Mental health status was rated by adolescents and parents by the SDQ for symptomatology and the KIDSCREEN for well-being.

RESULTS

We found that 29% of the adolescents showed emotional and behavioral problems. We found gender differences in mental health status but not in coping. Adolescents used a broad spectrum of coping strategies. Active problem-solving, distraction, acceptance, wishful thinking and seeking social support were the most frequently used coping strategies. The utilization of certain coping skills was mediated by their perceived efficacy. Problem-focused or approach-oriented coping strategies generally are associated with better mental health, while avoidance-oriented coping are associated with worse mental health. Emotion-focused coping was associated with both lower and higher mental health.

CONCLUSION

The strategies used by adolescents to cope with parental cancer are associated with their mental health. Problem-solving and approach-oriented coping strategies should be facilitated by psychological interventions regardless of age and gender. Age and gender differences in adolescents' mental health should be further investigated because these differences are not explained by differences in coping strategies.