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Fladeboe KM, Stock NM, Heike CL, Evans KN, Junkins C, Stueckle L, O'Daffer A, Rosenberg AR, Yi-Frazier JP. Feasibility and Acceptability of the Promoting Resilience in Stress Management-Parent (PRISM-P) Intervention for Caregivers of Children with Craniofacial Conditions. Cleft Palate Craniofac J 2024; 61:1125-1133. [PMID: 36802967 DOI: 10.1177/10556656231157449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVES Few evidence-based psychosocial programs exist within craniofacial care. This study (a) assessed feasibility and acceptability of the Promoting Resilience in Stress Management-Parent (PRISM-P) intervention among caregivers of children with craniofacial conditions and (b) described barriers and facilitators of caregiver resilience to inform program adaptation. DESIGN In this single-arm cohort study, participants completed a baseline demographic questionnaire, the PRISM-P program, and an exit interview. PARTICIPANTS Eligible individuals were English-speaking legal guardians of a child <12-years-old with a craniofacial condition. INTERVENTION PRISM-P included 4 modules (stress-management, goal-setting, cognitive-restructuring, meaning-making) delivered in 2 one-on-one phone or videoconference sessions 1-2 weeks apart. MAIN OUTCOME MEASURES Feasibility was defined as >70% program completion among enrolled participants; acceptability was defined as >70% willingness to recommend PRISM-P. Intervention feedback and caregiver-perceived barriers and facilitators of resilience were summarized qualitatively. RESULTS Twenty caregivers were approached and 12 (60%) enrolled. The majority were mothers (67%) of a child <1-year-old diagnosed with a cleft lip and/or palate (83%) or craniofacial microsomia (17%). Of these, 8 (67%) completed PRISM-P and 7 (58%) completed interviews; 4 (33%) were lost-to-follow-up before PRISM-P and 1 (8%) before the interview. Feedback was highly positive, with 100% willing to recommend PRISM-P. Perceived barriers to resilience included uncertainty about their child's health; facilitators included social support, parental identity, knowledge, and control. CONCLUSIONS PRISM-P was acceptable among caregivers of children with craniofacial conditions but not feasible based on program completion rates. Barriers and facilitators of resilience support the appropriateness of PRISM-P for this population and inform adaptation.
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Affiliation(s)
- Kaitlyn M Fladeboe
- Department of Pediatrics. University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Carrie L Heike
- Department of Pediatrics. University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Kelly N Evans
- Department of Pediatrics. University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Courtney Junkins
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Laura Stueckle
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Alison O'Daffer
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
| | - Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Palliative Care, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Joyce P Yi-Frazier
- Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, USA
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Boyden JY, Ersek M, Widger KA, Shea JA, Feudtner C. The Home-Based Experiences of Palliative and Hospice Care for Children and Caregivers (EXPERIENCE) Measure: Evaluation of Psychometric Properties. J Pain Symptom Manage 2024:S0885-3924(24)00838-8. [PMID: 38942094 DOI: 10.1016/j.jpainsymman.2024.06.018] [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: 04/24/2024] [Revised: 06/15/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024]
Abstract
CONTEXT Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in the home setting. Considerable variation, however, exists in the provision and quality of home-based PPHC in the U.S. Ensuring equitable, high-quality home-based PPHC for all children requires the evaluation of families' care experiences and assessment of whether these experiences are aligned with their needs and priorities. OBJECTIVES To evaluate the psychometric properties of the previously developed 23-item home-based PPHC EXPERIENCE Measure for use with families of children receiving home-based PPHC in the United States. METHODS Participants included families recruited from the Children's Hospital of Philadelphia, Courageous Parents Network, and several other hospital- and community-based PPHC programs across the U.S. who provide home-based PPHC services. Participants completed the EXPERIENCE Measure at baseline and again at retest. We evaluated the factor structure of the EXPERIENCE Measure, as well as evidence regarding score reliability and validity. RESULTS Eighty-two family participants completed the baseline and 53 completed the retest questionnaire from 15 states across the U.S. We found evidence for the score reliability and validity of a four-domain EXPERIENCE measure. CONCLUSION The EXPERIENCE Measure is a tool with evidence for reliable and valid scores to evaluate family-reported home-based PPHC experiences at the time care is being received. Future work will evaluate the usability (i.e., acceptability, feasibility, and clinical actionability) of EXPERIENCE, including the sensitivity of the instrument to change over time and its impact on real-time clinical actions.
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Affiliation(s)
- Jackelyn Y Boyden
- Department of Family and Community Health (J.Y.B.), Department of Biobehavioral Health Sciences (M.E.), School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Pediatrics (J.Y.B., C.F.), Children's Hospital of Philadelphia; Philadelphia, Pennsylvania, USA.
| | - Mary Ersek
- Department of Family and Community Health (J.Y.B.), Department of Biobehavioral Health Sciences (M.E.), School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center (M.E.), Philadelphia, Pennsylvania, USA
| | - Kimberley A Widger
- Lawrence Bloomberg Faculty of Nursing (K.A.W.), University of Toronto; Toronto, Ontario, Canada; Pediatric Advanced Care Team, Hospital for Sick Children (K.A.W.), Toronto, Ontario, Canada
| | - Judy A Shea
- Department of Medicine (J.A.S.), Department of Pediatrics (C.F.), Perelman School of Medicine, University of Pennsylvania; Philadelphia, Pennsylvania, USA
| | - Chris Feudtner
- Department of Pediatrics (J.Y.B., C.F.), Children's Hospital of Philadelphia; Philadelphia, Pennsylvania, USA; Department of Medicine (J.A.S.), Department of Pediatrics (C.F.), Perelman School of Medicine, University of Pennsylvania; Philadelphia, Pennsylvania, USA
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Perak K, McDonald FEJ, Conti J, Yao YS, Skrabal Ross X. Family adjustment and resilience after a parental cancer diagnosis. Support Care Cancer 2024; 32:409. [PMID: 38834818 PMCID: PMC11150317 DOI: 10.1007/s00520-024-08608-x] [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: 01/18/2024] [Accepted: 05/26/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE To explore the resources, parents with cancer and their partners draw upon to sustain their family resilience through the cancer experience. METHODS Fifteen participants who were parents of children aged 8 to 25 years completed phone, audio-recorded, and semi-structured interviews. Of these participants, 11 were parents diagnosed with cancer, and four were partners of a parent diagnosed with cancer. Interview questions aimed to increase understanding about how families communicate, connect, and face challenges from the cancer experience. Interview data was analysed using inductive thematic analysis to provide scope to generate themes from parent's experiences rather than to test pre-existing frameworks. RESULTS The thematic analysis of interview transcripts generated three key themes related to family resilience: (1) adaptability to changes in roles and routines, (2) open communication within the family, and (3) accepting support from others. CONCLUSION This study found that parents' ability to use personal resources when faced with significant challenges helped to improve the resilience of parents' family system. Further research is needed to understand the factors that influence family resilience when a parent is diagnosed with cancer. Implications for the development of targeted interventions that provide support to not only the patient, but their whole family system will be discussed.
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Affiliation(s)
- Katarina Perak
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Fiona E J McDonald
- Research, Policy & Patient Department, Canteen Australia, Sydney, Australia.
- Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
| | - Janet Conti
- School of Psychology, Western Sydney University, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Yi Sing Yao
- Research, Policy & Patient Department, Canteen Australia, Sydney, Australia
| | - Xiomara Skrabal Ross
- Research, Policy & Patient Department, Canteen Australia, Sydney, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia
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Cayrol J, Wakefield CE, Ilbawi A, Donoghoe M, Hoffman R, Echodu M, Schilstra C, Ortiz R, Wiener L. The lived experience of people affected by cancer: A global cross-sectional survey protocol. PLoS One 2024; 19:e0294492. [PMID: 38394101 PMCID: PMC10889872 DOI: 10.1371/journal.pone.0294492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/31/2023] [Indexed: 02/25/2024] Open
Abstract
A diagnosis of cancer impacts the person's physical and mental health and the psychosocial and financial health of their caregivers. While data on the experience of living with cancer is available, there is a dearth of data from persons in low- and middle-income countries (LMICs). The perspectives of other impacted individuals also remain understudied (e.g., bereaved family members), as well as the impact on survivors and their families over time. The objective of this study is to describe the psychosocial and financial impact of cancer on people diagnosed with cancer as a child, adolescent or adult, their families/caregivers, and the family members of those who have died from cancer, in high-income countries (HICs) and LMICs. This study is an observational, descriptive, quantitative study. Data will be collected anonymously via a digital online cross-sectional survey distributed globally by the World Health Organization (WHO) via the LimeSurvey software. Participants will include (a) adults aged 18+ who have been diagnosed with cancer at any age, who are currently undergoing cancer treatment or who have completed cancer treatment; (b) adult family members of individuals of any age with a cancer diagnosis, who are currently undergoing cancer treatment or who have completed cancer treatment; and (c) bereaved family members. Participants will be anonymously recruited via convenience and snowball sampling through networks of organisations related to cancer. Survey results will be analysed quantitatively per respondent group, per time from diagnosis, per disease and country. Results will be disseminated in peer-reviewed journals and at scientific conferences; a summary of results will be available on the WHO website. This study will suggest public health interventions and policy responses to support people affected by cancer and may also lead to subsequent research focusing on the needs of people affected by cancer.
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Affiliation(s)
- Julie Cayrol
- The Royal Children’s Hospital and Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, The University of Melbourne, Melbourne, Australia
- World Health Organization, Department of Non-Communicable Diseases, Geneva, Switzerland
| | - Claire E. Wakefield
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW Sydney, NSW Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - André Ilbawi
- World Health Organization, Department of Non-Communicable Diseases, Geneva, Switzerland
| | - Mark Donoghoe
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, NSW Sydney, Australia
| | - Ruth Hoffman
- American Childhood Cancer Organization, Beltsville, Maryland, United States of America
| | | | - Clarissa Schilstra
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW Sydney, NSW Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Australia
| | - Roberta Ortiz
- World Health Organization, Department of Non-Communicable Diseases, Geneva, Switzerland
| | - Lori Wiener
- National Cancer Institute, Center for Cancer Research, National Institute of Health, Bethesda, Maryland, United States of America
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Glenn T, Cousino MK, Wernovsky G, Schuchardt EL. Resilient Hearts: Measuring Resiliency in Young People With Congenital Heart Disease. J Am Heart Assoc 2023; 12:e029847. [PMID: 37889178 PMCID: PMC10727399 DOI: 10.1161/jaha.123.029847] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
Background Congenital heart disease (CHD) is a life-long disease with long-term consequences on physical and mental health. Patients with CHD face multifaceted physical and psychosocial challenges. Resilience is an important factor that can be protective and positively impact mental health. We studied resiliency and its associated factors in teenagers and young adults with and without CHD using a social media-delivered survey. Resilience was measured using the 25-item Connor-Davidson Resilience Scale, a validated metric with a historical mean of 80.4/100 in the general adult population. Methods and Results Individuals with and without CHD, aged 10 to 25 years, were prospectively recruited on social media to complete an online survey. The survey was completed from January to February 2022. Respondents provided information on their demographics and CHD details (where applicable) and completed the Connor-Davidson Resilience Scale. As a group, participants with CHD had higher resilience scores compared with same-aged healthy individuals (65.3±16.1 versus 55.4±13.8; P<0.001). For both cohorts, sex, race, and age were not associated with differences in resilience score. For individuals with CHD, lower resilience was associated with more hospital admissions, lack of exercise, presence of a mental health diagnosis, and no participation in support groups or disease-specific camps. Conclusions Young people with CHD had higher resilience than individuals without CHD in our sample. We identified several factors, both modifiable and nonmodifiable, that are associated with higher resilience. Awareness of resiliency and its contributors in the population with CHD may assist medical teams in improving patient physical and psychological well-being.
