1
|
Son H, Kim N. Therapeutic Parent-Child Communication and Health Outcomes in the Childhood Cancer Context: A Scoping Review. Cancers (Basel) 2024; 16:2152. [PMID: 38893270 PMCID: PMC11172360 DOI: 10.3390/cancers16112152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Family communication has been thought to be an important area to support children's adjustment to a cancer diagnosis. However, the characteristics of therapeutic parent-child communication that contribute to better patient outcomes and the specific patient health outcomes have been less explored. This current review explored the characteristics of therapeutic parent-child communication and its physical and psychological health outcomes. A total of 5034 articles were initially identified, and only 10 articles remained for inclusion in this review after application of the exclusion criteria. Most studies used a cross-sectional design and measured verbal communication characteristics and its psychological outcomes, but no physical outcomes. The characteristics of therapeutic verbal communication (openness, maternal validation, quality of information shared, etc.) and nonverbal communication (eye contact, close physical distance, and acknowledging behaviors) were identified. The psychological health outcomes included less distress, a lower level of PTSS, less internalizing and externalizing of symptoms, increased levels of social emotional competencies, better peer relationships, and more cooperation during the procedure at the individual level. Increased family cohesion and family adaptation were family-level outcomes. Longitudinal studies are needed to identify what qualities of communication predict better psychological outcomes so that interventions can be developed and tested. In addition, physical outcomes should be evaluated.
Collapse
Affiliation(s)
- Heeyeon Son
- College of Nursing, University of Tennessee, 1412 Circle Drive, Knoxville, TN 37996, USA
| | - Nani Kim
- School of Nursing, The University of Texas at Austin, 1710 Red River St., Austin, TX 78712, USA;
| |
Collapse
|
2
|
Critoph DJ, Taylor RM, Spathis A, Duschinsky R, Hatcher H, Clyne E, Kuhn I, Smith LAM. Triadic communication with teenagers and young adults with cancer: a systematic literature review - 'make me feel like I'm not the third person'. BMJ Open 2024; 14:e080024. [PMID: 38367963 PMCID: PMC10875529 DOI: 10.1136/bmjopen-2023-080024] [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: 09/18/2023] [Accepted: 02/02/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES Clinical communication needs of teenagers and young adults with cancer (TYACs) are increasingly recognised to differ significantly from younger children and older adults. We sought to understand who is present with TYACs, TYACs' experiences of triadic communication and its impact. We generated three research questions to focus this review: (1) Who is present with TYACs in healthcare consultations/communication?, (2) What are TYACs' experiences of communication with the supporter present? and (3) What is the impact of a TYAC's supporter being present in the communication? DESIGN Systematic review with narrative synthesis. DATA SOURCES The search was conducted across six databases: Medline, CINAHL, Embase, PsycINFO, Web of Science and AMED for all publications up to December 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Included papers were empirical research published after 2005; participants had malignant disease, diagnosed aged 13-24 years (for over 50% of participants); the research addressed any area of clinical communication. DATA EXTRACTION AND SYNTHESIS Three independent reviewers undertook full-text screening. A review-specific data extraction form was used to record participant characteristics and methods from each included paper and results relevant to the three review questions. RESULTS A total of 8480 studies were identified in the search, of which 36 fulfilled the inclusion criteria. We found that mothers were the most common supporter present in clinical communication encounters. TYACs' experiences of triadic communication are paradoxical in nature-the supporter can help or hinder the involvement of the young person in care-related communication. Overall, young people are not included in clinical communication and decisions at their preferred level. CONCLUSION Triadic communication in TYACs' care is common, complex and dynamic. Due to the degree of challenge and nuances raised, healthcare professionals need further training on effective triadic communication. PROSPERO REGISTRATION NUMBER CRD42022374528.
