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Chiou YG, Chen SY, Wu LM, Lotus Shyu YI, Chiang YC, Hsiao CC, Wu HC, Tang WR. Experiences and preferences of truth-telling in families of children with cancer: A phenomenological study. Asia Pac J Oncol Nurs 2024; 11:100500. [PMID: 38933686 PMCID: PMC11203385 DOI: 10.1016/j.apjon.2024.100500] [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: 03/06/2024] [Accepted: 04/27/2024] [Indexed: 06/28/2024] Open
Abstract
Objective The delivery of bad news is an unpleasant but necessary medical procedure. However, few studies have addressed the experiences and preferences of the families of school-aged children with cancer when they are informed of the children's condition. This study aimed to explore families of school-age children with cancer for their preferences and experiences of truth-telling. Methods This descriptive phenomenological qualitative research was conducted using focus group interviews and semistructured interview guidelines were adopted for in-depth interviews. Fifteen families participated in the study. The data were analyzed using Colaizzi's analysis. Data were collected from August 2019 to May 2020. Results The study identified two major themes: "caught in a dilemma" and "kind and comprehensive team support." The first major theme focused on families' experiences with cancer truth-telling. Three sub-themes emerged: (1) cultural aspects of cancer disclosure, (2) decision-making regarding informing pediatric patients about their illness, and (3) content of disclosure after weighing the pros and cons. The second major theme, which revealed families' preferences for delivering bad news, was classified into three sub-themes: (1) have integrity, (2) be realistic, and (3) be supportive. Conclusions This study underscores the dilemma encountered by the families of children with cancer after disclosure and their inclination toward receiving comprehensive information and continuous support. Health care personnel must improve their truth-telling ability in order to better address the needs of such families and to provide continuous support throughout the truth-telling process.
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Affiliation(s)
- Yen-Gan Chiou
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Ying Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yea-Ing Lotus Shyu
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Chien Chiang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chih-Cheng Hsiao
- Division of Hematology/Oncology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hui-Chuan Wu
- Department of Post Baccalaureate Nursing, College of Medicine, I-SHOU University, Kaohsiung, Taiwan
| | - Woung-Ru Tang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Atout M, Hasan AAH, Alkharabsheh AAH, Al-Tobasi AM, Ali AM. A narrative inquiry into the communication experiences of mothers caring for children with cancer in Jordan. J Pediatr Nurs 2024; 76:e132-e139. [PMID: 38453545 DOI: 10.1016/j.pedn.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND This study aims to investigate the parenting experiences of mothers who care for children with cancer in Jordan and specifically focuses on the communication experiences of mothers who care for children with cancer. METHODOLOGY A qualitative research design employing a narrative inquiry methodology was adopted; it employed the implementation of twenty semi-structured interviews with the mothers of children with cancer recruited from one pediatric hospital located in Amman, Jordan. FINDINGS The findings of this study reveal that the majority of mothers attempted to conceal or delay any discussion regarding the diagnosis with their child, particularly during the immediate post-diagnosis period. Additionally, the mothers expressed that their relationships with the parents of children diagnosed with the same illness contain positive and negative aspects. Finally, most mothers participating in this study praised the role of hope in helping them cope with the challenging health condition of their children. CONCLUSIONS The findings of this study reveal that mothers would withhold diagnostic information from their children for several reasons: firstly, they wished to safeguard their children from feelings of distress; secondly, they perceived that their children were too immature to fully comprehend the seriousness of their diagnosis; and, finally, they desired to protect their children from unnecessary fear and negative emotions. PRACTICAL IMPLICATIONS Pediatric cancer care requires effective communication between physicians, pediatric nurses, caregivers, and children; clear and accurate communication between healthcare providers and parents of children with cancer ensures that they fully understand the diagnosis and can make values-based decisions.
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Affiliation(s)
- Maha Atout
- Faculty of Nursing, Philadelphia University, Jarash Road, P.O. Box 19392, Amman, Jordan.
| | - Abd Al-Hadi Hasan
- Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia.
| | | | - Adnan Mahmmoud Al-Tobasi
- Faculty of Arts, Department of Counseling Psychology, Philadelphia University, Jarash Road, P.O. Box 19392, Amman, Jordan.
| | - Amira M Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt.