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Affiliation(s)
- Thomas Glenn
- Congenital Heart Center, Departments of Pediatrics and Cardiac SurgeryUniversity of MichiganAnn ArborMI
- Rady Children’s Hospital, Division of Cardiology, Department of PediatricsUniversity of California San Diego School of MedicineSan DiegoCA
| | - Melissa K. Cousino
- Congenital Heart Center, Departments of Pediatrics and Cardiac SurgeryUniversity of MichiganAnn ArborMI
| | - Gil Wernovsky
- Cardiac Critical Care and Pediatric CardiologyChildren’s National Hospital and George Washington University School of Medicine and Health SciencesWashingtonDC
| | - Eleanor L. Schuchardt
- Rady Children’s Hospital, Division of Cardiology, Department of PediatricsUniversity of California San Diego School of MedicineSan DiegoCA
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O'Daffer A, Comiskey L, Scott SR, Zhou C, Bradford MC, Yi-Frazier JP, Rosenberg AR. Protocol for the promoting resilience in stress management (PRISM) intervention: a multi-site randomized controlled trial for adolescents and young adults with advanced cancer. BMC Palliat Care 2023; 22:60. [PMID: 37189149 DOI: 10.1186/s12904-023-01179-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) with cancer are at high risk of poor psychosocial outcomes, and evidence-based interventions designed to meet their psychosocial and communication needs are lacking. The main objective of this project is to test the efficacy of a new adaptation of the Promoting Resilience in Stress Management intervention for AYAs with Advanced Cancer (PRISM-AC). METHODS/DESIGN The PRISM-AC trial is a 2-arm, parallel, non-blinded, multisite, randomized controlled trial. 144 participants with advanced cancer will be enrolled and randomized to either usual, non-directive, supportive care without PRISM-AC ("control" arm) or with PRISM-AC ("experimental" arm). PRISM is a manualized, skills-based training program comprised of four 30-60 min, one-on-one sessions targeting AYA-endorsed resilience resources (stress-management, goal-setting, cognitive-reframing, and meaning-making). It also includes a facilitated family meeting and a fully equipped smartphone app. The current adaptation includes an embedded advance care planning module. English- or Spanish-speaking individuals 12-24 years old with advanced cancer (defined as progressive, recurrent, or refractory disease, or any diagnosis associated with < 50% survival) receiving care at 4 academic medical centers are eligible. Patients' caregivers are also eligible to participate in this study if they are able to speak and read English or Spanish, and are cognitively and physically able to participate. Participants in all groups complete surveys querying patient-reported outcomes at the time of enrollment and 3-, 6-, 9-, and 12-months post-enrollment. The primary outcome of interest is patient-reported health-related quality of life (HRQOL) and secondary outcomes of interest include patient anxiety, depression, resilience, hope and symptom burden, parent/caregiver anxiety, depression and health-related quality of life, and family palliative care activation. We will conduct intention-to-treat analysis to compare the group means of primary and secondary outcomes between PRISM-AC arm and control arm with regression models. DISCUSSION This study will provide methodologically rigorous data and evidence regarding a novel intervention to promote resilience and reduce distress among AYAs with advanced cancer. This research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for this high-risk group. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03668223, September 12, 2018.
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Affiliation(s)
| | - Liam Comiskey
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Samantha R Scott
- Seattle Children's Research Institute, Seattle, WA, USA
- University of Denver, Denver, CO, USA
| | - Chuan Zhou
- Seattle Children's Research Institute, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
| | | | | | - Abby R Rosenberg
- Dana-Farber Cancer Institute, 450 Brookline Ave, JF7, Boston, MA, 02215, USA.
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Chung JOK, Li WHC, Ho LLK, Cheung AT. The Association of Resilience with Way of Coping, Psychological Well-Being and Quality of Life in Parents of Children with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105765. [PMID: 37239492 DOI: 10.3390/ijerph20105765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Evidence shows that resilience is crucial to maintain psychological well-being and quality of life in the face of stress and adversity. However, the relationships between resilience and psychological well-being and factors associated with quality of life in Hong Kong Chinese parents of children with cancer are underexplored. This study aimed to examine the interrelationships among resilience, ways of coping, psychological well-being, and quality of life among Chinese parents of children with cancer, and identify factors associated with their quality of life. A cross-sectional study was conducted with 119 Chinese parents of children with cancer at the Hong Kong Children's Hospital between January 2020 and March 2022. Parents' resilience level, ways of coping, depressive symptoms, state anxiety scores, perceived social support, and quality of life were assessed. Participating parents (n = 119) included 98 mothers (82.4%) and 11 parents were from single-parent families (9.2%). Almost half (47.9%) of the parents were potentially at risk for depression. The results showed that participants from single-parent families reported statistically significantly lower levels of resilience (p < 0.001), more depressive symptoms (p < 0.001), and poorer quality of life (p < 0.001) than those who lived with their partners (married). In addition, parents who adopted problem-focused coping strategies reported statistically significantly higher levels of resilience (p < 0.001), fewer depressive symptoms (p < 0.001), and better quality of life (p < 0.001) than those who adopted emotion-focused coping strategies. A multiple regression analysis revealed that resilience (p < 0.001) was associated with quality of life among parents of children with cancer. This study provides further support that resilience is an important factor associated with quality of life in parents of children with cancer. Assessing resilience in parents is an important prerequisite for designing appropriate interventions to increase their resilience and enhance their quality of life.
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Affiliation(s)
| | - William Ho Cheung Li
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Laurie Long Kwan Ho
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Ankie Tan Cheung
- School of Nursing, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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O'Daffer A, Comiskey L, Scott SR, Zhou C, Bradford MC, Yi-Frazier JP, Rosenberg AR. Protocol for The Promoting Resilience in Stress Management (PRISM) Intervention: a multi-site randomized controlled trial for adolescents and young adults with advanced cancer. RESEARCH SQUARE 2023:rs.3.rs-2748874. [PMID: 37066150 PMCID: PMC10104275 DOI: 10.21203/rs.3.rs-2748874/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Adolescents and young adults (AYAs) with cancer are at high risk of poor psychosocial outcomes, and evidence-based interventions designed to meet their psychosocial and communication needs are lacking. The main objective of this project is to test the efficacy of a new adaptation of the Promoting Resilience in Stress Management intervention for AYAs with Advanced Cancer (PRISM-AC). Methods/design: The PRISM-AC trial is a 2-arm, parallel, non-blinded, multisite, randomized controlled trial. 144 participants with advanced cancer will be enrolled and randomized to either usual, non-directive, supportive care without PRISM-AC ("control" arm) or with PRISM-AC ("experimental" arm). PRISM is a manualized, skills-based training program comprised of four 30-60 minute, one-on-one sessions targeting AYA-endorsed resilience resources (stress-management, goal-setting, cognitive-reframing, and meaning-making). It also includes a facilitated family meeting and a fully equipped smartphone app. The current adaptation includes an embedded advance care planning module. English- or Spanish-speaking individuals 12-24 years old with advanced cancer (defined as progressive, recurrent, or refractory disease, or any diagnosis associated with < 50% survival) receiving care at 4 academic medical centers are eligible. Patients' caregivers are also eligible to participate in this study if they are able to speak and read English or Spanish, and are cognitively and physically able to participate. Participants in all groups complete surveys querying patient-reported outcomes at the time of enrollment and 3-, 6-, 9-, and 12-months post-enrollment. The primary outcome of interest is patient-reported health-related quality of life (HRQOL) and secondary outcomes of interest include patient anxiety, depression, resilience, hope and symptom burden, parent/caregiver anxiety, depression and health-related quality of life, and family palliative care activation. We will conduct intention-to-treat analysis to compare the group means of primary and secondary outcomes between PRISM-AC arm and control arm with regression models. Discussion This study will provide methodologically rigorous data and evidence regarding a novel intervention to promote resilience and reduce distress among AYAs with advanced cancer. This research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for this high-risk group. Trial registration: ClinicalTrials.gov Identifier NCT03668223, September 12, 2018.
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Bouchard EG, Prince MA, McCarty C, Vincent PC, Patel H, LaValley SA, Collins RL, Sahler OJZ, Krenz T, Kelly KM. Understanding social network support, composition, and structure among cancer caregivers. Psychooncology 2023; 32:408-417. [PMID: 36588195 PMCID: PMC10520919 DOI: 10.1002/pon.6087] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We examined the social network support, composition, and structure of pediatric cancer caregivers. METHODS We used a self-report survey to collect egocentric social network data from 107 caregivers of pediatric cancer patients and calculated descriptive statistics to examine cancer-related support network composition, function, and structure. We then ran logistic regressions to examine the relationships between network characteristics and overall satisfaction with social support. RESULTS Family members were the most common source of emotional support and logistical support, and health care providers were the most common source of informational support. Participants perceived the "most helpful" forms of support as being: (1) emotional support from family and health care providers; (2) informational support from health care providers and other cancer caregivers; and (3) logistical support from family. Overall, caregivers wished that 9.8% of their network ties had provided more support, with family members being the most common alter type to disappoint caregivers and offer less support than needed/expected. Caregivers who reported higher network disappointment (having network members who offered less support than needed/expected) were significantly less satisfied with emotional support than those with lower network disappointment (Odds Ratio = 0.18, p = 0.02), and caregivers with higher network disappointment were significantly less satisfied with logistical support compared to those with lower network disappointment (Odds Ratio = 0.14, p = 0.01). CONCLUSION Our results show differences in the nature of social support provided by different types of network members. These findings have implications for tailoring social network interventions to improve caregiver and family outcomes.
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Affiliation(s)
- Elizabeth G. Bouchard
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | | | | | - Paula C. Vincent
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | - Hital Patel
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | - Susan A. LaValley
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | | | | | - Till Krenz
- UHealth Information Technology, Sylvester Comprehensive Cancer Center
| | - Kara M. Kelly
- Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center
- Department of Pediatrics, University at Buffalo
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Snaman JM, Mazzola E, Helton G, Feifer D, Morris SE, Clark L, Baker JN, Wolfe J. Early Bereavement Psychosocial Outcomes in Parents of Children Who Died of Cancer With a Focus on Social Functioning. JCO Oncol Pract 2023; 19:e527-e541. [PMID: 36724414 DOI: 10.1200/op.22.00538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The early grief experience of parents of children who died of cancer remains understudied. Understanding psychosocial symptomology and functioning of parents early in their bereavement is essential to developing supportive interventions aimed at offsetting poor mental and physical outcomes. METHODS Parents of children from two centers who died of cancer 6 to 24 months before were mailed a survey that included validated tools and additional Likert scale-based questions. We used correlation and univariate and multiple regression analyses to assess the associations between psychosocial and grief outcomes and parental social functioning. RESULTS One hundred twenty-five parents representing 88 children completed the survey. Most respondents identified as female (63%), White (84%), and non-Hispanic (91%). The mean time since child's death was 14.7 (range, 8-26) months. Bereaved parents' mean score for social functioning was only slightly below normative values, and most parents indicated post-traumatic growth and adaptive coping. Parents had high symptom levels for depression, anxiety, post-traumatic stress, and prolonged grief, with those identifying as female having significantly higher symptom scores. Using multivariate analysis, parental scores for resilience and continuing bonds were associated with higher social functioning scores and parental scores for depressive symptoms and prolonged grief were associated with lower social functioning scores. CONCLUSION Although bereaved parents exhibit resilience and positive coping, they also show high levels of psychosocial distress in the first 2 years after their child's death, which may reflect the typical parental bereavement experience. Screening for low parental social functioning may identify parents who would benefit from additional support early in bereavement.
