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Kerr AM, Wehrli J, Contente C, Dodia P, Sisk BA. Dyadic coping experiences of parents of children with vascular anomalies. Pediatr Blood Cancer 2024:e31261. [PMID: 39171558 DOI: 10.1002/pbc.31261] [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: 04/09/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Vascular anomalies (VAs) are a spectrum of rare pediatric disorders that require coordinated care from multiple subspecialists. Parents often struggle to coordinate care for their child's complex rare disorder. Even when they do access expert care, parents of children with VAs report high levels of stress and uncertainty. While previous research has explored parents' experiences navigating care for VAs, we know very little about how parents cope with stress together. Given the effect that dyadic coping can have on individual, couple, family, and child outcomes, we aimed to gain a better understanding of dyadic coping in the context of VAs. PROCEDURES We collected data using semi-structured interviews with 27 parents (13 dyads and one individual parent). Data were analyzed using dyadic thematic analysis. RESULTS Parents experienced stress related to medical, personal, logistical, and financial aspects of their child's healthcare. They relied on eight coping strategies: active coping, seeking emotional support, seeking informational support, cognitive avoidance, distraction, cognitive reframing, acceptance, and internalization. When analyzed together, we found evidence of five dyadic coping dynamics: collaborative, supportive, delegated, separate, and negative. CONCLUSION Dyadic coping is complex and multilayered for parents of children with VAs. While the child's diagnosis is considered a shared stressor, both parents may not share preferred coping strategies. Parents of the same child may also be coping with different medical, relational/social, personal, or logistical stressors altogether. Psychosocial interventions designed to facilitate parental coping should address these complex coping dynamics.
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Affiliation(s)
- Anna M Kerr
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio, USA
| | - Jacqueline Wehrli
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Clarice Contente
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Prathana Dodia
- School of Communication Studies, Ohio University Scripps College of Communication, Athens, Ohio, USA
| | - Bryan A Sisk
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
- Bioethics Research Center, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
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Duan H, Wang L, Li H, Wang Z, Jiao S, Liu Y, Li H, Chen J, Feng Q. The influence of WeChat education and care program on anxiety, depression, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia patients. J Cancer Res Clin Oncol 2024; 150:138. [PMID: 38502341 PMCID: PMC10950967 DOI: 10.1007/s00432-024-05646-0] [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] [Received: 12/27/2023] [Accepted: 02/05/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE WeChat-based education and care program serves as a promising nursing method for relieving mental stress in parents of pediatric patients. This study purposed to explore the influence of the WeChat education and care program (WECP) on mental health, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia (ALL) patients. METHODS Totally, 146 parents of 73 primary pediatric ALL patients were randomized into the WECP group (74 parents of 37 patients) and standard care (SC) group (72 parents of 36 patients) to receive a 6-month corresponding intervention. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), Athens insomnia scale (AIS), and 12-item general health questionnaire (GHQ-12) were assessed in parents of patients. RESULTS SAS scores at the third month (M3) (P = 0.041) and M6 (P = 0.032) were reduced in WECP group versus SC group. SAS-defined anxiety rate at M6 (P = 0.035) was declined in WECP group versus SC group. SDS score at M6 was descended in WECP group versus SC group (P = 0.024). However, there was no discrepancy in SDS-defined depression rate at any time point between groups (all P > 0.05). AIS scores at M1 (P = 0.015) and M6 (P = 0.021), as well as GHQ-12 scores at M3 (P = 0.007) and M6 (P = 0.001) were decreased in WECP group versus SC group. By subgroup analyses, WECP exhibited good effects at M6 in mothers, but not in fathers. CONCLUSION WECP is a feasible and efficacy intervention to improve mental stress and health status among parents of pediatric ALL patients, especially in mothers.
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Affiliation(s)
- Hui Duan
- Department of Pediatrics, Affiliated Hospital of Hebei Engineering University, No. 81 Congtai Road, Handan, 056002, China
| | - Li Wang
- Department of Pediatrics, Affiliated Hospital of Hebei Engineering University, No. 81 Congtai Road, Handan, 056002, China.
| | - Hui Li
- Department of Intensive Care Unit, Hebei Engineering University Affiliated Hospital, Handan, 056000, China
| | - Zhongyu Wang
- Department of Oncology 4, Handan Central Hospital, Handan, 056002, China
| | - Shuili Jiao
- Department of Pediatrics Ward 2, Handan Central Hospital, Handan, 056002, China
| | - Yanli Liu
- Department of Neonatology Ward 1, Handan Central Hospital, Handan, 056002, China
| | - Huihui Li
- Department of Neonatology Ward 1, Handan Central Hospital, Handan, 056002, China
| | - Jie Chen
- Department of Nephrology 2, Handan Central Hospital, Handan, 056002, China
| | - Qiang Feng
- Department of Cardiology 4, Handan Central Hospital, Handan, 056002, China
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Guido A, Marconi E, Peruzzi L, Dinapoli N, Tamburrini G, Attinà G, Romano A, Maurizi P, Mastrangelo S, Chiesa S, Gambacorta MA, Ruggiero A, Chieffo DPR. Psychological Experiences of Parents of Pediatric Cancer Patients during and after COVID-19 Pandemic. Cancers (Basel) 2024; 16:891. [PMID: 38473253 DOI: 10.3390/cancers16050891] [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: 01/30/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Family members dealing with the devastating impact of a cancer diagnosis are now facing even greater vulnerability due to the COVID-19 pandemic. Alongside the already overwhelming trauma, they must also bear the distressing burden of the infection risks. The purpose of this study was to examine and explore the effects in parents of pediatric cancer patients two years after the start of the COVID-19 pandemic to compare these data with the previous data. METHODS We conducted a single-center prospective observational study, enrolling 75 parents of 42 pediatric oncology patients. Four questionnaires (IES-R; PSS; STAI-Y and PedsQL) were given to the parents 2 years after the first evaluation. RESULTS The bivariate matrix of correlation found a strong significant positive correlation between IES-R and PSS scores (r = 0.526, p < 0.001) as in T1. Stress symptoms (t = 0.00, p < 0.001) and levels of anxiety (trait) (t = 0.32, p < 0.001) remained unchanged; anxiety state levels appeared to have increased (t = 0.425, p < 0.001); there was a significant decrease in the PedsQL tot (t = 5.25, p < 0.001). CONCLUSIONS The COVID-19 pandemic has influenced the levels of stress and anxiety of parents and the quality of life of patients, also correlating with the traumatic impact of the diagnosis.