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Xu L, Sheng Z, Zhou T, Xie C, Wang X, Zhang W, Wu T, Gronholm P, Chen D, Ma H, Thornicroft G, Guan L, Yu X. 'Let's Talk About Children' family focused practice for children of parents with schizophrenia and bipolar disorder: protocol for a randomized controlled trial. BMC Psychiatry 2024; 24:5. [PMID: 38166946 PMCID: PMC10763063 DOI: 10.1186/s12888-023-05457-6] [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: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION 'Let's Talk About Children' is a brief family focused intervention developed to improve mental health outcomes of children of parents with mental illness (COPMI). This study aims to assess the efficacy of LTC in improving mental health of children of parents with schizophrenia or bipolar disorder in China. METHODS The planned study is a multicentre parallel group randomized wait-list controlled trial. A total of 400 eligible families with children aged 8 to 18 years will be recruited, 200 each for families with parental schizophrenia or bipolar disorder. The intervention group will receive Let's Talk About Children delivered by a trained therapist, while the control group will receive treatment as usual. The primary outcomes are child mental health measured by the strengths and difficulties questionnaire and parent-child communication measured using the parent-adolescent communication scale. Parental mental health and family functioning are secondary outcomes. This study also plans to explore mediating factors for the effect of Let's Talk About Children on child mental health, as well as conduct a cost-effectiveness analysis on using Let's Talk About Children in China. CONCLUSION The present study will provide evidence for the efficacy of Let's Talk About Children in families with parental schizophrenia and bipolar disorder in China. In addition, it will evaluate potential mechanisms of action and cost-effectiveness of Let's Talk About Children, providing a basis for future implementation. TRIAL REGISTRATION ChiCTR2300073904.
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Affiliation(s)
- Lingzi Xu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Zhi Sheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Tianhang Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Chenmei Xie
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Xun Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Wufang Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Tingfang Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Petra Gronholm
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hong Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lili Guan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
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Kim B, Choi S. Nursing Interventions for Children with Atopic Dermatitis and Their Families: A Scoping Review. MCN Am J Matern Child Nurs 2023; 48:312-319. [PMID: 37589960 DOI: 10.1097/nmc.0000000000000959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
PURPOSE The purpose of this scoping review was to summarize and synthesis studies about nursing interventions for children and adolescents with atopic dermatitis and their families. METHODS A scoping review was conducted and described as per PRISMA-ScR via four electronic databases, PubMed, Web of science, Scopus, and EBSCOhost, evaluating research on nursing interventions for children diagnosed with atopic dermatitis and their families. RESULTS Eleven articles were included in the review. Nursing interventions were conducted for children, parents, or both and primarily focused on education, consultation, and management of complications. Outcomes of the interventions showed improvements in atopic dermatitis severity for children and enhanced quality of life for children and their families. CLINICAL IMPLICATIONS Nursing interventions targeting children and parents have been found to be effective in alleviating the severity of atopic dermatitis in children and improving their quality of life. Despite the increasing prevalence of atopic dermatitis in children, studies on nursing interventions are insufficient and outdated. Future research should focus on providing comprehensive and age-appropriate interventions for children with atopic dermatitis and their families to improve their well-being and overall quality of life.
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Sezgin G, Yaylaci A, Unal I. Quality of life in parents of Turkish and Syrian pediatric bone marrow transplant and oncology patients. Niger J Clin Pract 2023; 26:1563-1567. [PMID: 37929536 DOI: 10.4103/njcp.njcp_269_23] [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: 11/07/2023]
Abstract
Background The success of the treatment depends on the well-being of the parents in pediatric cancer patients. In addition, migrants need to deal with the consequences of war. Aim Our purpose was to compare the HRQoL of parents of Syrian and Turkish children followed in our bone marrow transplant and oncology units. Materials and Methods One hundred SF 36 questionnaires, fifty from each group were collected between October 2019 and March 2020 in this cross-sectional study. Demographic characteristics of the patients (sex, age, cancer type, presence of relapse, duration of follow-up) and education level of parents were recorded. Analyses were performed using IBM SPSS Statistics version 20.0. Results Turkish parents reported better results in physical functioning, emotional well-being, physical pain, general health, and physical health composite score (P < 0.05). There were more fathers in the Syrian group and education status was significant between the two groups (P = 0.01, P = 0.001, respectively). There was no correlation between QoL and education levels in the Turkish group. In Syrian parents, pain score was high in middle school graduates (P = 0.043). In the presence of relapse, although the physical function score decreased, the physical role function score increased in Turkish parents (P = 0.0035, P = 0.005, respectively). Syrian parents' emotional role function and energy/fatigue score were both increased when children had relapses (P = 0.027for both). Conclusion Migration is a complex issue. Turkish parents were better in physical functioning, emotional well-being, physical pain, general health, and physical health composite score. Screening for parental burden, assisting them to find appropriate support services is essential in improving the health and QoL of both our patients and their parents.