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Affiliation(s)
- Jennifer M Snaman
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA.,Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Emanuele Mazzola
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - Gabrielle Helton
- Doctor of Medicine Program, University of Colorado School of Medicine, Aurora, CO
| | - Deborah Feifer
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
| | - Sue E Morris
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA.,Department of Psychiatry, Boston Children's Hospital and Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
| | - Lisa Clark
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Justin N Baker
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA.,Department of Pediatrics, Boston Children's Hospital, Boston, MA
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Parents of children with congenital heart defects during the COVID-19 pandemic: An examination of mental health variables, risk factors, and protective factors. Heart Lung 2023; 57:130-139. [PMID: 36194947 PMCID: PMC9515340 DOI: 10.1016/j.hrtlng.2022.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/05/2022] [Accepted: 09/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Little is known about the mental health burden or the factors that contribute to mental health variables in parents of children with congenital heart defects (CHD) during the COVID-19 pandemic. OBJECTIVE The purpose of this study was to examine risk and protective factors associated with anxiety symptoms, depression symptoms, and perceived stress in parents of young children with CHD during the COVID-19 pandemic. METHODS A nonexperimental design was used in this study of 127 parents of children aged newborn to five years with CHD during the COVID-19 pandemic. Regression analyses were conducted to examine associations between COVID-19 stressors, CHD care-related factors, parental resilience, external support, and mental health variables. RESULTS Parental resilience, emotional support, and informational support were key protective factors for anxiety, depression, and stress. However, resilience was remarkably low in CHD parents. Increased levels of anxiety symptoms, depression symptoms, and perceived stress were associated with 1) Exposure to a greater number of COVID-19-related stressors, 2) Distress from family visitation restrictions during healthcare encounters, 3) Worry related to the perceived risk of their CHD child's exposure to COVID-19 during healthcare encounters, and 4) Worry about their CHD child's risk of death or serious illness from COVID-19. CONCLUSIONS The additive impact of the COVID-19 pandemic plus CHD care-related worries on this parent population's mental health is significant. Interventions that promote resilience, address the effect of healthcare system changes, and support the needs of parents of young children with CHD during this and future pandemics are needed.
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12
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Associations among resilience, hope, social support, stress, and anxiety severity in Chinese women with abnormal cervical cancer screening results. Heliyon 2022; 8:e12539. [PMID: 36593859 PMCID: PMC9803708 DOI: 10.1016/j.heliyon.2022.e12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/30/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
This study was to explore the resilience level and its potential correlates and further to evaluate the influence of these resilience-centred variables on anxiety severity among Chinese women with abnormal cervical cancer screening results. One hundred and seventy-five subjects completed self-administered questionnaires to collect relevant variables. The level of resilience of our sample is moderate (70.57 ± 12.14). The data identified hope (β = 0.218), social support (β = 0.247) and perceived stress (β = -0.320) as independent associates for resilience. Finally, among variables, only perceived stress is found to have a direct and positive influence on anxiety severity. Interventions on these variables can be effective for resilience promotion in this population. In addition, anxiety should be preferentially intervened in through the alleviation of perceived stress.
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13
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Chavan SS, Mendonca TL. Effectiveness of Psychosocial Intervention on Quality of Life of Mothers of Children with Cancer: A Feasibility Study. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1758527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
Background Mothers of children with cancer are reported to experience stress more often. For children with cancer, parents are the primary source of social and emotional support, and they are also in charge of how successfully patients manage their illness. The degree of difficulty parents suffer after learning that their child has cancer significantly influences the child's psychological adjustment.
Aim The study aimed to assess the effectiveness of psychosocial intervention on quality of life (QoL) among mothers of children with cancer.
Materials and Methods Quasi-intervention study design was undertaken, and a purposive sampling technique was used to select the 60 mothers of children with cancer who were assigned randomly to the intervention and control groups. A pretested and validated self-administered questionnaire was used; the sociodemographic, WHOQOL-BREF scale with 26 items was studied.
Statistical Analysis Prevalence, demographic pro forma of mother and child was analyzed in terms of frequency, percentage, mean, and standard deviation. Two-factor repeated measures analysis of variance was used to establish the effectiveness of the psychosocial intervention on QoL. Association was done by using the chi-square test. SPSS package was used for analysis.
Results Psychosocial intervention was found to be effective in improving QoL scores in psychological health domain (p = 0.02*, p < 0.05), social relationship domain (p = 0.04*, p < 0.05), and environmental health domain (p = 0.001**, p < 0.05). A significant association was found between the physical health domain and information on cancer (p = 0.01*), psychological health domain and financial status (p = 0.03*), social relationship domain and cost of treatment (p = 0.04*), Q1 and Q2 with the place of residence (p = 0.004**, p = 0.02*), and Q2 and financial status (p = 0.03*).
Conclusion Mothers of children with cancer undergo a lot of stress and emotional turmoil and are at risk of deteriorating their QoL. Hence, they need to be provided support to address their issues. Thus, health professionals must develop and implement interventions to promote the QoL.
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Affiliation(s)
- Seema S. Chavan
- Department of Pediatric Nursing, Father Muller College of Nursing, Mangaluru, Karnataka, India
- Department of Pediatric Nursing, Laxmi Memorial College of Nursing, Mangaluru, Karnataka, India
- Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
| | - Theresa L. Mendonca
- Department of Pediatric Nursing, Father Muller College of Nursing, Mangaluru, Karnataka, India
- Department of Pediatric Nursing, Laxmi Memorial College of Nursing, Mangaluru, Karnataka, India
- Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
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14
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Oftedal A, Bekkhus M, Haugen G, Hjemdal O, Czajkowski NO, Kaasen A. Long-Term Impact of Diagnosed Fetal Anomaly on Parental Traumatic Stress, Resilience, and Relationship Satisfaction. J Pediatr Psychol 2022; 48:181-192. [PMID: 36399086 PMCID: PMC9941832 DOI: 10.1093/jpepsy/jsac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Knowledge regarding the long-term psychological adjustment of parents to children with prenatal diagnosis of congenital malformation is scarce. The aim of this study is to examine traumatic stress trajectories, resilience, and relationship satisfaction among parents to children with prenatal diagnosis of a congenital malformation, and to compare this to a sample of non-affected parents. METHODS A prospective longitudinal cohort study was conducted at a tertiary perinatal referral center. Ninety-three mothers and 80 fathers who received a diagnosis of fetal anomaly during obstetric ultrasound examination (study group), and 110 mothers and 98 fathers with normal ultrasound findings (comparison group), reported their traumatic stress at four timepoints during pregnancy (T1-T4), 6 weeks after birth (T5), and 10-12 years after birth (T6). Resilience and relationship satisfaction was reported at 10-12 years after birth. RESULTS Parents to children with a congenital malformation experienced significantly elevated traumatic stress levels over time, compared with parents of children without congenital malformation. The difference between groups was largest acutely after diagnosis and remained significant 10-12 years after the birth of the child. Resilience and relationship satisfaction levels were similar in both groups. CONCLUSIONS Despite experiencing high levels of traumatic stress over time, parents to children with a congenital malformation reported resilience and relationship satisfaction at similar levels to non-affected parents. This suggests that despite ongoing long-term distress, parents are still able to maintain positive psychological coping resources.
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Affiliation(s)
- Aurora Oftedal
- All correspondence concerning this article should be addressed to Aurora Oftedal, Faculty of Health Science, Oslo Metropolitan University, Pilestredet 32, 0166 Oslo, Norway. E-mail:
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Guttorm Haugen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Nikolai Olavi Czajkowski
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway,Department of Mental Disorders, Norwegian Institute of Public Health, Norway
| | - Anne Kaasen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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15
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House TR, Rosenberg AR, Zimmerman CT, Barton KS, Wightman A. Caregiver perspectives of dialysis initiation for children with kidney disease: a qualitative study. Pediatr Nephrol 2022; 37:2457-2469. [PMID: 35181825 PMCID: PMC10433404 DOI: 10.1007/s00467-022-05472-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND To better support family-centered care surrounding dialysis initiation, greater understanding of caregiver experience is necessary. METHODS Using thematic analysis, we conducted a secondary analysis of semi-structured interview data from a qualitative study of caregivers of children receiving dialysis recruited from 3 pediatric centers. Prominent themes in caregiver experience of caring for a child initiating dialysis were identified. RESULTS Thirty-five caregivers participated. Three major themes emerged from qualitative analysis: (1) parenting disrupted - caregivers experienced an acute disruption in their parenting role due to the unexpected, emergent circumstances and vast information accompanying their child's diagnosis; (2) redefining parenting - caregivers sought to reestablish their innate parental role and foster their evolving medical provider role through reassurance that their child could survive, communication with the medical team, and engaging in care plan development; and (3) leveraging dual identities - to positively impact their child's experience and enable flourishing, caregivers leveraged their established caregiver role and newly realized medical provider role through voicing their perspectives, watching over their child's care, and preparing for future changes in their child's health. If caregivers' evolution was not nurtured and enabled, acute fluctuations in their child's care could contribute to future disruption and need to restore their parental role. However, if caregiver development was fostered, caregivers acquired increased ability to prepare for vacillations in their child's care. CONCLUSIONS Improving delivery of family-centered care and support of caregivers at dialysis initiation will require directed efforts by nephrology care teams to foster caregiver evolution and resilience and respond to the family's changing experience of kidney disease. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Taylor R House
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA.
| | - Abby R Rosenberg
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA
| | - Cortney T Zimmerman
- Department of Pediatric Psychology, Texas Children's Hospital, 6701 Fannin Street 16th Floor, Houston, TX, 77030, USA
| | - Krysta S Barton
- Seattle Children's Research Institute, 1920 Terry Ave, M/S CURE-4, PO Box 5371, Seattle, WA, 98145, USA
| | - Aaron Wightman
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA
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16
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Burles M, Bally JMG, Holtslander L, Zimmer M, Hodgson-Viden H. Supporting parental caregivers of seriously ill children: findings from a feasibility and acceptability study of a hope intervention. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2119975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Meridith Burles
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jill M. G. Bally
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Lorraine Holtslander
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Heather Hodgson-Viden
- Department of Pediatrics, Saskatchewan Health Authority, Saskatoon, SK, Canada
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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17
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Affiliation(s)
- Douglas L Hill
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Chris Feudtner
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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18
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Pediatric Cancer as a Factor of Changes in the Family. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095002. [PMID: 35564396 PMCID: PMC9105820 DOI: 10.3390/ijerph19095002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
The occurrence of pediatric cancer is an example of a non-normative situation that reorganizes family life. The aim of the study was to evaluate the functioning of a family with a child affected by cancer. The study was conducted on 339 families. The study group consisted of 153 families with children with cancer (mean age 36.4 ± 6.8 years). The control group was composed of 186 families with healthy children (mean age 39.0 ± 6.3 years). All of them completed the author’s survey questionnaire on family functioning and the Resilience Measurement Scale (RMS). A statistically significant association was found between the place of residence (p < 0.001), education (p < 0.001), assessment of the material status (p < 0.001) and employment structure (p < 0.001) of parents and the membership in the study group or the control group. Statistical significance was achieved for the main effects as measured on the RMS (5 factors and 2 groups). The study group showed consistently lower levels of the factors of the scale. Statistically significant observations were reported for Factor 1 (perseverance, proactive approach) and Factor 4 (tolerance to failure, life as a challenge) (12.0 vs. 14.5, p < 0.001, 13.4 vs. 14.2, p = 0.04, respectively). Parents of children with cancer were characterized by lower persistence, determination and tolerance to failure, which could affect the quality of life of the whole family. In addition, different socio-economic conditions of family functioning were found in families with children with cancer as compared to families with healthy children.