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Affiliation(s)
- Antonella Guido
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Elisa Marconi
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Laura Peruzzi
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Nicola Dinapoli
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Gianpiero Tamburrini
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Giorgio Attinà
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Alberto Romano
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
| | - Palma Maurizi
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Stefano Mastrangelo
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Silvia Chiesa
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Maria Antonietta Gambacorta
- Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00128 Rome, Italy
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Woman and Child Health and Public Health, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128 Rome, Italy
- Department of Life Sciences and Public Health Department, Università Cattolica Sacro Cuore, 00168 Rome, Italy
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Werner KM. "The gender gap in caring for children with medical complexity". J Perinatol 2023; 43:835-836. [PMID: 36964205 PMCID: PMC10036961 DOI: 10.1038/s41372-023-01652-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Affiliation(s)
- Kelly M Werner
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
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Christen S, Roser K, Harju E, Gumy-Pause F, Mader L, Vetsch J, von Bueren AO, Michel G. Worries and anxiety in parents of adult survivors of childhood cancer: A report from the Swiss Childhood Cancer Survivor Study-Parents. Pediatr Blood Cancer 2023; 70:e30246. [PMID: 36772880 DOI: 10.1002/pbc.30246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Having a child diagnosed with cancer is distressing for parents. We aimed to compare worries and anxiety in parents of adult childhood cancer survivors with parents of the Swiss general population (GP-parents), and to evaluate characteristics associated with worry in parents of survivors. METHODS We conducted a nationwide, population-based study in parents of survivors (survivors aged ≥20 years at study, ≤16 years at diagnosis, >5 years post diagnosis) and GP-parents (≥1 child aged ≥20 years at study). We used the Worry and Anxiety Questionnaire (WAQ), and computed the WAQ total score (worries; possible range 0-80) and caseness for generalized anxiety disorder (anxiety), cognitive, somatic, and any criteria. We used multilevel, multivariable linear regression to identify characteristics associated with worries in parents of survivors. RESULTS We included 787 parents of 513 survivors (41.0% fathers) and 478 GP-parents (42.3% fathers). Parents of survivors and GP-parents did not differ regarding worries (16.6 vs. 17.1, p = .977), anxiety (2.7% vs. 3.6%, p = .536), cognitive (p = .440), and somatic criteria (p = .067). Less parents of survivors met any criteria (17.7% vs. 24.0%, p = .039). Half of parents reported current cancer-related worries. Higher cancer-related worries were reported by mothers (β = 4.1; 95% CI: 2.0-6.2), parents with one child (β = 5.9; 95% CI: 2.0-9.7), currently experiencing disadvantages because of their child's former disease (β = 7.3; 95% CI: 4.0-10.6), or with support needs (β = 9.0; 95% CI: 3.9-14.2; p = .001). CONCLUSIONS It is encouraging that most parents of adult survivors report similar worries and anxiety as GP-parents, but cancer-related worries are still prevalent. Efforts should be made to empower parents to seek psycho-social support if required.
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Affiliation(s)
- Salome Christen
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
| | - Erika Harju
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
| | - Fabienne Gumy-Pause
- Pediatric Oncology and Hematology Unit, Department of Women, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
- CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Luzius Mader
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Janine Vetsch
- Department of Health Sciences, Institute of Applied, Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Andre O von Bueren
- Pediatric Oncology and Hematology Unit, Department of Women, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
- CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, Department of Health Sciences, University of Lucerne, Lucerne, Switzerland
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Howard Sharp KM, Tillery Webster R, Cook J, Okado Y, Long A, Phipps S. Profiles of Resilience, Distress, and Posttraumatic Growth in Parents of Children with Cancer and the Relation to Subsequent Parenting and Family Functioning. J Pediatr Psychol 2023; 48:375-385. [PMID: 36668686 PMCID: PMC10118855 DOI: 10.1093/jpepsy/jsac097] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The aim of this study was to identify patterns of distress and growth in parents of children with cancer and examine associations with subsequent parenting, parent-child relationship, and family environment. METHODS Participants included children with cancer history (8-17 years) stratified by time since diagnosis and their parent. At enrollment, parents (n = 254) reported depression and anxiety, and post-traumatic stress symptoms, posttraumatic growth (PTG), and benefit finding in relation to their child's cancer. Three years later, children (n = 214) reported parenting behavior, parent reactions to their distress, and family environment. Parents reported their reaction to children's distress and qualities of the parent-child relationship. RESULTS Latent profile analysis empirically identified 3 cross-sectional profiles using baseline data: "Resilience, High Growth" (50%), characterized by the lowest distress and the highest PTG/benefit finding; "Moderate Distress with Growth" (33%), characterized by relatively high levels of all indicators; and "Resilience, Low Growth" (17%), characterized by relatively low distress with low PTG/benefit finding. Membership in profiles was associated with parent gender; parents' stressful life events; socioeconomic status; and child diagnosis, on versus off treatment status, and treatment intensity. Parent membership in the Moderate Distress with Growth profile was generally linked with poorer parenting behavior, parent-child relationship quality, and family functioning. CONCLUSION The majority of parents exhibited resilience and growth. However, a subset of parents displaying moderate distress may be at risk for subsequent parenting and family functioning challenges. Findings further highlight the importance of screening for even moderate parent distress and the possible impact of parent psychosocial interventions indirectly on parenting and family functioning.