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Affiliation(s)
- G Sezgin
- Department of Pediatric Oncology and Pediatric BMT Unit, Çukurova University Medical School, Adana, Türkiye
| | - A Yaylaci
- Department of Pediatric Oncology and Pediatric BMT Unit, Çukurova University Medical School, Adana, Türkiye
| | - I Unal
- Department of Biostatistics, Çukurova University Medical School, Adana, Türkiye
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Cho E, Dietrich MS, Friedman DL, Gilmer MJ, Gerhardt CA, Given BA, Hendricks-Ferguson VL, Hinds PS, Akard TF. Effects of a Web-Based Pediatric Oncology Legacy Intervention on the Coping of Children With Cancer. Am J Hosp Palliat Care 2023; 40:34-42. [PMID: 35535490 DOI: 10.1177/10499091221100809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recurrent or refractory cancer often results in substantial and extensive physical, emotional, psychosocial, and spiritual burdens for children and their families. However, the therapeutic benefits of legacy interventions in children with recurrent or refractory cancer have been examined only recently, with limited attention to specific effects on children's coping abilities. OBJECTIVE The purpose of this study was to determine the effects of a digital storytelling-legacy intervention on the adaptive coping of children with recurrent or refractory cancer. METHODS This study used a 2-arm randomized, waitlist-controlled trial design. A total of 150 children with recurrent or refractory cancer and their parents were recruited via Facebook advertisements. RESULTS The analysis sample included 92 dyads (35-intervention group, 57-control group). The legacy intervention showed small and statistically nonsignificant effects on primary-control and disengagement coping strategies among children with recurrent or refractory cancer. CONCLUSIONS Legacy interventions using readily accessible digital storytelling have the potential to enhance the adaptive coping skills among children with recurrent or refractory cancer. Further research should determine how to enhance interventions tailored to this population to optimize the benefits.
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Affiliation(s)
- Eunji Cho
- School of Nursing, 5718Vanderbilt University, Nashville, TN, USA
| | - Mary S Dietrich
- School of Nursing, 5718Vanderbilt University, Nashville, TN, USA.,School of Medicine, 5718Vanderbilt University, Nashville, TN, USA
| | - Debra L Friedman
- Division of Hematology-Oncology, Department of Pediatrics, 12328Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Mary Jo Gilmer
- School of Nursing, 5718Vanderbilt University, Nashville, TN, USA.,School of Medicine, 5718Vanderbilt University, Nashville, TN, USA
| | - Cynthia A Gerhardt
- Departments of Pediatrics and Psychology, 2647The Ohio State University, Columbus, OH, USA.,Center for Biobehavioral Health, 51711The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Barbara A Given
- College of Nursing, 3078Michigan State University, East Lansing, MI, USA
| | | | - Pamela S Hinds
- Department of Nursing Science, Professional Practice and Quality Outcomes, 8404Children's National Health System, Washington, DC, USA.,Department of Pediatrics, 8367George Washington University, Washington, DC, USA
| | - Terrah Foster Akard
- School of Nursing, 5718Vanderbilt University, Nashville, TN, USA.,School of Medicine, 5718Vanderbilt University, Nashville, TN, USA
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Stanek C, Garcia D, Olsavsky AL, Hill KN, Himelhoch AC, Kenney AE, Humphrey L, Olshefski R, Gerhardt CA, Nahata L. Communication within families about advanced pediatric cancer: A qualitative study. Palliat Support Care 2022:1-8. [PMID: 36573009 DOI: 10.1017/s1478951522001705] [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] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This qualitative study examined how families share information and feelings about advanced pediatric cancer from the perspective of both parents and children, as well as how these perspectives vary by child developmental stage. METHODS Participants (24 mothers, 20 fathers, 23 youth [children and adolescents]) were from a larger longitudinal study at an academic pediatric hospital. Eligible youth had advanced cancer (physician-estimated prognosis of <60%, relapse, or refractory disease), were aged 5-19 years (>8 years old to participate independently), had an English-speaking parent, and lived within 140 miles of the hospital. Interviews were completed at enrollment and asked how families share information and emotions about the child's cancer as a family. RESULTS Saturation was reached at 20 interviews for mothers, fathers, and youth. Analyses revealed 4 major themes: (A) parents managing cancer-related information based on child age/developmental stage and processing styles of family members; (B) parents withholding poor prognosis information and emotions to maintain positivity; (C) lack of personal and familial emotion sharing; and (D) emotion sharing among their family and externally. Both parents and youth endorsed themes A, C, and D, but only parents endorsed theme B. Adolescents endorsed more themes than children. Parents of children (as opposed to adolescents) endorsed theme A more. SIGNIFICANCE OF RESULTS Although both parents and youth with advanced cancer were generally willing to talk about treatment, emotions were not consistently shared. Perspectives varied depending on the child's developmental stage. Clinicians should assess parent and child information and emotion-sharing needs and provide individualized support to families regarding communication about advanced cancer.
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Affiliation(s)
- Charis Stanek
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Dana Garcia
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Anna L Olsavsky
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Kylie N Hill
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Alexandra C Himelhoch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Ansley E Kenney
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Lisa Humphrey
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Randal Olshefski
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Leena Nahata
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatric Endocrinology, The Ohio State University College of Medicine, Columbus, OH, USA
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Uber A, Ebelhar JS, Lanzel AF, Roche A, Vidal-Anaya V, Brock KE. Palliative Care in Pediatric Oncology and Hematopoietic Stem Cell Transplantation. Curr Oncol Rep 2022; 24:161-174. [DOI: 10.1007/s11912-021-01174-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
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