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19
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Bates CR, Fairclough D, Noll RB, Barrera ME, Kupst MJ, Egan AM, Gartstein MA, Ach EL, Gerhardt CA, Vannatta KA. Psychosocial functioning of caregivers of pediatric brain tumor survivors. Pediatr Blood Cancer 2022; 69:e29565. [PMID: 35044078 PMCID: PMC8860870 DOI: 10.1002/pbc.29565] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/06/2021] [Accepted: 12/23/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Assessment of caregiver needs is a recommended standard of care in pediatric oncology. Caregivers of pediatric brain tumor survivors (PBTS) are a subgroup that may be at highest psychosocial risk. This study examined psychosocial functioning of caregivers of PBTS in comparison to caregivers of youth without cancer history. We hypothesized that caregivers of PBTS would exhibit more psychological symptoms, higher caregiver burden, and lower perceptions of social support than caregivers of comparison youth. PROCEDURE As part of a five-site study, we utilized a matched sample design to evaluate psychosocial functioning of 301 caregivers of 189 PBTS (ages 8-15) who were 1-5 years post treatment, and 286 caregivers of 187 comparison youth matched for sex, race, and age. Caregivers completed measures of psychological symptoms, caregiver burden, and perceptions of social support. Repeated measures mixed models compared outcomes between groups and examined differences based on caregiver sex. Socioeconomic status (SES) was examined as a moderator of significant main effects. RESULTS Caregivers of PBTS reported similar levels of psychological symptoms to caregivers of comparison youth. Mothers of PBTS mothers reported higher caregiver burden and lower perceptions of social support than mothers of comparison youth. Low SES exacerbated group differences in caregiver burden. CONCLUSIONS Mothers of PBTS may have more caregiving responsibilities and perceive less social support, but reported similar levels of psychological symptoms to comparison mothers; fathers of PBTS were similar to comparison fathers. The mechanisms involved in this complex psychosocial dynamic require further investigation.
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Affiliation(s)
- Carolyn R. Bates
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS
| | - Diane Fairclough
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Robert B. Noll
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Maru E. Barrera
- Division of Hematology/Oncology, Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mary Jo Kupst
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anna M. Egan
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO,University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
| | | | - Emily L. Ach
- Department of Psychiatry, Stanford University School of Medicine, Stanford, California, USA
| | - Cynthia A. Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Kathryn A. Vannatta
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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20
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Baum LV, Koyama T, Schremp EA, Zhang K, Rodweller CA, Roth MC, Compas BE, Friedman DL. Posttraumatic stress symptoms and financial toxicity among adolescent and young adult oncology patients and their caregivers at cancer diagnosis. Cancer 2022; 128:2005-2014. [PMID: 35226364 DOI: 10.1002/cncr.34146] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/19/2022] [Accepted: 01/31/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Adolescent and young adult oncology (AYAO) patients and caregivers may experience significant psychosocial dysfunction and financial toxicity. Understanding early risk factors is critical to improving survivorship trajectories. METHODS The authors conducted a cross-sectional study of baseline survey data from a prospective cohort of AYAO patient-caregiver dyads enrolled within 1 month of medical oncology treatment initiation. Posttraumatic stress symptoms (PTSS) were measured by the Impacts of Events Scale-Revised, and financial toxicity was measured with the Comprehensive Score (COst). The authors fit models of linear association between PTSS, financial toxicity, and other end points and pairwise associations of PTSS and financial toxicity within dyads. RESULTS The analytic cohort contained 41 patients, 37 caregivers, and 34 complete dyads. Clinically-concerning PTSS were observed among patients (44%) and caregivers (52%). The median COst scores were 20.0 for patients (quartiles, 12.5-29.5) and 22.0 for caregivers (quartiles, 12.8-26.0), which were consistent with high financial toxicity (patients, 46%; caregivers, 44%). PTSS were positively associated with financial toxicity (P = .013 for patients, P = .039 for caregivers), subjective distress (P < .001 for all), depressive (P < .001 for all) and anxiety symptoms (P = .005 for patients, P = .024 for caregivers), and poorer quality of life (P < .001 for patients, P = .003 for caregivers). A significant paired association was not found in PTSS (Pearson correlation coefficient [PCC], 0.23; 95% confidence interval [CI], -0.15 to 0.56). Financial toxicity was positively associated within dyads (PCC, 0.65; 95% CI, 0.36-0.83). CONCLUSIONS At diagnosis, AYAO patients and caregivers exhibit substantial PTSS, which are associated with greater financial toxicity and other psychosocial distress.
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Affiliation(s)
- Laura V Baum
- Division of Hematology/Oncology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Master of Public Health Program, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.,Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Emma A Schremp
- Vanderbilt Institute for Clinical and Translational Research, Nashville, Tennessee
| | - Kevin Zhang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Casey A Rodweller
- Vanderbilt Institute for Clinical and Translational Research, Nashville, Tennessee
| | - Marissa C Roth
- Psychological Sciences, Vanderbilt University, Nashville, Tennessee
| | - Bruce E Compas
- Vanderbilt Ingram Cancer Center, Nashville, Tennessee.,Psychological Sciences, Vanderbilt University, Nashville, Tennessee
| | - Debra L Friedman
- Vanderbilt Ingram Cancer Center, Nashville, Tennessee.,Division of Pediatric Hematology Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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21
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Luo Y, Wang A, Zeng Y, Zhang J. A latent class analysis of resilience and its relationship with depressive symptoms in the parents of children with cancer. Support Care Cancer 2022; 30:4379-4387. [DOI: 10.1007/s00520-022-06860-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022]
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22
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Arora T, Grey I, Östlundh L, Alamoodi A, Omar OM, Hubert Lam KB, Grandner M. A systematic review and meta-analysis to assess the relationship between sleep duration/quality, mental toughness and resilience amongst healthy individuals. Sleep Med Rev 2022; 62:101593. [DOI: 10.1016/j.smrv.2022.101593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
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23
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Chu Y, Zhang Y, Wang S, Dai H. Resilience mediates the influence of hope, optimism, social support, and stress on anxiety severity among Chinese patients with cervical spondylosis. Front Psychiatry 2022; 13:997541. [PMID: 36213904 PMCID: PMC9539388 DOI: 10.3389/fpsyt.2022.997541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Cervical spondylosis (CS) is a potential stressor threatening mental health among affected individuals. This study was to analyze resilience level and associated factors among cervical spondylosis (CS) patients, and to explore the underlying mechanism of anxiety based on resilience-focused psychological variables. METHODS Resilience Scale-14 (RS-14), Zung Self-Rating Anxiety Scale (SAS), Herth Hope Index (HHI), Revised Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale-10 (PSS-10) were used in this cross-sectional investigation among 250 CS patients. RESULTS The score of resilience was 65.58 ± 16.14. Hierarchical linear regression analysis revealed that hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases were the independent associates of resilience among CS patients, which explained 63.9% of the total variance. The structural equation model showed that hope, optimism, perceived social support and perceived stress affected anxiety via resilience, and hope and optimism also had direct effects on anxiety. CONCLUSION Chinese patients with CS had moderate level of mental resilience, which was independently related to hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases. Resilience played a mediating role between various psychological variables and anxiety. Improving the level of resilience, hope, optimism and perceived social support and reducing the level of perceived stress are important strategies to reduce anxiety level. Relevant healthcare professionals should put more focus on the mental problems of Chinese CS patients and help maintain good psychological status by improving their resilience and associated psychological variables thereof.
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Affiliation(s)
- Yuying Chu
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Yuqiang Zhang
- The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Suyan Wang
- Centre for Mental Health Guidance, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Hongliang Dai
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
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24
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Eche IJ, Yusufov M, Isibor DA, Wolfe J. A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes. Pediatr Blood Cancer 2021; 68:e29328. [PMID: 34523798 DOI: 10.1002/pbc.29328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/28/2021] [Accepted: 08/13/2021] [Indexed: 11/11/2022]
Abstract
Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p = .97) and depression (-0.56, 95% CI: -1.65, 0.54, p = .32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.
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Affiliation(s)
- Ijeoma Julie Eche
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Miryam Yusufov
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
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25
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Feudtner C, Nye RT, Boyden JY, Schwartz KE, Korn ER, Dewitt AG, Waldman AT, Schwartz LA, Shen YA, Manocchia M, Xiao R, Lord BT, Hill DL. Association Between Children With Life-Threatening Conditions and Their Parents' and Siblings' Mental and Physical Health. JAMA Netw Open 2021; 4:e2137250. [PMID: 34928360 PMCID: PMC8689391 DOI: 10.1001/jamanetworkopen.2021.37250] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Despite concerns regarding the potential deleterious physical and mental health outcomes among family members of a child with a life-threatening condition (LTC), few studies have examined empirical measures of health outcomes among these family members. OBJECTIVES To examine whether mothers, fathers, sisters, and brothers of children with 1 of 4 types of pediatric LTCs have higher rates of health care encounters, diagnoses, and prescriptions compared with families of children without these conditions. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included US families with commercial insurance coverage from a single carrier. Children who had 1 of 4 LTCs (substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe neurologic impairment) were identified by a diagnosis in their insurance claim data between July 1, 2015, and June 30, 2016. Each case child and their family was matched with up to 4 control children and their families based on the age of the case and control children. Data were analyzed between August 2020 and March 2021. EXPOSURES Having a child or sibling with substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe and progressive neurologic impairment. MAIN OUTCOMES Rates of occurrence of health care encounters, physical and mental health diagnoses, and physical and mental health medication prescriptions, identified from insurance claims data, were compared between case and control families using a multivariable negative binomial regression model. The statistical analysis adjusted for observed differences between case and control families and accounted for clustering at the family level. RESULTS The study included 25 528 children (6909 case children [27.1%] and 18 619 control children [72.9%]; median age, 6.0 years [IQR, 1-13 years]; 13 294 [52.1%] male), 43 357 parents (11 586 case parents [26.7%] and 31 771 control parents [73.3%]; mean [SD] age, 40.4 [8.1] years; 22 318 [51.5%] female), and 25 706 siblings (7664 case siblings [29.8%] and 18 042 control siblings [70.2%]; mean [SD] age, 12.1 [6.5] years; 13 114 [51.0%] male). Overall, case mothers had higher rates of the composite outcome of health care encounters, diagnoses, and prescriptions compared with control mothers (incident rate ratio [IRR], 1.61; 95% CI, 1.54-1.68), as did case fathers compared with control fathers (IRR, 1.55; 95% CI, 1.46-1.64). Sisters of children with LTCs had higher rates of the composite outcome compared with sisters of children without LTCs (IRR, 1.68; 95% CI, 1.55-1.82), as did brothers of children with LTCs compared with brothers of children without LTCs (IRR, 1.70; 95% CI, 1.56-1.85). CONCLUSIONS AND RELEVANCE In this cohort study, mothers, fathers, sisters, and brothers who had a child or sibling with 1 of 4 types of LTCs had higher rates of health care encounters, diagnoses, and medication prescriptions compared with families who did not have a child with that condition. The findings suggest that family members of children with LTCs may experience poorer mental and physical health outcomes. Interventions for parents and siblings of children with LTCs that aim to safeguard their mental and physical well-being appear to be warranted.