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Affiliation(s)
| | | | - Jessica Cook
- Department of Psychology, St. Jude Children’s Research Hospital, USA
- Department of Psychology, The University of Memphis, USA
| | - Yuko Okado
- Department of Psychology, California State University, USA
| | - Alanna Long
- Department of Psychology, St. Jude Children’s Research Hospital, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children’s Research Hospital, USA
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Ringnér A, Björk M, Olsson C. What Was on the Parents' Minds? Changes Over Time in Topics of Person-Centred Information for Mothers and Fathers of Children with Cancer. Compr Child Adolesc Nurs 2023; 46:114-125. [PMID: 36811905 DOI: 10.1080/24694193.2023.2168790] [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: 02/24/2023]
Abstract
Acquiring information about one's child's cancer diagnosis is a complex and ever-changing process, and parents' needs change over time. As yet, we know little about what information parents require at different stages of their child's illness. This paper is part of a larger randomized control trial studying the parent-centered information given to mothers and fathers. The aim of this paper was to describe the topics addressed in person-centered meetings between nurses and parents of children with cancer and how those changed over time. Using qualitative content analysis, we analyzed nurses' written summaries of 56 meetings with 16 parents and then computed for each topic the percentage of parents who brought it up at any time during the intervention. The main categories were Child's disease and treatment (addressed by 100% of parents), Consequences of treatment (88%), Emotional management for the child (75%), Emotional management for the parent (100%), Social life of the child (63%), and Social life of the parent (100%). Different topics were addressed at different points in time, and fathers raised more concerns about the child's emotional management and the consequences of treatment than mothers. This paper suggests that parental information demands change over time and differ between fathers and mothers, implying that information should be person-centered. Registered at Clinicaltrials.gov (NCT02332226).
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Affiliation(s)
- Anders Ringnér
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Maria Björk
- CHILD Research Group, Department of Nursing, School of Health and Welfare, Jönköping, Sweden
| | - Cecilia Olsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Department of Bachelor in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
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Liu Y, Sundquist J, Sundquist K, Zheng D, Ji J. Mental health outcomes in parents of children with a cancer diagnosis in Sweden: A nationwide cohort study. EClinicalMedicine 2023; 55:101734. [PMID: 36419464 PMCID: PMC9676277 DOI: 10.1016/j.eclinm.2022.101734] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The diagnosis of paediatric cancer is a crisis for the parents who are the primary caregivers of the affected child. A comprehensive assessment of the longitudinal impact of childhood cancer on parental mental health and the potential sex differences between the parents is lacking. Thus, we aimed to explore the subsequent short- and long-term mental health outcomes among the parents of children with cancer and examine whether the outcomes vary between the mother and father. METHODS By combining several Swedish registers, parents of a child (ages 0-14 years) with a cancer diagnosis between Jan 1, 2006, and Dec 31, 2016 were identified. For each parent of children with cancer, up to five mothers or fathers of cancer-free children were randomly selected and matched, respectively. Hospital contacts for any mental health disorders between 5 years before and 7 years after the diagnosis of childhood cancer were retrieved. An interrupted time series negative binomial regression was performed to assess the short- and long-term impact of a childhood cancer diagnosis on the parents' subsequent mental health outcomes. FINDINGS 16,199 mothers (2852 with a child with cancer and 13,347 without) and 15,708 fathers (2769 with a child with cancer and 12,939 without) were included in this study. Compared with mothers of children without cancer, mothers of children with cancer had higher risks of mental health disorders in the first year after diagnosis (rate ratio [RR] and 95% Confidence Interval [CI], 1.17 (1.03-1.32)), and notably, the adverse impact became more severe over time (RR and 95% CI, 1.36 (1.07-1.74), in the seventh year). For fathers of children with cancer, the risk of mental health disorders was continuously higher compared to matched comparisons (RR and 95% CI, 1.31 (1.01-1.71)). INTERPRETATION Our findings suggested that parental mental health was affected continuously by a diagnosis of childhood cancer in their children. In particular, the mother's mental health was affected more severely. Customised psychological services or interventions are highly needed for the parents of children with cancer. FUNDING Swedish Research Council, Allmänna Sjukhusets i Malmö Stiftelsen för bekämpande av cancer, Swedish Heart-Lung Foundation, ALF funding from Region Skåne and China Scholarship Council.
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Affiliation(s)
- Yishan Liu
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Corresponding author.
| | - Jianguang Ji
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Sweden
- Corresponding author.
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Davies J, O'Connor M, Halkett GKB, Kelada L, Bosco AM, Gottardo NG. 'Torn in two': Experiences of Mothers Who Are Pregnant when Their Child Is Diagnosed With Cancer. QUALITATIVE HEALTH RESEARCH 2022; 32:1795-1808. [PMID: 35976776 DOI: 10.1177/10497323221117924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Mothers of children diagnosed with cancer have been shown to experience high rates of psychological distress and poor physical health. Pregnancy further increases the healthcare needs of mothers due to the marked physiological changes and psychological adaptations. Our study aimed to explore the experiences of mothers who were pregnant and/or had a baby while their older child was receiving treatment for cancer. Our study employed a qualitative description methodology using semi-structured interviews. Participants were recruited from across Australia via notices on social media sites and the distribution of flyers. The sample comprised 13 mothers who were pregnant and/or had a baby and had a child diagnosed with cancer who was under 17 years old. Thematic analysis was used to analyse the data from which six themes were identified: (1) an impossible balancing act, (2) mother's health and well-being, (3) creating certainty: birthing plans, (4) a bit of sunshine and a time to rest, (5) challenges of caring for the baby and (6) an unenviable position: doing my best versus feeling guilty. Our study demonstrates the additional challenges faced by mothers who are pregnant while their child is receiving cancer treatment. There is a need for a comprehensive and coordinated program that provides pregnant mothers with practical and psychological support. The implementation of such a program has the potential to improve health outcomes for all family members, particularly the mother and their newborn.