Collapse
Affiliation(s)
- Deborah J Critoph
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Rachel M Taylor
- CNMAR, University College London Hospitals NHS Foundation Trust, London, UK
| | - Anna Spathis
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Robbie Duschinsky
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Helen Hatcher
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Isla Kuhn
- Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Luke A M Smith
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
3
|
van Driessche A, Gilissen J, De Vleminck A, Kars M, Fahner J, van der Werff ten Bosch J, Deliens L, Cohen J, Beernaert K. The BOOST paediatric advance care planning intervention for adolescents with cancer and their parents: development, acceptability and feasibility. BMC Pediatr 2022; 22:210. [PMID: 35428281 PMCID: PMC9010242 DOI: 10.1186/s12887-022-03247-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background Although advance care planning (ACP) has been widely recommended to support patient and family engagement in understanding the patient’s values, preferences and goals of care, there are only a few models in paediatric oncology that capture ACP as a process of behaviour change. We aimed to develop and test the acceptability and feasibility of BOOST pACP (Benefits of Obtaining Ownership Systematically Together in paediatric Advance Care Planning) – an intervention to improve ACP in adolescents with cancer, their parents and paediatric oncologists. Methods Several methods informed the intervention development process: 1) Problem identification: interviews with 11 healthcare professionals working in paediatric oncology; 2) Identification of evidence: literature review of existing pACP tools and barriers and facilitators in performing pACP; 3) Logic model and 4) Intervention design: collaborative expert meetings with researchers and professionals in pACP; 5a) Acceptability test of the materials: interviews with nine healthcare professionals, four adolescents and young adults with cancer and six parents; 5b) Feasibility test of core intervention components with three families, including interviews about their experiences. Results The BOOST pACP intervention was iteratively developed and adapted, based on feedback from families, healthcare professionals, and pACP experts (e.g., components were changed, deleted, and added; formulation of themes and associated questions were amended to enhance acceptability). The core components of the BOOST pACP intervention include: four ACP conversation sessions with the adolescent and/or parent(s) provided by a trained facilitator, structured by interactive conversation cards covering different ACP themes, followed by a transfer of information from the intervention facilitator to the paediatric oncologist. Core intervention components were deemed feasible by all participating families. Conclusion The BOOST pACP intervention was developed by close involvement of both adolescent patients and their parents, healthcare professionals and pACP experts. The final intervention and supporting materials are considered appropriate and feasible. Its effectiveness in improving parent-adolescent communication on ACP themes is currently being tested in a multi-centre randomised controlled trial. Researchers aiming to develop a complex psychosocial intervention for a vulnerable target group could use the step-by-step approach described in this paper. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03247-9.
Collapse
|
4
|
Foster Akard T, Dietrich MS, Friedman DL, Wray S, Gerhardt CA, Given B, Hendricks-Ferguson VL, Hinds PS, Cho E, Gilmer MJ. Effects of a Web-Based Pediatric Oncology Legacy Intervention on Parental Coping. Oncol Nurs Forum 2021; 48:309-316. [PMID: 33855995 DOI: 10.1188/21.onf.309-316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the effects of a legacy intervention for children with advanced cancer and their parents on parental coping strategies. SAMPLE & SETTING The authors recruited 150 children with advanced cancer and their parents via Facebook. METHODS & VARIABLES Child-parent dyads were randomly assigned to the intervention or usual care. Children in the intervention group created electronic digital storyboards to assist in documenting their legacies. Parents completed the Responses to Stress Questionnaire at baseline/preintervention (T1) and postintervention (T2). Linear regressions were used to test for differences between the groups in the amount of change from T1 to T2 for each parent coping score. RESULTS Although not statistically significant, the legacy intervention showed trends toward increasing use of primary control and disengagement coping strategies in parents over time relative to usual care. IMPLICATIONS FOR NURSING Nurses can help to facilitate opportunities for parents to use adaptive coping strategies. More work is needed to determine how legacy interventions in pediatric oncology can facilitate adaptive coping strategies for parents of children with cancer.
Collapse
|
5
|
Chen CY, Lo FS, Wang RH. Roles of Emotional Autonomy, Problem-Solving Ability and Parent-Adolescent Relationships on Self-Management of Adolescents with Type 1 Diabetes in Taiwan. J Pediatr Nurs 2020; 55:e263-e269. [PMID: 32493633 DOI: 10.1016/j.pedn.2020.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND High emotional autonomy has a negative association, whereas good problem-solving ability and parent-adolescent relationships have positive association with self-management in adolescents with type 1 diabetes (T1D). Exploring roles of these variables is crucial to design specific interventions to improve self-management in such afflicted adolescents. PURPOSE To explore the roles of emotional autonomy, problem-solving ability and parent-adolescent relationships on self-management in adolescents with T1D. DESIGN AND METHODS Cross-sectional design was used in this study. A total of 242 adolescents with T1D were recruited from an outpatient clinic of a medical center by convenience sampling in Taiwan. Self-reported questionnaires were used to collect personal characteristics, self-management, emotional autonomy, problem-solving ability, and parent-adolescent relationships. RESULTS Hierarchical multiple regressions indicated that body mass index, problem-solving ability, father-adolescent relationship, and emotional autonomy were significant factors associated with self-management. The interactions of emotional autonomy with problem-solving ability and with parent-adolescents relationship were not significantly associated with self-management. The overall model explained 47.5% variance of self-management. CONCLUSIONS High emotional autonomy was significantly associated with poor self-management. Problem-solving ability and father-adolescent relationships could not moderate, but were independently and significantly associated with self-management in adolescents with T1D. PRACTICE IMPLICATION Healthcare providers should evaluate emotional autonomy earlier and provide more timely help to reduce any negative impact on self-management in adolescents with T1D. Improving problem-solving ability and encouraging fathers to develop optimal father-adolescents relationship might be promising strategies to enhance self-management in adolescents with T1D.