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Affiliation(s)
- Chris Feudtner
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of General Pediatrics, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Russell T. Nye
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jackelyn Y. Boyden
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Katherine E. Schwartz
- Division of Neonatology, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Emilie R. Korn
- Division of General Pediatrics, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Aaron G. Dewitt
- Division of Cardiology, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Amy T. Waldman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Lisa A. Schwartz
- Division of Oncology, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | | | - Michael Manocchia
- Cigna, Bloomfield, Connecticut
- Department of Sociology, University of North Florida, Jacksonville
| | - Rui Xiao
- Division of General Pediatrics, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | | | - Douglas L. Hill
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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Luo Y, Xia W, Cheung AT, Ho LLK, Zhang J, Xie J, Xiao P, Li HCW. Effectiveness of a Mobile Device-Based Resilience Training Program in Reducing Depressive Symptoms and Enhancing Resilience and Quality of Life in Parents of Children With Cancer: Randomized Controlled Trial. J Med Internet Res 2021; 23:e27639. [PMID: 34847060 PMCID: PMC8669578 DOI: 10.2196/27639] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/21/2021] [Accepted: 10/05/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Caring for children with cancer can be a stressful experience for parents and may have negative effects on their physical and psychological well-being. Although evidence has shown that resilience is associated with positive psychological well-being, few interventions have been specifically designed to enhance the resilience of parents of children with cancer. OBJECTIVE The aim of this study is to examine the effectiveness of a mobile device-based resilience training program in reducing depressive symptoms and enhancing resilience and quality of life (QoL) in parents of children with cancer. METHODS Parents of children diagnosed with cancer were recruited from the pediatric oncology wards of 3 tertiary hospitals in China. The participants were randomly assigned to either the experimental group (52/103, 50.5%) to undergo an 8-week mobile device-based resilience training program or to the control group (51/103, 49.5%) to receive an 8-week program of placebo information. The study outcomes included resilience, depressive symptoms, and QoL, as measured by the Connor-Davidson Resilience Scale, the Self-Rating Depression Scale, and the Short Form of the 6-Dimension Health Survey, respectively. All data were collected at baseline and at 2 and 6 months of follow-up. The data analysis followed the intention-to-treat principle. A generalized estimating equation was used to examine the effects of the intervention. RESULTS The participants were mostly female (72/103, 69.9%), and their mean age was 33.6 (SD 5.2) years. The participants in the experimental group showed significantly higher levels of resilience (mean 67.96, SD 15.8 vs mean 58.27, SD 19.0; P<.001) and lower levels of depressive symptoms (mean 40.17, SD 9.9 vs mean 46.04, SD 10.9; P<.001) than those in the control group at 6 months of follow-up. The intervention showed statistically significant effects in improving resilience (β=6.082; P=.01) and decreasing depressive symptoms (β=-2.772; P=.04) relative to the control group. The QoL score in the experimental group was higher than that in the control group at 6 months of follow-up (mean 0.79, SD 0.2 vs mean 0.76, SD 0.3; P=.07); however, no statistically significant intervention effect was detected (β=.020; P=.38). CONCLUSIONS The mobile device-based resilience training program effectively enhanced resilience and alleviated depressive symptoms in parents of children with cancer. It is highly recommended that health care professionals incorporate this resilience training program when providing psychological care to parents of children with cancer. TRIAL REGISTRATION Clinical.Trials.gov NCT04038242; http://clinicaltrials.gov/ct2/show/NCT04038242.
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Affiliation(s)
- Yuanhui Luo
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Wei Xia
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Ankie Tan Cheung
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Laurie Long Kwan Ho
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jianhui Xie
- Department of Nursing, Hunan Children's Hospital, Changsha, China
| | - Pin Xiao
- Department of Hematology, Hunan Children's Hospital, Changsha, China
| | - Ho Cheung William Li
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Dionne-Odom JN, Azuero A, Taylor RA, Wells RD, Hendricks BA, Bechthold AC, Reed RD, Harrell ER, Dosse CK, Engler S, McKie P, Ejem D, Bakitas MA, Rosenberg AR. Resilience, preparedness, and distress among family caregivers of patients with advanced cancer. Support Care Cancer 2021; 29:6913-6920. [PMID: 34031751 PMCID: PMC9733586 DOI: 10.1007/s00520-021-06265-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Resilience has been proposed as a primary factor in how many family caregivers of patients with advanced cancer are able to resist psychological strain and perform effectively in the role while bearing a high load of caregiving tasks. To evaluate this hypothesis, we examined whether self-perceived resilience is associated with distress (anxiety and depressive symptoms), caregiver preparedness, and readiness for surrogate decision-making among a racially diverse sample of family caregivers of patients with newly diagnosed advanced cancer. METHODS Secondary analysis of baseline data from two small-scale, pilot clinical trials that both recruited family caregivers of patients with newly diagnosed advanced cancer. Using multivariable linear regression, we analyzed relationships of resilience as a predictor of mood, caregiving preparedness, and readiness for surrogate decision-making, controlling for sociodemographics. RESULTS Caregiver participants (N = 112) were mean 56 years of age and mostly female (76%), the patient's spouse/partner (52%), and White (56%) or African-American/Black (43%). After controlling for demographics, standardized results indicated that higher resilience was relevantly associated with higher caregiver preparedness (beta = .46, p < .001), higher readiness for surrogate decision-making (beta = .20, p < .05) and lower anxiety (beta = - .19, p < .05), and depressive symptoms (beta = - .20, p < .05). CONCLUSIONS These results suggest that resilience may be critical to caregivers' abilities to manage stress, be effective sources of support to patients, and feel ready to make future medical decisions on behalf of patients. Future work should explore and clinicians should consider whether resilience can be enhanced in cancer caregivers to optimize their well-being and ability to perform in the caregiving and surrogate decision-making roles.
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Affiliation(s)
| | - Andres Azuero
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Richard A Taylor
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Rachel D Wells
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Bailey A Hendricks
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Avery C Bechthold
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Rhiannon D Reed
- Comprehensive Transplant Institute, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Erin R Harrell
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Chinara K Dosse
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Sally Engler
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Peggy McKie
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Deborah Ejem
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Marie A Bakitas
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Abby R Rosenberg
- Division of Hematology-Oncology, Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Seattle, WA, USA
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Gise J, Cohen LL. Social Support in Parents of Children With Cancer: A Systematic Review. J Pediatr Psychol 2021; 47:292-305. [PMID: 34643692 DOI: 10.1093/jpepsy/jsab100] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Parents of children with cancer (PCCs) experience stress as they navigate managing their child's illness. Arguably, social support is critical to PCCs' well-being. This review examines the literature on social support in PCCs. METHODS Studies of social support in PCCs were collected from PsycINFO, CINHAL, and MEDLINE. Data were extracted from 37 studies published between January 2010 and May 2021 related to the conceptualization, measurement, and availability of social support in PCCs. Relationships between PCCs' social support, well-being, and unique parent and child factors were also synthesized. Risks of biases were assessed using domains of the Effective Public Health Practice Project. RESULTS Social support in PCCs is conceptualized as (a) perceived availability and satisfaction with social support and (b) social support seeking as a coping strategy. Parents of children with cancer report receiving as much or more support than typical adults, but PCCs engage in less social support seeking. Family and significant others are the most prevalent sources of support, and emotional support is the most received type of social support. Social support is positively related to well-being and negatively related to distress, anxiety, and posttraumatic stress. Findings related to social support differences based on parent and child unique factors were minimal and present opportunities for future research. The risk of bias was generally low, with caution that most studies cannot demonstrate directionality of findings due to cross-sectional study designs. CONCLUSIONS Given the consistent positive association between social support and well-being in PCCs, clinicians should assess and encourage social support for this vulnerable population.
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Affiliation(s)
- Jensi Gise
- Department of Psychology, Georgia State University, USA
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29
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Rosenberg AR, Steiner J, Lau N, Fladeboe K, Toprak D, Gmuca S, O'Donnell MB, Smith K, Brown CE, Yi-Frazier JP. From Theory to Patient Care: A Model for the Development, Adaptation, and Testing of Psychosocial Interventions for Patients With Serious Illness. J Pain Symptom Manage 2021; 62:637-646. [PMID: 33677072 PMCID: PMC8418616 DOI: 10.1016/j.jpainsymman.2021.02.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
Psychosocial and supportive care interventions are a cornerstone of palliative care science, yet there is little published guidance regarding how to develop, test, adapt, and ultimately disseminate evidence-based interventions. Our objective was to describe the application of a single intervention-development model in multiple populations of patients with serious illness. Specifically, we use the "Promoting Resilience in Stress Management" (PRISM) intervention as an exemplar for how the Obesity Related Behavioral Intervention Trials (ORBIT) intervention-development model may be applied to: 1) create an initial palliative care intervention; 2) adapt an existing intervention for a new patient-population; 3) expand an existing intervention to include new content; and, 4) consider dissemination and implementation of a research-proven intervention. We began by identifying key psychological and social science theories and translating them a testable clinical hypothesis. Next, we conducted observational studies and randomized trials to design, refine, and standardize PRISM within unique patient-populations. We moved backwards in the ORBIT model when necessary to adapt or expand PRISM content and delivery-strategies to meet patient-reported needs. Finally, we began to explore PRISM's effectiveness using Dissemination and Implementation research methods. Key lessons include the need to ground intervention-development in evidence-based theory; involve patient, clinician, and other stakeholders at every phase of development; "meet patients where they are at" with flexible delivery strategies; invest in the time to find the right scientific premise and the right intervention content; and, perhaps most importantly, involve an interdisciplinary research team.
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Affiliation(s)
- Abby R Rosenberg
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
| | - Jill Steiner
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Nancy Lau
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Child Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Kaitlyn Fladeboe
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Demet Toprak
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Sabrina Gmuca
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA; Division of Rheumatology, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania and Center for Pediatric Clinical Effectiveness and PolicyLab at Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maeve B O'Donnell
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA
| | - Kiska Smith
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA
| | - Crystal E Brown
- Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, WA, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Center for Clinical and Translational Science, Seattle Children's Research Institute, Seattle, WA, USA
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30
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Shimizu Y, Hayashi A, Maeda I, Miura T, Inoue A, Takano M, Aoyama M, Matsuoka YJ, Morita T, Kizawa Y, Tsuneto S, Shima Y, Masukawa K, Miyashita M. Changes in depressive symptoms among family caregivers of patients with cancer after bereavement and their association with resilience: A prospective cohort study. Psychooncology 2021; 31:86-97. [PMID: 34343380 PMCID: PMC9292523 DOI: 10.1002/pon.5783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
Objectives To elucidate changes in depressive symptoms after bereavement and the impact of pre‐loss resilience on such changes and on the extent of complicated grief and posttraumatic growth. Methods Prospective cohort surveys were provided to family caregivers of patients with cancer in four palliative care units (PCUs) before and after bereavement. Pre‐loss Connor–Davidson Resilience Scale scores, pre‐ and post‐loss Patient Health Questionnaire‐9 scores, post‐loss Brief Grief Questionnaire scores, and the expanded Posttraumatic Growth Inventory scores were determined. Results Out of 186 bereaved family caregivers, 71 (38.2%) responses were analyzed, among which 47% pre‐loss and 15% post‐loss responses suggested to be a high risk for major depressive disorder (MDD). Approximately 90% of family caregivers at a high risk for post‐loss MDD were already at a high risk for pre‐loss MDD. Even after adjustment of the background variables as covariates, the interaction effect between family caregivers' pre‐loss depressive symptoms and resilience on post‐loss depressive symptoms was observed (F = 7.29; p < 0.01). Moreover, pre‐loss resilience was not associated with other bereavement outcome measures. Conclusions Among family caregivers of patients with cancer in PCUs, 47% and 15% had high risk for MDD before and after bereavement, respectively. Moreover, pre‐loss resilience mitigated post‐loss depressive symptoms among family caregivers who had high risk for MDD before bereavement. However, considering the study's small sample size, further research is needed.