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Affiliation(s)
- Jenny Davies
- 1649School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Moira O'Connor
- 1649School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Georgia K B Halkett
- 1649Curtin School of Nursing / Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA, Australia
| | - Lauren Kelada
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, NSW, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Anna Maria Bosco
- 1649Curtin School of Nursing / Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA, Australia
| | - Nicholas G Gottardo
- 117610Telethon Kids Institute, Nedlands, WA, Australia
- 2720University of Western Australia, Perth, WA, Australia
- 60081Perth Children's Hospital, Nedlands, WA, Australia
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Roorda D, van der Steeg AFW, van Dijk M, Derikx JPM, Gorter RR, Rotteveel J, van Goudoever JB, van Heurn LWE, Oosterlaan J, Haverman L. Distress and post-traumatic stress in parents of patients with congenital gastrointestinal malformations: a cross-sectional cohort study. Orphanet J Rare Dis 2022; 17:353. [PMID: 36089585 PMCID: PMC9465926 DOI: 10.1186/s13023-022-02502-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Congenital gastrointestinal malformation (CGIM) require neonatal surgical treatment and may lead to disease-specific sequelae, which have a potential psychological impact on parents. The aim of this study is to assess distress and symptoms of post-traumatic stress disorder (PTSD) in parents of patients with CGIM. In this cross-sectional study, seventy-nine parents (47 mothers and 32 fathers) of 53 patients with CGIM completed the Distress Thermometer for Parents (DT-P) and the Self Rating Scale for Posttraumatic Stress Disorders (SRS-PTSD) as part of the multidisciplinary follow-up of their children (aged 5–35 months). Group differences were tested between parents and representative Dutch reference groups with regard to rates of (clinical) distress and PTSD, and severity of overall distress and PTSD, for mothers and fathers separately. Mixed model regression models were used to study factors associated with the risk of (clinical) distress, PTSD and with severity of symptoms of PTSD (intrusion, avoidance and hyperarousal).
Results
Prevalence of clinical distress was comparable to reference groups for mothers (46%) and fathers (34%). There was no difference in severity of overall distress between both mothers as well as fathers and reference groups. Prevalence of PTSD was significantly higher in mothers (23%) compared to the reference group (5.3%) (OR = 5.51, p < 0.001), not in fathers (6.3% vs 2.2.%). Symptoms of intrusion were commonly reported by all the parents (75%). Longer total length of child’s hospital stay was associated with more severe symptoms of intrusion, avoidance and hyperarousal. Child’s length of follow-up was negatively associated with severity of intrusion.
Conclusions
Having a child with CGIM has a huge impact on parents, demonstrated by a higher prevalence of PTSD in mothers, but not fathers, compared to parents in the general population. Monitoring of symptoms of PTSD of parents in follow-up is necessary.
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Mogensen N, Saaranen E, Olsson E, Klug Albertsen B, Lähteenmäki P, Kreicbergs U, Heyman M, Harila‐Saari A. Quality of life in mothers and fathers of children treated for acute lymphoblastic leukaemia in Sweden, Finland and Denmark. Br J Haematol 2022; 198:1032-1040. [PMID: 35852790 PMCID: PMC9543076 DOI: 10.1111/bjh.18350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/28/2022]
Abstract
Acute lymphoblastic leukaemia (ALL) has a high survival rate, but treatment is lengthy with risk of severe side‐effects, which may also impact parents' health‐related quality of life (HRQOL). We present data on 526 parents of 310 children treated for ALL according to the NOPHO ALL2008‐protocol, in Sweden, Finland and Denmark. Parents were asked to complete the 36‐Item Short Form Survey (SF‐36) at least 6 months after end of treatment and data were compared with Norwegian reference data. Parental background factors were collected via a study‐specific questionnaire. Participating parents scored significantly lower than the reference population on both physical and mental summary indexes, but only surpassed a minimal clinically important difference for the mental summary index (Mental Component Summary [MCS]). Mothers scored lower than fathers in the MCS and stopped working and took care of the affected child more often than the fathers. Higher mental HRQOL was associated with male gender and living in Finland or Denmark (compared to Sweden). Correlations within spouses in physical and mental scores were weak to moderate. In conclusion, ALL negatively affects parental HRQOL, especially the mental domains, even after treatment. Findings suggest that mothers are more affected than fathers and may require extra support.
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Affiliation(s)
- Nina Mogensen
- Department of Pediatric Oncology Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
| | - Ella Saaranen
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Erik Olsson
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Birgitte Klug Albertsen
- Department of Pediatrics and Adolescent Medicine Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine, Faculty of Medicine University of Aarhus Aarhus Denmark
| | - Päivi M. Lähteenmäki
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
- Department of Pediatrics and Adolescent Medicine Turku University Hospital, and Turku University Turku Finland
| | - Ulrika Kreicbergs
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
- Department of Health Care Sciences, Palliative Research Centre Marie Cederschiöld University Stockholm Sweden
| | - Mats Heyman
- Department of Pediatric Oncology Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health, Childhood Cancer Research Unit Karolinska Institutet Stockholm Sweden
| | - Arja Harila‐Saari
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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12
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Family Experiences with the Upbringing and Education of a Child with Congenital Malformations, Focusing on the Conditions of an Inclusive School Environment. EDUCATION SCIENCES 2022. [DOI: 10.3390/educsci12050362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The birth of a child with congenital malformation and serious illness impacts the experiences of all family members and the educational process, but there are only rare descriptions of such cases in the literature. The aim of this study is to understand better the lived experiences of a Czech family who have a child with congenital malformations with a focus on his education in an inclusive environment. The study is based on van Manen’s methodology and autobiographic (or semi-structured) interviews with Karl (19), his mother (46), and his father (49). Data were analyzed for every participant separately: the mother—repeated challenges associated with increasing new health complications, discomfort of son, school support, the future, optimism, and gratefulness; the father—comprehensive support of the son, including all family; Karl—concealment of disability, difficulties associated with disability, participation, school support, relationship with peers, and the future. Based on the results of this case study, for the education of students with congenital malformation and illness, we recommend including parents, healthcare professionals, and school staff in the mutual teamwork; adapting the timetables and spatial arrangements at school; and coordinating the educational process with necessary interventions.
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13
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Sex differences in the outcome of expressive writing in parents of children with leukaemia. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e5533. [PMID: 36397745 PMCID: PMC9667348 DOI: 10.32872/cpe.5533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 10/03/2021] [Indexed: 11/26/2022] Open
Abstract
Background Sex differences are widely reported in clinical psychology but are rarely examined in interventions. Method This mixed-method explorative study examined sex differences in 13 mothers and 10 fathers of children in the off-therapy phase of acute lymphoblastic leukaemia. Parents underwent an expressive writing intervention using the guided written disclosure protocol (GWDP). Results Mothers had more negative mood profiles than fathers but improved more during the intervention. Conclusion Though preliminary, our findings highlight the importance of sex as a potential moderator of intervention and treatment outcome that could be of great clinical significance. Parents of children in remission from cancer can benefit from expressive writing. Expressive writing can improve mood states. Mothers may benefit more than fathers. More research on gender differences in outcomes is needed.