Collapse
Affiliation(s)
- Chia-Ying Chen
- Administration Center of Research and Education, Ditmanson Medical Foundation Chai-Yi Christian Hospital, Taiwan.
| | - Fu-Sung Lo
- Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chung Gung University, Taiwan.
| | - Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
| |
Collapse
|
6
|
Akard TF, Dietrich MS, Friedman DL, Gerhardt CA, Given B, Hendricks-Ferguson V, Hinds PS, Ridner SH, Beckmann N, Gilmer MJ. Improved Parent-Child Communication following a RCT Evaluating a Legacy Intervention for Children with Advanced Cancer. PROGRESS IN PALLIATIVE CARE 2020; 29:130-139. [PMID: 34239227 DOI: 10.1080/09699260.2020.1826778] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although legacy-building is a priority for quality palliative care, research has rarely examined effects of legacy interventions in children, particularly their impact on parent-child communication.We examined the impact of a web-based legacy intervention on parent-child communication. We hypothesized that compared to usual care, legacy-making would improve quality of parent-child communication.Between 2015 and 2018, Facebook advertisements were used to recruit families of children (ages 7-17) with relapsed/refractory cancer. Parent-child dyads were randomly assigned to the intervention or usual care group. The intervention website guided children to create digital storyboards over 2 weeks by directing them to answer legacy questions about themselves and upload photographs, videos, and music. Families received a copy of the child's final digital story. Children and parents completed the Parent-Adolescent Communication Scale pre- (T1) and post-intervention (T2). Linear regressions tested for differences in change from T1 to T2 between the groups controlling for T1 values using an alpha of p < .05. Intervention effects were measured using Cohen's d. Ninety-seven parent-child dyads were included for analysis. Changes in parent-child communication were not statistically significantly different between the groups, yet meaningful intervention effects were observed. The strongest effects were observed for improving father-child communication (Cohen's d = -0.22-0.33). Legacy-making shows promise to facilitate improved parent-child communication, particularly for fathers. Future studies should include fathers and measure expression of feelings and parent-child interaction. Providers should continue to facilitate family communication for children with advanced disease and realize that legacy interventions may impact mother-child versus father-child communication differently.
Collapse
Affiliation(s)
- Terrah Foster Akard
- Vanderbilt University School of Nursing, Nashville, USA.,Vanderbilt University School of Medicine, Nashville, USA
| | - Mary S Dietrich
- Vanderbilt University School of Nursing, Nashville, USA.,Vanderbilt University School of Medicine, Nashville, USA
| | - Debra L Friedman
- Vanderbilt University School of Medicine, Nashville, USA.,Vanderbilt University Medical Center, Nashville, USA
| | - Cynthia A Gerhardt
- The Ohio State University and The Research Institute at Nationwide Children's Hospital, Columbus, USA
| | - Barbara Given
- Michigan State University College of Nursing, East Lansing, USA
| | | | - Pamela S Hinds
- Children's National Health System and The George Washington University, Washington DC, USA
| | | | | | - Mary Jo Gilmer
- Vanderbilt University School of Nursing, Nashville, USA.,Vanderbilt University Medical Center, Nashville, USA
| |
Collapse
|
7
|
Khooshab E, Jahanbin I, Akbarzadeh M. Effectiveness of Health-Centered Life Skills Training on Health-Related Quality of Life in Mothers with Blind Children: A Randomized Controlled Interventional Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:122-127. [PMID: 32195157 PMCID: PMC7055182 DOI: 10.4103/ijnmr.ijnmr_16_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 01/27/2019] [Accepted: 12/02/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Child visual impairment is one of the disabilities that influence the Health Related Quality of Life (HRQOL) of mothers. Therefore, it is necessary to establish appropriate interventions for enhancing their HRQOL. This study was conducted to assess the efficiency of a Health-Centered Life Skills Training (HCLST) program on the HRQOL of mothers with visually impaired children aged 7 to 12 years. MATERIALS AND METHODS The present study was a nonblinded, randomized, controlled trial on 52 mothers with visually impaired children studying at an educational complex. The participants were selected using convenience sampling method and were randomly divided into intervention and control groups using balanced block randomization method. The intervention group participated in a HCLST program, but the control group did not. Data were collected using a demographic questionnaire and the 36-item Short Form (SF-36) Health Survey, which were completed by the participants of both groups before, immediately after, and 3 months after the intervention. RESULTS There was no significant difference between the intervention and control groups in terms of total mean score of HRQOL before the intervention; however, it increased significantly immediately (Z = -5.73, p < 0.001) and 3 months (Z = -5.84, p < 0.001) after the intervention in the intervention group. A statistically significant increase was observed in the mean scores of the two main domains of the HRQOL, which were physical health (Z = -3.61, p < 0.001) and emotional health (Z = -6.19, p < 0.001) domains, only in the intervention group. CONCLUSIONS HCLST program can be used as an effective technique for the improvement of the HRQOL in mothers with blind children.
Collapse
Affiliation(s)
- Elham Khooshab
- Department of Community Health Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iran Jahanbin
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Akbarzadeh
- Maternal – Fetal Medicine Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|