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Affiliation(s)
- Yoichi Shimizu
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan.,Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akitoshi Hayashi
- Department of Palliative Care, St. Luke's International Hospital, Tokyo, Japan
| | - Isseki Maeda
- Department of Palliative Care, Senri-Chuo Hospital, Toyonaka, Japan
| | - Tomofumi Miura
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mayuko Takano
- Department of Nursing, St. Luke's International Hospital, Tokyo, Japan
| | - Maho Aoyama
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Tatsuya Morita
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Kento Masukawa
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Yan Z, Zhang Q, Chang L, Liu Y, Li Y. Dyadic effects of family resilience on post-traumatic stress symptoms among breast cancer patients and their primary family caregivers: A cross-sectional study. Eur J Oncol Nurs 2021; 53:101998. [PMID: 34294577 DOI: 10.1016/j.ejon.2021.101998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE The aims of this study were to verify actor and partner effects, by examining the effects of family resilience on post-traumatic stress symptoms (PTSS) among Chinese breast cancer patients and their primary family caregivers. METHODS In this cross-sectional study, 104 breast cancer patients (age range 20-75, Mean = 47, Standard Deviation = 10), and their principal caregivers (n = 104), were recruited from a comprehensive cancer center of a public hospital in China. The patients and their caregivers self-reported sociodemographic, family resilience, and PTSS factors. The actor-partner interdependence model were adopted to examine whether the patients and caregivers' perceived family resilience could contribute to their own ("actor effect") and each other's ("partner effect") PTSS. RESULTS There were significant correlations between patients' and caregivers' shortened Chinese version of Family Resilience Assessment Scale scores (r = 0.58, p < 0.01) and Post-traumatic Stress Disorder Checklist-Civilian Version scores (r = 0.69, p < 0.01). Caregivers' perceived family resilience was negatively related to their PTSS (actor effect), and the patients' PTSS (partner effect). However, the patients' perceived family resilience was not significantly related to their or the caregivers' PTSS. CONCLUSIONS The primary caregivers' perceived family resilience had both actor and partner effects on patient/caregiver PTSS within the first year of breast cancer diagnosis. Family-based interventions should be designed to enhance family resilience to decrease PTSS within families dealing with cancer patients. Supportive care should focus on the primary family caregivers within the first year of breast cancer diagnosis.
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Affiliation(s)
- Zeping Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Qin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Lixia Chang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Ye Liu
- Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, 200011, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
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Sánchez-Rubio L, Cleveland LM, Durán de Villalobos MM, McGrath JM. Parental Decision-Making in Pediatric Intensive Care: A Concept Analysis. J Pediatr Nurs 2021; 59:115-124. [PMID: 33848782 DOI: 10.1016/j.pedn.2021.03.018] [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: 07/09/2020] [Revised: 02/23/2021] [Accepted: 03/18/2021] [Indexed: 11/15/2022]
Abstract
The development of nursing knowledge requires a close relationship between theory, research, and practice. The purpose of the analysis of the concept of "parental decision-making in pediatric critical care" is to facilitate nurses' therapeutic care of critically ill children and their families. To construct, structure, and give meaning to the concept, we use our experience in the field, critical reading of the literature, and careful analysis of data that have emerged about parental decision-making in pediatric intensive care. Several factors affect parent's ability to act as decision-makers: the psychosocial and physical disorders they develop, the subordination of their parental roles by the health care team, and the child's critical state of health. While different disciplines, including nursing, have well described the decision-making concept, parental decision-making in the context of pediatric intensive care has not been as well delineated. Nursing science recognizes the importance of decision-making and has incorporated the concept as an essential domain of its philosophical and disciplinary interests. Following the method proposed by Walker and Avant, the concept was analyzed, attributes, background, and consequences described. A model case was presented and discussed. An operational definition emerges, providing knowledge for professional nursing practice and will be the basis for an essential theoretical development around this phenomenon. Parents' recognition, the promotion of family-centered care, and shared decisions are ideal for encouraging parental participation.
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Affiliation(s)
- Lorena Sánchez-Rubio
- Programa de Enfermería, Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Colombia.
| | - Lisa M Cleveland
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | | | - Jacqueline M McGrath
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
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Dolan JG, Hill DL, Faerber JA, Palmer LE, Barakat LP, Feudtner C. Association of psychological distress and religious coping tendencies in parents of children recently diagnosed with cancer: A cross-sectional study. Pediatr Blood Cancer 2021; 68:e28991. [PMID: 33844421 PMCID: PMC8285076 DOI: 10.1002/pbc.28991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Parents of children with cancer exhibit high levels of psychological distress. Parents of children with serious illness report religion and spirituality are important coping resources. We sought to describe characteristics of religion, religious coping, social support, and resiliency in parents of children newly diagnosed with cancer and examine associations between psychological distress and self-reported religious coping, religiosity, resiliency, and social support. PATIENTS AND METHODS Cross-sectional observational study of 100 parents of 81 unique children recently diagnosed with cancer. Parents provided demographic information and completed measures of psychological distress, importance of religion, religious coping, resiliency, and social support. Patients' type of tumor and intensity of treatment were collected by medical record abstraction. RESULTS Compared to nationally reported data for adults, parents of children with cancer reported high scores for psychological distress but similar levels of religiosity, religious coping, and resiliency. Negative religious coping (feelings of negativity related to the divine) was associated with higher levels of psychological distress. This effect was most prominent in parents who reported the highest levels of religiosity. Positive religious coping, religiosity, and social support were not associated with levels of psychological distress. DISCUSSION Findings confirm high levels of distress for parents of children with cancer. Negative religious coping was associated with higher levels of psychological distress but positive religious coping, religiosity, and other coping factors were not found to be significantly associated with distress. Further assessment of negative religious coping to inform interventions to promote resiliency is warranted as they may impact parental decision-making and care.
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Affiliation(s)
- J. Gregory Dolan
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Douglas L. Hill
- The Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jennifer A. Faerber
- Healthcare Analytics Unit, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Laura E. Palmer
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA,Dept of Spiritual Care, Patient and Family Services, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lamia P. Barakat
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA,Department of Pediatrics, Division of Oncology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Chris Feudtner
- The Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA,Department of Pediatrics, Medical Ethics and Health Policy, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Psychological interventions for enhancing resilience in parents of children with cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 29:7101-7110. [PMID: 34131847 DOI: 10.1007/s00520-021-06344-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Caring for children with cancer is considerably stressful for parents and may negatively affect their physical and psychological well-being. Resilience plays a pivotal role in maintaining psychological well-being in the face of stress and adversity. The aim of this systematic review was to evaluate the effectiveness of psychological interventions in promoting resilience among parents of children with cancer. METHODS Five English databases and two Chinese databases were subjected to a systematic search from inception to March 2020. The methodological quality of the included randomised controlled trials was evaluated using the Cochrane risk of bias tool (RoB 2.0). Meta-analyses and descriptive analyses were used. Subgroup analyses of the intervention modes and time since diagnosis were also conducted. RESULTS Five studies involving 308 participants were included. The systematic review identified three types of psychological intervention, namely resilience training, self-disclosure and peer support, which had different essential components and characteristics. The meta-analyses of three randomised controlled trials revealed that the psychological interventions enhanced parents' resilience with a large effect size (Hedges' adjusted g 0.92; 95% CI 0.22, 1.62; p = .01). CONCLUSION Evidence supports the effectiveness of psychological interventions for enhancing resilience in the parents of children with cancer. Healthcare professionals can incorporate evidence-based psychological interventions to enhance resilience to help these parents better navigate adversity, adapt to their children's situations and improve their psychological well-being.
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Xie Q, Wong DFK. Culturally sensitive conceptualization of resilience: A multidimensional model of Chinese resilience. Transcult Psychiatry 2021; 58:323-334. [PMID: 33043831 DOI: 10.1177/1363461520951306] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cultural sensitivity is missing in the widely researched construct of resilience. The assumption that resilience takes the same form in all cultures fails to acknowledge that culture shapes the interpretation and instantiation of resilience. Examining how suffering and adversity are perceived and dealt with in Chinese contexts, can identify cultural concepts related to resilience. In this paper, we examine the ways in which Confucianism, Buddhism, and Taoism, the three main belief systems that have influenced Chinese people's perception of the nature of life, can serve as sources of strength to individuals facing adversity. We summarise three culturally inflected elements of dealing with adversities and compare them with existing, widely researched notions of resilience. Taking a socio-ecological perspective to explore resilience, this paper proposes a multidimensional model that can improve understanding of culturally embedded resilience.
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Affiliation(s)
- Qiuyuan Xie
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai 519087, China
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36
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Chardon ML, Brammer C, Madan-Swain A, Kazak AE, Pai ALH. Caregiver Religious Coping and Posttraumatic Responses in Pediatric Hematopoietic Stem Cell Transplant. J Pediatr Psychol 2021; 46:465-473. [PMID: 33517435 DOI: 10.1093/jpepsy/jsaa126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Caregivers often experience their child's hematopoietic stem cell transplant (HCT) treatment as traumatic. Although many caregivers develop posttraumatic stress symptoms (PTSS) in response to supporting their child through HCT, other caregivers demonstrate posttraumatic growth (PTG). Religious coping may contribute to these different adjustment trajectories; however, more information is needed to clarify the unique associations of positive versus negative religious coping on caregiver PTSS and PTG in the context of pediatric HCT. This study aimed to examine the relationships between negative and positive religious coping on caregivers PTSS and PTG while controlling for caregiver sex, self-efficacy, and social support. METHODS Caregivers (N = 140) of youth admitted to the hospital for their first HCT were asked to complete self-report measures of their use of positive and negative religious coping, PTSS, PTG, social support, and self-efficacy. Two hierarchical linear regressions were conducted to test hypotheses. RESULTS Greater positive religious coping, but not negative religious coping, was associated with caregivers reporting more PTG in response to pediatric HCT. More negative religious coping, but not positive religious coping, was associated with caregivers experiencing greater PTSS. CONCLUSIONS Engaging in positive religious coping appears to promote better caregiver adjustment to pediatric HCT, whereas negative religious coping may increase caregiver risk for developing PTSS. Screening caregivers' religious beliefs, including the type of religious coping they employ, could inform providers regarding the best approach to supporting caregivers towards a growth trajectory and mitigate PTSS.
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Affiliation(s)
- Marie L Chardon
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Caitlin Brammer
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Avi Madan-Swain
- Division of Pediatric Hematology and Oncology, University of Alabama at Birmingham
| | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System.,Department of Pediatrics, Thomas Jefferson University
| | - Ahna L H Pai
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine
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Khosrobeigi M, Hafezi F, Naderi F, Ehteshamzadeh P. Effectiveness of self-compassion training on hopelessness and resilience in parents of children with cancer. Explore (NY) 2021; 18:357-361. [PMID: 33906814 DOI: 10.1016/j.explore.2021.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/31/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES the psychological state of parents, who are considered the primary caregivers of a sick child, can affect the child's behavior and emotions. This study analyzed the effectiveness of self-compassion training on hopelessness and resilience in the parents of children with cancer. METHODS this was an experimental study with a pre-test and post-test design and a control group. The statistical population included all parents of children with cancer hospitalized in Amir Kabir Hospital of Arak in 2020. The research sample consisted of 30 parents of children with cancer selected through convenience sampling. The participants were equally divided into experimental (n = 15) and control (n = 15) groups at random. The research instruments were the Connor-Davidson Resilience Scale (CD-RISC) and the Beck Hopelessness Scale (BHS). The experimental group underwent eight 90 min sessions of self-compassion training on a weekly basis. Finally, the multivariate analysis of covariance (MANCOVA) was employed for data analysis. RESULTS the mean (±SD) of the post-test scores of hopelessness and resilience were reported 10.20 (±4.95) and 43.33 (±4.27), respectively, in the experimental group, whereas they were reported 13.78 (±4.94) and 38.73 (±4.07), respectively, in the control group. According to the results, self-compassion training had significant effects on the resilience and hopelessness of the parents of children with cancer (p < 0.01). Self-compassion training had a positive, significant effect on their resilience. It was also efficient in decreasing their hopelessness. CONCLUSIONS self-compassion training improved resilience and mitigated hopelessness in the parents of children with cancer.