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14
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Metsä-Simola NS, Remes HM, Hiltunen EM, Martikainen PT. Changes in parents' psychotropic medication use following child's cancer diagnosis: A fixed-effects register-study in Finland. Cancer Med 2022; 11:3145-3155. [PMID: 35345057 PMCID: PMC9385598 DOI: 10.1002/cam4.4662] [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] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Symptoms of depression and anxiety are elevated among parents of children with cancer. However, knowledge of parents' psychotropic medication use following child's cancer diagnosis is scarce. METHODS We use longitudinal Finnish register data on 3266 mothers and 2687 fathers whose child (aged 0-19) was diagnosed with cancer during 2000-2016. We record mothers' and fathers' psychotropic medication use (at least one annual purchase of anxiolytics, hypnotics, sedatives, or antidepressants) 5 years before and after the child's diagnosis and assess within-individual changes in medication use by time since diagnosis, cancer type, child's age, presence of siblings, and parent's living arrangements and education using linear probability models with the individual fixed-effects estimator. The fixed-effects models compare each parent's annual probability of psychotropic medication use after diagnosis to their annual probability of medication use during the 5-year period before the diagnosis. RESULTS Psychotropic medication use was more common among mothers than fathers already before the child's diagnosis, 11.2% versus 7.3%. Immediately after diagnosis, psychotropic medication use increased by 6.0 (95% CI 4.8-7.2) percentage points among mothers and by 3.2 (CI 2.1-4.2) percentage points among fathers. Among fathers, medication use returned to pre-diagnosis level by the second year, except among those whose child was diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma. Among mothers of children with a central nervous system cancer, medication use remained persistently elevated during the 5-year follow-up. For mothers with other under-aged children or whose diagnosed child was younger than 10 years, the return to pre-diagnosis level was also slow. CONCLUSIONS Having a child with cancer clearly increases parents' psychotropic medication use. The increase is smaller and more short-lived among fathers, but among mothers its duration depends on both cancer type and family characteristics. Our results suggest that an increased care burden poses particular strain to the long-term mental well-being of mothers.
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Affiliation(s)
| | - Hanna M Remes
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Elina M Hiltunen
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Pekka T Martikainen
- Population Research Unit, University of Helsinki, Helsinki, Finland.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Laboratory of Public Health, Max Planck Institute for Demographic Research, Rostock, Germany
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15
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Factors associated with the comprehensive needs of caregivers of childhood cancer survivors in Korea. J Cancer Surviv 2021; 16:948-959. [PMID: 34741691 DOI: 10.1007/s11764-021-01087-7] [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: 12/31/2020] [Accepted: 07/09/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Caregivers of childhood cancer survivors (CCS) have diverse needs, which should be addressed to provide comprehensive cancer care. We aimed to evaluate the unmet needs of caregivers of CCS. METHODS The subjects were 700 caregivers recruited at three major hospitals in South Korea. We collected study data using self-administered questionnaires and a thorough review of medical records. We assessed the unmet needs of caregivers using the comprehensive needs assessment tool for cancer caregivers and evaluated factors associated with the highest tertile range of unmet needs by multiple logistic regression analysis. RESULTS The greatest unmet needs of caregivers had to do with healthcare staff, followed by information. Compared with father-caregivers, mother-caregivers had greater unmet needs related to health and psychological problems, family/social support, and religious/spiritual support, with odds ratios (95% confidence interval) of 3.79 (2.52-5.69), 3.17 (2.09-4.81), and 1.69 (1.14-2.50), respectively. Compared with caregivers of the youngest CCS (< 6 years), caregivers of CCS aged 12-18 years and caregivers of the oldest CCS (≥ 19 years) respectively showed 2.62 (1.24-5.52) and 3.18 (1.34-7.55) times greater unmet needs for information. Caregivers of CCS who received haematopoietic stem-cell transplantation had a 2.01-fold (1.14-3.57) greater need for practical support. CONCLUSION Caregivers of CCS had substantial unmet needs required for comprehensive care for CCS. Several individual characteristics of caregivers and their children were significantly associated with greater unmet needs of the caregivers. IMPLICATIONS FOR CANCER SURVIVORS Personalized support based on the characteristics of both CCS and their caregivers is required to provide comprehensive care for CCS.
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16
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Psychosocial risk, symptom burden, and concerns in families affected by childhood cancer. Support Care Cancer 2021; 30:2283-2292. [PMID: 34719739 DOI: 10.1007/s00520-021-06646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/18/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The revised Psychosocial Assessment Tool (PATrev) is a common family-level risk-based screening tool for pediatric oncology that has gained support for its ability to predict, at diagnosis, the degree of psychosocial support a family may require throughout the treatment trajectory. However, ongoing screening for symptoms and concerns (e.g., feeling alone, understanding treatment) remains underutilized. Resource limitations necessitate triaging and intervention based on need and risk. Given the widespread use of the PATrev, we sought to explore the association between family psychosocial risk, symptom burden (as measured by the revised Edmonton Symptom Assessment System (ESAS-r)), and concerns (as measured by the Canadian Problem Checklist (CPC)). METHODS Families (n = 87) with children ≤ 18 years of age (M = 11.72, male: 62.1%) on or off treatment for cancer were recruited from the Alberta Children's Hospital. One parent from each family completed the PATrev and the CPC. Participants 8-18 years of age completed the ESAS-r. RESULTS Risk category (universal/low risk = 67.8%, targeted/intermediate risk = 26.4%, clinical/high risk = 5.7%) predicted symptom burden (F[2, 63.07] = 4.57, p = .014) and concerns (F[2, 82.06] = 16.79, p < .001), such that universal risk was associated with significantly lower symptom burden and fewer concerns. CONCLUSION Family psychosocial risk is associated with cross-sectionally identified concerns and symptom burden, suggesting that resources might be prioritized for families with the greatest predicted need. Future research should evaluate the predictive validity of the PATrev to identify longitudinal concerns and symptom burden throughout the cancer trajectory.