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Affiliation(s)
- Mostafa Khosrobeigi
- Department of Health Psychology, Khorramshahr-Persian Gulf International Branch, Islamic Azad University, Khorramshahr, Iran
| | - Fariba Hafezi
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran.
| | - Farah Naderi
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
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Luo YH, Li WHC, Cheung AT, Ho LLK, Xia W, He XL, Zhang JP, Chung JOK. Relationships between resilience and quality of life in parents of children with cancer. J Health Psychol 2021; 27:1048-1056. [PMID: 33522296 DOI: 10.1177/1359105321990806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
CLINICALTRIALS.GOV ID NCT03631485.
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Affiliation(s)
- Y H Luo
- University of Hong Kong, Hong Kong
| | - W H C Li
- University of Hong Kong, Hong Kong
| | | | - L L K Ho
- University of Hong Kong, Hong Kong
| | - W Xia
- University of Hong Kong, Hong Kong
| | - X L He
- People's Hospital of Hunan Province, China
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Barakat LP, Madden RE, Vega G, Askins M, Kazak AE. Longitudinal predictors of caregiver resilience outcomes at the end of childhood cancer treatment. Psychooncology 2021; 30:747-755. [PMID: 33432694 DOI: 10.1002/pon.5625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Caregiver resilience in the context of childhood cancer treatment has been described using cross-sectional and retrospective studies, but little is known about prospective predictors of resilience outcomes. We examined associations of demographics, cancer-related variables, and intrapersonal and interpersonal factors at diagnosis (family psychosocial risk, perceived social support, and healthcare self-efficacy) and psychosocial services provided during treatment with caregiver resilience outcomes at the end of treatment. METHODS For a study validating a family psychosocial risk screener, 314 primary caregivers completed the measures at diagnosis of their child (aged 0-17 years) and when cancer treatment ended. Resilience outcomes were ratings of distress, posttraumatic stress, and posttraumatic growth. Multiple regression analyses evaluated the relative contribution of hypothesized predictors. RESULTS Caregivers endorsed clinically significant distress, moderate posttraumatic growth, and low posttraumatic stress based on norms. Posttraumatic growth was not associated with posttraumatic stress or distress, which were significantly associated with each other. Over and above resilience at diagnosis, family psychosocial risk was associated with resilience at the end of treatment. Perceived social support, healthcare self-efficacy, and psychosocial services provided demonstrated associations with resilience in univariate analyses, but demographics and cancer-related variables did not. CONCLUSIONS Resilience and family psychosocial risk at diagnosis were the strongest predictors of caregiver resilience outcomes at the end of the treatment. Intrapersonal and interpersonal predictors were weaker and varied by resilience measure. Consistent with psychosocial standards of care, broad evaluation of caregiver risks, resources, and resilience processes and outcomes is recommended at diagnosis and through the treatment trajectory including the end of treatment.
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Affiliation(s)
- Lamia P Barakat
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecca E Madden
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Gabriela Vega
- Nemours Children's Health System, Orlando, Florida, USA
| | - Martha Askins
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne E Kazak
- Nemours Children's Health System, Orlando, Florida, USA.,Sidney Kimmel Medical School, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Psychosocial Factors Predicting Resilience in Family Caregivers of Children with Cancer: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020748. [PMID: 33477253 PMCID: PMC7830523 DOI: 10.3390/ijerph18020748] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 01/10/2023]
Abstract
Chronic diseases in childhood can affect the physical and mental health of patients and their families. The objective of this study was to identify the sociodemographic and psychosocial factors that predict resilience in family caregivers of children with cancer and to define whether there are differences in the levels of resilience derived from these sociodemographic variables. Three hundred and thirty family caregivers of children with cancer, with an average age of 32.6 years were interviewed. The caregivers responded to a battery of tests that included a questionnaire of sociodemographic variables, the Measuring Scale of Resilience, the Beck Depression Inventory, the Inventory of Quality of Life, the Beck Anxiety Inventory, an interview of caregiver burden and the World Health Organization Well-Being Index. The main findings indicate that family caregivers of children with cancer reported high levels of resilience, which were associated positively with quality of life, psychological well-being and years of study and associated negatively with depression, anxiety and caregiver burden. The variables that predicted resilience in families of children with cancer were quality of life, psychological well-being, depression and number of children. Family caregivers who were married and Catholic showed higher resilience scores. We conclude that being a caregiver in a family with children with cancer is associated with symptoms of anxiety and with depressive episodes. These issues can be overcome through family strength, well-being, quality of life and positive adaptation processes and mobilization of family resources.
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Yuan L, Gao Y, Pan B, Wang J, Wang Y, Gong C, Wang W, Li X. Resilience and Related Factors: A Comparison of Fathers and Mothers of Patients With Cleft Lip and/or Palate in China. Front Psychiatry 2021; 12:791555. [PMID: 35095604 PMCID: PMC8792896 DOI: 10.3389/fpsyt.2021.791555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Resilience has become a hot spot in the field of positive psychology to study life-change events. However, there were little information on resilience among the fathers and mothers of patients with cleft lip and/or palate respectively. The present study aimed to explore and compare the level and potential influential factors associated with resilience among fathers/mothers of patients with cleft lip and/or palate in China. Method: A cross-sectional study was carried out between April 2019 and July 2020 among fathers/mothers of patients with cleft lip and/or palate in two cleft lip and/or palate treatment centers in China. Sixty Nine fathers and 179 mothers of patients with cleft lip and/or palate were interviewed with a questionnaire on demographic variables and the Resilience Scale-14 (RS-14), Herth Hope Index (HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Parenting Stress Index-Short Form (PSI-SF) and Coping Health Inventory for Parents (CHIP). T-test/univariate one-way ANOVA, Pearson's r, hierarchical linear regression analysis were conducted to explore the influential factors of resilience. Results: Fathers of patients with cleft lip and/or palate had a higher level of resilience (77.77 ± 14.18) than mothers (74.52 ± 14.33) though without significance. Resilience was positively associated with hope, perceived social support, optimism and coping and negatively correlated with parenting stress both in the fathers and the mothers. Hierarchical linear regression analysis showed that hope (β = 0.400, P < 0.01), coping (β = 0.281, P < 0.05), job status, medical payments (β = -0.240, P < 0.05) were found to be associated with resilience among the fathers of patients with CL/P, and all four variables in the model could explain 42.8% of the variance in resilience; Hope (β = 0.225, P < 0.05), perceived social support (β = 0.194, P < 0.05), the age of patients (β = 0.189, P < 0.05) were found to be associated with resilience among the mothers, and all three variables in the model could explain 27.6% of the variance in resilience. Conclusion: Our study showed that, in China, fathers of patients with cleft lip and/or palate had a higher level of resilience than mothers though without significance. Hope was the only communal variable strongly associated with resilience among both the fathers and the mothers; besides, coping, job status and medical payments were found to be associated with resilience among the fathers; while perceived social support and the age of patients were found to be associated with resilience among the mothers. The results suggest that enhance hope in parents of patients with cleft lip and/or palate might greatly help improve their resilience. Besides, fathers and mothers need specific intervention to prompt their resilience.
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Affiliation(s)
- Lulu Yuan
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China.,School of Nursing, China Medical University, Shenyang, China
| | - Yuqin Gao
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Bochen Pan
- Shengjing Hospital, China Medical University, Shenyang, China
| | - Junyan Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yanjie Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Caixia Gong
- West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weiren Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, China
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Ghazi M, Zare M, Ramezani M, Heidarzadeh M, Behnam Vashani H. The Effect of Home Visit Program Based on the Continued Kangaroo Mother Care on Maternal Resiliency and Development of Premature Infant: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2021; 9:64-75. [PMID: 33521150 PMCID: PMC7829586 DOI: 10.30476/ijcbnm.2020.86141.1321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Premature birth is a crisis for mothers and affects resilience. Premature babies are at risk for developmental disorders. The Kangaroo Mother Care (KMC) can reduce maternal stress and improve the growth of the baby. This study aimed at assessing the effect of home visit based on the continued KMC on maternal resiliency and development of premature infant. METHODS This randomized controlled trial conducted on 50 pairs of mothers and premature babies with gestational age of 26-32 weeks who were admitted to Neonatal Intensive Care Unit of Om-al-Banin Hospital, Mashhad, Iran in 2019. The KMC is practiced routinely for all eligible newborns in this hospital. The experimental group continued the KMC one month after discharge at home and received two home visits. Resiliency of the mothers was assessed in admission, discharge, and one month after discharge with the Connor and Davison questionnaire and the development of the newborns was assessed in two months of adjusted age with Ages and Stages Questionnaire (ASQ). Data analysis was performed using SPSS software version 16 and t-test, Mann-Whitney, ANOVA, Friedman, Chi-square, Fishers exact. The significance level was set at P<0.05. RESULTS The resiliency score of the mothers one month after discharge was112.50±5.50 and 76.40±5.60 in the experimental and control groups, which was significantly different (P<0.001). The ASQ development score of the newborns in two months of adjusted age was also significantly higher in the experimental than the control group (280.40±15.60vs223.80±22.00) (P<0.001). CONCLUSION The results showed that the home visit program based on the continued KMC was effective in increasing maternal resilience and the development of premature infants. Trial Registration Number IRCT20181121041718N1.
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Affiliation(s)
- Marzieh Ghazi
- Department of Community Health Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Zare
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Heidarzadeh
- Department of Pediatric, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamidreza Behnam Vashani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Chen C, Wang H, Zhang L, Wang K, Jiang L, Li S, Xiang W, Song L, Hu S, Yang C, Zhou J. Clinical study of preoperative psychological distress and its related factors in the primary caregivers of patients with glioma. Clin Neurol Neurosurg 2020; 200:106364. [PMID: 33348302 DOI: 10.1016/j.clineuro.2020.106364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/18/2020] [Accepted: 11/07/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the preoperative psychological distress in the primary caregivers of glioma patients and its influencing factors and to determine the relationship between preoperative psychological states of glioma patients and their caregivers. METHODS Using a mixed methods design, the caregivers of patients with malignant glioma were interviewed and completed questionnaires about anxiety/depression and family function during preoperative period. RESULTS Caregivers of glioma patients had different types of psychological distress before surgery. A total of 46 caregivers (36.5 %) had preoperative psychological depression or anxiety symptom; 30 caregivers (23.8 %) had depression symptoms, 39 caregivers (31.0 %) had anxiety symptoms, and 23 (18.3 %) had both preoperative anxiety and depression symptoms. Female gender was an influential factor for both preoperative depression and anxiety symptoms in caregivers, surgical information was a risk factor for caregivers' preoperative depression symptoms and residence was a risk factor for caregivers' preoperative anxiety symptoms. The preoperative psychological states of patients was positively correlated with the preoperative anxiety and depression symptoms of caregivers. CONCLUSION The rural female caregivers are more likely to experience psychological distress before surgery, and the preoperative psychological states of patients was positively correlated with the psychological distress in caregivers.
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Affiliation(s)
- Chaoyi Chen
- School of Nursing, Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Department of Anorectal, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Chunhui Road 16#, Lu Zhou, 646000, China.
| | - Haorun Wang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Liying Zhang
- School of Nursing, Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China
| | - Ke Wang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Lin Jiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Shenjie Li
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Wei Xiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Li Song
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Shasha Hu
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China
| | - Changmei Yang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China.
| | - Jie Zhou
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China.
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Mezgebu E, Berhan E, Deribe L. Predictors of Resilience Among Parents of Children with Cancer: Cross-Sectional Study. Cancer Manag Res 2020; 12:11611-11621. [PMID: 33235494 PMCID: PMC7678500 DOI: 10.2147/cmar.s276599] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/04/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose Resilience is an ability to overcome adversities in response to a potentially traumatic event. It relieves parents’ discomfort and builds personal capacity when facing a stressful situation like childhood cancer. Therefore, the study’s objective is to assess the magnitude of resilience and its predictors among the parents of children with cancer at Jimma medical center, Ethiopia, 2020. Methods The institutional-based cross-sectional design was employed on 126 parents of children with cancer at Jimma Medical Center. All study populations who attend the hospital from February 25 to April 25, 2020, and fulfill the inclusion criteria were included. Data were entered into Epi data version 4.6.0.2 and analyzed by SPSS version 25. Descriptive analysis was used to describe the study variables. Furthermore, linear regression analysis was calculated to assess predictors of resilience. Results The level of resilience among parents’ children with cancer were a mean scored 51.41±12.02. In this study, factors associated with resilience were receiving support from friends (β=5.67, 95% CI=1.58, 9.77; P=0.007), attend recreational activities (β=13.8, 95% CI=5.32, 22.37; P=0.03) and receiving health information from health care professionals (β=6.37; 95% CI= (1.75, 11.00), P=0.007), parents depression (β= −0.827, 95% CI= (−1.619,-0.034), P=0.041) and parents stress (β =−0.88,95% CI (−1.54,-0.23), P=0.031). Conclusion The magnitude of resilience among parents of children with cancer was low relative to other studies. Support from friends, attending recreational activities, and receiving health information from health care professionals were positively associated with resilience. In contrast, parents’ depression and stress were negatively associated with resilience.
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Affiliation(s)
| | - Emebet Berhan
- Addis Ababa University College of Health Science, School of Nursing and Midwifery, Addis Ababa, Ethiopia
| | - Leul Deribe
- Addis Ababa University College of Health Science, School of Nursing and Midwifery, Addis Ababa, Ethiopia
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45
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Üzar-Özçeti̇n YS, Dursun Sİ. Quality of life, caregiver burden, and resilience among the family caregivers of cancer survivors. Eur J Oncol Nurs 2020; 48:101832. [DOI: 10.1016/j.ejon.2020.101832] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/17/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
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Risk and Protective Factors for PTSD in Caregivers of Adult Patients with Severe Medical Illnesses: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165888. [PMID: 32823737 PMCID: PMC7459858 DOI: 10.3390/ijerph17165888] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/13/2022]
Abstract
Caregivers of severely ill individuals often struggle to adjust to new responsibilities and roles while experiencing negative psychological outcomes that include depression, anxiety and Post-Traumatic Stress Disorder (PTSD). This systematic review aims to outline potential risk and protective factors for the development of PTSD in caregivers of adult subjects affected by severe somatic, potentially life-threatening illnesses. Twenty-nine studies on caregivers of adult patients affected by severe, acute, or chronic somatic diseases have been included. Eligibility criteria included: full-text publications reporting primary, empirical data; PTSD in caregivers of adult subjects affected by severe physical illnesses; risk and/or protective factors related to PTSD; and English language. Specific sociodemographic and socioeconomic characteristics, besides the illness-related distress, familiar relationships, exposure characteristics, coping style, and support, were identified as relevant risk/protective factors for PTSD. The review limitations are the small number of studies; studies on different types of diseases; studies with same samples. It is crucial to consider factors affecting caregivers of severely ill adult patients in order to plan effective intervention strategies aimed at reducing the risk of an adverse mental health outcome and at enhancing the psychological endurance of this population.
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Xie W, Liang C, Xiang D, Chen F, Wang J. Resilience, anxiety and depression, coping style, social support and their correlation in parents of premature infants undergoing outpatient fundus examination for retinopathy of prematurity. PSYCHOL HEALTH MED 2020; 26:1091-1099. [PMID: 32692601 DOI: 10.1080/13548506.2020.1797129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Retinopathy of prematurity (ROP) has become the main cause of blindness in children. To study resilience, anxiety and depression, coping style and social support and their correlation in parents of premature infants undergoing outpatient fundus examination for ROP, and thereby provide evidence for clinical intervention. Questionnaire surveys were conducted by using General Information Questionnaire, Connor-Davidson Resilience Scale, Self-rating Anxiety Scale, Self-rating Depression Scale, Social Support Scale, and the Simplified Coping Style Questionnaire. The resilience in the parents scored (63.24 ± 12.97) points, which was lower than that of Chinese norm (t = 2.309, P < 0.05). The scores of anxiety and depression were higher than those of Chinese norm (t = 12.592, t = 2.362, both P < 0.05). The score of social support was lower than that of Chinese norm (t = 3.793, p < 0.01). Resilience was negatively correlated with anxiety and depression (r = -0.287, -0.358, both P < 0.01), and positively correlated with coping tendency and social support (r = 0.299, 0.139, both P < 0.05). These findings suggested that the parents have low resilience, high levels of anxiety and depression, and low level of social support. Medical staff should assess and improve their psychological status.
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Affiliation(s)
- Wanhua Xie
- Outpatient Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Chunyan Liang
- Outpatient Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Daoman Xiang
- Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Feng Chen
- Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jianxun Wang
- Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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Abstract
BACKGROUND Hope is negatively associated with parental psychosocial distress and psychological maladjustment as well as an important aspect of emotional well-being and coping for adults with cancer and their caregivers. Yet, little is known about hope experiences of parents of children with cancer. OBJECTIVE The aim of this study was to comprehensively describe hope experiences in parents of children with cancer using a systematic mixed-studies review. INTERVENTION/METHODS Psych INFO, PubMed, Academic Search Premier, and CINAHL databases were used to retrieve articles published in English between January 2005 and October 2019. Using the systematic mixed-studies review convergent design, qualitative and quantitative data were collected and extracted followed by qualitative synthesis. Seventeen articles met the inclusion criteria. Exclusion criteria were systematic reviews, nonresearch articles, case reports, and abstracts. RESULTS Hope is a fundamental source of strength and inner guidance for parents. Findings suggest that hope is negatively correlated with parental psychological distress symptoms and coping dysfunctions. Religiosity, spirituality, and adequate provider-parent communication may strengthen hope in parents. CONCLUSION Parental hope may help minimize psychological distress and maladjustment after a child's cancer diagnosis. Open communication channels between providers and parents are critical in preserving hope. An understanding of religiosity, spirituality, optimism, and sociodemographic variables may inform parental psychosocial interventions. IMPLICATIONS FOR PRACTICE Early identification of parents with psychological distress is critical as they may struggle more in the absence of hope. Targeted psychosocial interventions may help parents of children with cancer cope better. Ongoing assessments of spiritual needs may be important in sustaining hope.
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Seko Y, Lamptey DL, Nalder E, King G. Assessing resiliency in paediatric rehabilitation: A critical review of assessment tools and applications. Child Care Health Dev 2020; 46:249-267. [PMID: 31944352 DOI: 10.1111/cch.12743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/12/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUNDS Resiliency has attracted a growing interest in paediatric rehabilitation as a key capacity for disabled children and their families to thrive. This study aimed to identify measures used to assess resiliency of disabled children/youth and their families and critically appraise the current use of resiliency measures to inform future research and practice. METHODS A two-stage search strategy was employed. First, systematic reviews of resiliency measures published since 2000 were searched. Second, full names of measures identified in at least two systematic reviews were searched across four electronic databases. Included studies assessed resiliency among children/youth (0-18 years old) with chronic health conditions and/or disabilities and their families. Identified articles were then analysed to discern the study's definition of resiliency, authors' rationales for measurement selection, and types of perceived adversities facing the study participants. RESULTS From an initial yield of 25 measures identified in five systematic reviews, 11 were analysed in two or more reviews. The second stage yielded 41 empirical studies published between 2012 and 2018, which used 8 of the 11 resiliency measures searched by name. Of 41, 17 studies measured resiliency of disabled children/youth, 23 assessed resiliency within family members, and 1 studied both children/youth and their families. Our critical appraisal identified inconsistencies between the studies' definition of resiliency and chosen measures' operationalization, implicit assumption of disabilities as a developmental risk that automatically results in life adversities, and the tendency among family studies to reduce resiliency down to stress coping skills. Research that encompasses contextual factors and developmental influences is lacking. CONCLUSIONS There is a need for a situated measurement approach that captures multiple interacting factors shaping resiliency over one's life course. Resiliency measures would benefit from a greater focus on a person-environment transaction and an alternative definition of resiliency that accounts for multiple capacities to navigate through disabling environments.
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Affiliation(s)
- Yukari Seko
- School of Professional Communication, Ryerson University, Toronto, Ontario, Canada
| | | | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Gillian King
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
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Toprak D, Nay L, McNamara S, Rosenberg AR, Rosenfeld M, Yi-Frazier JP. Resilience in adolescents and young adults with cystic fibrosis: A pilot feasibility study of the promoting resilience in stress management intervention. Pediatr Pulmonol 2020; 55:638-645. [PMID: 31794160 PMCID: PMC8685161 DOI: 10.1002/ppul.24574] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/26/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Disease burden in cystic fibrosis (CF) impacts quality of life, distress, and treatment adherence. The promoting resilience in stress management (PRISM), is a brief patient-focused intervention to promote resilience in adolescents and young adults (AYAs), which may mitigate the negative outcomes, and is proven to be feasible and acceptable in other diseases. OBJECTIVE Our aim was to test the feasibility and acceptability of PRISM among AYAs with CF in addition to collecting pilot data regarding patient-reported resilience, distress, and quality of life. METHODS Eligible English speaking, 12 to 21 year patients admitted to the hospital were enrolled. We defined feasibility as 80% completion of all sessions. Acceptability was defined qualitatively based on feedback about timing, content and delivery of intervention. As an exploratory aim, questionnaires measuring resilience (Connor-Davidson resilience scale), distress (Kessler-6 scale), and disease-specific health-related quality of life (CF questionnaire-revised [CFQ-R]) were given at baseline and postintervention. RESULTS 10 out of 17 (59%) patients consented to participate. Eight were Caucasian, eight female with age range 13 to 20 years (median: 18). Nine completed all PRISM sessions with universally positive feedback. Health perception and respiratory domain scores of the CFQ-R improved (47.2-65.1; 95% confidence interval [CI], 2.6-35.6; 50.9-61.9; 95% CI, 1.7-19.9, respectively), however in the setting of inpatient exacerbation treatment it would be hard to attribute these changes to PRISM. CONCLUSION PRISM was feasible and highly acceptable among AYAs with CF. Future research is needed to test the efficacy of PRISM among a larger group of patients with CF in a multicenter trial.
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Affiliation(s)
- Demet Toprak
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Laura Nay
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Sharon McNamara
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Abby R Rosenberg
- Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington.,Division of Hematology and Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Division of Bioethics and Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Margaret Rosenfeld
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.,Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
| | - Joyce P Yi-Frazier
- Seattle Children's Hospital, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
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