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17
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Childbearing culture: a prominent context in the process of maternal role attainment in Iranian mothers with preterm neonates. J Biosoc Sci 2021; 54:1035-1046. [PMID: 34643173 DOI: 10.1017/s0021932021000535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Transition to the role of mothering is one of the most important events in a woman's life. While childbirth is a biological event, pregnancy and the experiences around it are more influenced by social structure, which is shaped by cultural perceptions and practices. The aim of this study was to explore cultural context during maternal role attainment in neonatal intensive care units (NICUs) in Iran. The study was part of a grounded theory study on how the mothers of preterm neonates go through maternal role attainment. Data collection was carried out by purposeful sampling from 20 participants (15 mothers of preterm neonates and 5 NICU nurses). Data were analysed according to Corbin and Strauss's (2015) approach. Four categories of childbearing culture emerged: 'The necessity of childbearing', 'Childbearing rituals', 'Maternal persistent presence' and 'Attitudes and religious beliefs'. The findings showed that the special beliefs and practices in Iranian culture affected all of the participants' reactions to mothering process. Culture is one of the most important factors affecting the development of motherhood in Iran. In order to provide sensitive and culturally appropriate care, nurses should be aware of the general impact of cultural norms and values on the process of maternal role attainment and strive to meet the cultural needs of all mothers.
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18
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Reyna-García PD, Caycho-Rodríguez T, Rojas-Jara C. Síndrome de sobrecarga y estrategias de afrontamiento en cuidadores principales de pacientes oncológicos pediátricos. PSICOONCOLOGIA 2021. [DOI: 10.5209/psic.77753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: Los cuidadores oncológicos pediátricos se encontrarán con circunstancias que llegarán a desafiar sus recursos personales para afrontar las diversas demandas propias del cuidado. Por lo tanto, el objetivo del estudio fue determinar la relación entre el síndrome de sobrecarga y las estrategias de afrontamiento en cuidadores de pacientes oncológicos pediátricos. Método: Participaron 93 cuidadores principales de pacientes oncológicos pediátricos (69,9% mujeres, 30,1% varones, edad promedio =37,20 años, DE=11,32), seleccionados de forma no probabilística. Se aplicó la Escala de Sobrecarga del Cuidador y el Cuestionario COPE-28. Se utilizaron estadísticos correlacionales y comparativos para el análisis de datos. Resultados: Los resultados indican la presencia de correlaciones significativas e inversas que varían entre r = -,25 y r = -,56. Sin embargo, no se evidenció una asociación significativa entre las dimensiones de la sobrecarga del cuidador y el uso de sustancias. Por otro lado, aquellos cuidadores que utilizan estrategias poco adaptativas, son más propensos a generar sobrecarga frente a su rol, influyendo en su vida personal, familiar y social. Conclusión: Existe una relación significativa entre el síndrome de sobrecarga y las estrategias de afrontamiento. Además, se identifican diferencias significativas en la sobrecarga según el lugar de procedencia y las horas dedicadas al cuidado.
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19
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Oshiro R, Soejima T, Tada K, Suzuki M, Ohno S, Yubune K, Nakamura S, Fukuchimoto H, Takei J, Yamauchi H, Kamibeppu K. Anxiety and related factors among parents of patients with breast cancer after surgery in Japan: A multi-informant and multilevel study. Jpn J Nurs Sci 2021; 19:e12452. [PMID: 34476897 DOI: 10.1111/jjns.12452] [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: 02/28/2021] [Revised: 06/06/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022]
Abstract
AIM Anxiety and its correlates in parents of patients with breast cancer have rarely been studied. We explored anxiety among parents of postoperative patients with breast cancer and its relationship with parents' social support and care needs and patients' anxiety. METHODS A cross-sectional survey using self-report questionnaires and medical records was conducted among patients with breast cancer after surgery and their parents at four designated cancer care hospitals between September 2015 and June 2016. Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS). Parents provided information about social support and care needs. Multilevel analysis was performed on patient-parent paired data controlling for patient-level variation. RESULTS Participants included 107 patients, 83 mothers, and 51 fathers. The mean HADS anxiety scores reported by mothers and fathers were 7.2 and 6.5, respectively, which were higher than patients' HADS anxiety scores. Fulfillment of important care needs was related to lower anxiety among mothers and fathers (estimate = -1.38, p = .01). Lower family support and higher patient anxiety were associated with higher anxiety in mothers, but not fathers. CONCLUSIONS Parents of patients with breast cancer had high anxiety. Communication, providing cancer-related information, and fulfilling care needs can alleviate anxiety in parents of patients with breast cancer after surgery. Furthermore, increasing family support and decreasing patients' anxiety are essential to alleviating mothers' anxiety.
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Affiliation(s)
- Rei Oshiro
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takafumi Soejima
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiichiro Tada
- Department of Breast and Endocrine Surgery, Nihon University Itabashi Hospital, Itabashi City, Japan
| | - Miho Suzuki
- Nursing Department, Cancer Institute Hospital of the Japanese Foundation of Cancer Research, Tokyo, Japan
| | - Shinji Ohno
- Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation of Cancer Research, Tokyo, Japan
| | - Kuniko Yubune
- Department of Nursing, Faculty of Human Care, Tohto University, Fukaya, Japan
| | - Seigo Nakamura
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Harumi Fukuchimoto
- Department of Clinical Nursing, Showa University School of Nursing and Rehabilitation Sciences, Tokyo, Japan
| | - Junko Takei
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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20
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Mazhari F, Rayyani M, Iranmanesh S, Heidari S, Sabzevari S. Power of Religious Beliefs and Coping with Cancer: Opinions of Iranian Parents. JOURNAL OF RELIGION AND HEALTH 2021; 60:2878-2891. [PMID: 31820276 DOI: 10.1007/s10943-019-00959-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Childhood cancer as a stressful event has many consequences for both the parents and their children. The aim of the study was to assess the coping strategies used by Iranian parents of children with cancer. The present study was conducted through convenience sampling with the participation of 205 parents with at least one child with cancer referred to the oncology ward, in the southeast of Iran. The Coping Health Inventory for Parents was used to measure parental coping strategies. Results showed that the highest and the lowest mean coping score belonged to the dimensions of social support and medical factors, respectively. Briefly, "Belief in God" and "Gratefulness for his Blessings" were the most helpful coping strategies among parents. Based on results of this study, it seems necessary for nurses to be aware of all aspects of human existence, including religion and spirituality as strong sources of power for parents to adapt with the illness of their child. Also, providing interventions to teach effective coping skills to parents may reduce their distress and improve their quality of life.
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Affiliation(s)
- Fariba Mazhari
- Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Rayyani
- Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
| | - Sedigheh Iranmanesh
- Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahin Heidari
- Department of Fundamental Nursing, Geriatric Care Research Center, Faculty of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Sakineh Sabzevari
- Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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21
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Öhman M, Woodford J, von Essen L. Socioeconomic consequences of parenting a child with cancer for fathers and mothers in Sweden: A population-based difference-in-difference study. Int J Cancer 2021; 148:2535-2541. [PMID: 33320976 PMCID: PMC8048859 DOI: 10.1002/ijc.33444] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/09/2020] [Accepted: 12/09/2020] [Indexed: 12/21/2022]
Abstract
Parents are the primary source of support for children with cancer. To inform clinical practice and health policies, the socioeconomic consequences of childhood cancer for fathers and mothers in Sweden were investigated. A total of 3865 mothers and 3865 fathers of 3865 children diagnosed with cancer in Sweden when 0 to 18 years were followed for 5 years before and 10 years after diagnosis. Socioeconomic consequences of the cancer diagnosis on earnings and employment, and mental health (number of inpatient diagnoses), were investigated exploiting variation in timing of cancer diagnosis. Data were obtained from the Swedish Childhood Cancer Registry, Intergenerational Registry and Inpatient Registry. Childhood cancer has a negative short-term effect on fathers' and mothers' earnings; a negative long-term effect on fathers' earnings; a positive long-term effect on mothers' earnings; negative short- and long-term effects on fathers' and mothers' employment; and no effect on the number of inpatient diagnosis of mental and behavioral disorders for fathers or mothers. Taken together, findings show that in Sweden childhood cancer has negative effects on parents' employment, a more negative impact on fathers' than mothers' earnings and no effect on inpatient diagnosis of mental and behavioral disorders. Future research should explore mechanisms possibly explaining, for example, mental health, social support and priorities regarding work and private life potentially resulting in changes from full-time to part-time work or vice versa. The novel findings should change clinical practice and help inform health policies for parents of children with cancer in Sweden and countries with a similar health and welfare system.
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Affiliation(s)
- Mattias Öhman
- Institute for Housing and Urban Research, Uppsala UniversityUppsalaSweden
- Clinical Psychology in Healthcare, Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
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22
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Mader L, Frederiksen LE, Bidstrup PE, Hargreave M, Kjær SK, Kuehni CE, Nielsen TT, Krøyer A, Winther JF, Erdmann F. Hospital Contacts for Psychiatric Disorders in Parents of Children With Cancer in Denmark. JNCI Cancer Spectr 2021; 5:pkab036. [PMID: 34085001 PMCID: PMC8164824 DOI: 10.1093/jncics/pkab036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/25/2021] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background Having a child diagnosed with cancer is a devastating experience that may affect parents' mental health. We aimed to assess the risk of hospital contacts for psychiatric disorders in parents of children with cancer. Methods We conducted a nationwide population-based cohort study using Danish registry data. Parents of children diagnosed with cancer between 1982 and 2014 (n = 6689 mothers, n = 5509 fathers) were matched with comparison parents of cancer-free children (n = 67 544 mothers, n = 55 756 fathers). We used Cox proportional hazards models to estimate the risk of hospital contacts for any psychiatric disorder and specific disorders. Cox models were also used to investigate sociodemographic and cancer-related risk factors for psychiatric disorders. Results Incidence rates of hospital contacts for any psychiatric disorder were 426 per 100 000 person-years in mothers of children with cancer and 345 per 100 000 person-years in comparison mothers. For fathers, the respective incidence rates were 260 and 262 cases per 100 000 person-years. Compared with parents of cancer-free children, mothers of children with cancer were at an increased risk of hospital contacts for any psychiatric disorder (hazard ratio = 1.23, 95% confidence interval = 1.12 to 1.36), whereas no elevated risk was seen in fathers (hazard ratio = 0.99, 95% confidence interval = 0.87 to 1.13). Among mothers, risks were particularly elevated for affective and stress-related disorders. Parents of deceased children and children diagnosed at a younger age were at particular risk of hospital contacts for psychiatric disorders. Conclusion Hospital contacts for psychiatric disorders were overall rare. Health-care professionals should draw attention to subgroups of vulnerable parents to meet their needs of support and adequate treatment.
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Affiliation(s)
- Luzius Mader
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | | | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Marie Hargreave
- Virus, Lifestyle and Genes Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjær
- Virus, Lifestyle and Genes Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.,Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland
| | | | - Anja Krøyer
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Aarhus, Denmark
| | - Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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23
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Postavaru GI, Swaby H, Swaby R. A meta-ethnographic study of fathers' experiences of caring for a child with a life-limiting illness. Palliat Med 2021; 35:261-279. [PMID: 33339475 PMCID: PMC7897781 DOI: 10.1177/0269216320979153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is a growing body of qualitative studies examining parents' experiences of caring for a child with a life-limiting condition, coinciding with recent evidence that indicates an increasing incidence of paediatric life-limiting conditions. However, research focusing on fathers' needs remains sparse and is often diluted among a predominant 'mother's voice', raising questions about whether practices in clinical settings meet fathers' needs. AIM To provide an in-depth assembly of the current state of knowledge around fathers' experiences of caring for their children diagnosed with life-limiting conditions and understand the implications for healthcare services and policies. DESIGN A meta-ethnography was conducted to synthesise findings from existing qualitative studies exploring fathers' experiences of caring. DATA SOURCES Four electronic databases (PubMed, PsycINFO, CINAHL and Science Direct) were searched up until April 2020. Qualitative studies exploring fathers' care experience and published in English language were included. The Critical Appraisal Skills Programme (CASP) checklist was employed for study quality appraisal. No temporal limits were used. RESULTS Sixty-three studies met the inclusion criteria. Thirty life-limiting conditions were included. Based on responses from 496 fathers, a conceptual model was developed which translates key experiences within the fathers' caregiving journeys. The overarching concepts identified were: the paradox of support, challenges in the caring process, 'nobody thinks of men', impact on family life and the fall of the curtain: an irrevocably altered world. These and associated sub-concepts are discussed, with recommendations for future research and practice provided. CONCLUSION The findings indicate the value of a family-oriented approach to develop psychosocial interventions and support channels for fathers, thus empowering them whilst reducing the care-giving burden on the family unit.
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Affiliation(s)
| | | | - Rabbi Swaby
- Nottingham University Hospitals NHS Trust, Nottingham, UK
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24
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The experiences of mothers who have a child diagnosed with cancer. Psychol Health 2021; 37:597-614. [PMID: 33449823 DOI: 10.1080/08870446.2021.1872791] [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: 10/22/2022]
Abstract
Objective: This qualitative study explored the experiences of mothers who had a child diagnosed with cancer.Design and Outcome Measure: Informed by Interpretative Phenomenological Analysis, semi-structured interviews were completed with 13 participants, transcribed verbatim with individual and cross-case analysis conducted.Results: One superordinate theme, Protecting My Child, Whatever the Cost, was identified with five related subordinate themes. Participants battled to protect the development of their ill child. They richly described the personal costs and losses experienced, including putting their life on hold, and lost time with their healthy children. Participants faced realities of cancer treatment that were incongruent with their goal of protecting their child. Self-care awareness was significant for well-being as they protected themselves from reminders of their child's mortality. Despite living in a crisis, participants reported changes suggestive of posttraumatic growth.Conclusion: Childhood cancer brings profound psychosocial and biographical disruption to the lives of mothers as they lose socially valued roles and have their identity as competent mothers challenged. Mothers protect their child, often at a cost to their health and well-being but also bringing positive consequences. The findings offer insights for psychologists in supporting mothers to reclaim their identity as competent mothers and renegotiate their mothering expectations.
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Vercasson C, Auquier P, Michel G, Bertrand Y, Ansoborlo S, Tabone MD, Leverger G, Gandemer V, Baruchel A, Contet A, Dalle JH, Paillard C, Poirée M, Thouvenin-Doulet S, Sirvent N, Kanold J, Freycon C, Hamidou Z, Berbis J. Quality of life in parents of childhood leukemia survivors. A French Childhood Cancer Survivor Study for Leukemia study. Pediatr Blood Cancer 2020; 67:e28419. [PMID: 32798263 DOI: 10.1002/pbc.28419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Our objectives were to assess the quality of life (QoL) of parents of childhood leukemia survivors compared with population norms and to identify the determinants of parents' long-term QoL. METHODS Parents of minors who had survived childhood leukemia participating in the French LEA cohort (Leucémie de l'Enfant et de l'Adolescent-French Childhood Cancer Survivor Study for Leukemia) were asked to complete the French version of the WHOQOL-BREF. Results were compared with age- and sex-matched values from a French reference population. Parents' and survivors' characteristics likely to be associated with QoL, long after the child's leukemia diagnosis, were explored using multivariate analysis. RESULTS We included 487 parents (mean age 42.9 ± 6.0 years, mean follow-up time from diagnosis 7.3 ± 3.3 years). Compared with the reference population, scores for physical health and social relationships for parents of childhood leukemia survivors were significantly lower (P < 0.001, effect size = 0.24 and P < 0.001, effect size = 0.29, respectively) contrary to scores for psychological health which were significantly higher (P < 0.001, effect size = 0.29). Even if health- and cancer-related characteristics were associated with parents' QoL in some dimensions, the only factor associated with each of the three dimensions (social relationships, physical health, and psychological) in the multivariate analysis was the parent's financial situation. CONCLUSIONS Long after leukemia diagnosis, the parents reported lower scores in the physical health and social relationship domains. Despite the difficulties of actually influencing socioeconomic characteristics, it is important to consider the social situation of each family in the long-term care of survivors and their families.
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Affiliation(s)
- Camille Vercasson
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
| | - Pascal Auquier
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
| | - Gérard Michel
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France.,Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille Univ, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology and Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - André Baruchel
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Audrey Contet
- Department of Pediatric Onco-Haematology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Maryline Poirée
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | | | - Nicolas Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital, Montpellier, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Claire Freycon
- Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, France
| | - Zeinab Hamidou
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France.,National Clinical Research Quality of Life in Oncology Platform, Nancy, France
| | - Julie Berbis
- Aix-Marseille Univ, EA 3279: CERESS-Health Service Research and Quality of Life Center, Marseille, France
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Kelada L, Wakefield CE, Vetsch J, Schofield D, Sansom-Daly UM, Hetherington K, O'Brien T, Cohn RJ, Anazodo A, Viney R, Zeppel MJB. Financial toxicity of childhood cancer and changes to parents' employment after treatment completion. Pediatr Blood Cancer 2020; 67:e28345. [PMID: 32333636 DOI: 10.1002/pbc.28345] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Childhood cancer can have short- and long-term impacts on parents' finances and employment. It is important to understand how families adjust to the financial and employment changes caused by childhood cancer, the ongoing impacts after treatment completion, and which families need more targeted support. Qualitative research is necessary to facilitate an in-depth understanding of the employment and financial impacts on families and to capture parents' complex and nuanced experiences and perspectives. METHODS We interviewed 56 parents of childhood cancer survivors (M = 2.13 years after treatment completion; 89% mothers) using the vocational and financial impact section of the Psychosocial Adjustment to Illness Scale-Carer Interview Form. We analyzed interviews using content analysis. RESULTS Parents reported multiple sources of financial toxicity including travel to and from the hospital and needing to reduce their working hours during their child's cancer treatment. Workplace flexibility was an important factor to protect against unwanted vocational changes. After treatment completion, families living in low socioeconomic areas commonly reported ongoing financial difficulties. Mothers, particularly those who were on maternity leave when their child was diagnosed with cancer, reported ongoing employment impacts including unemployment. CONCLUSIONS Clinical staff including social workers could more consistently assess families' financial distress and refer to professional services who can offer guidance for financial decision-making as standard care. Flexible workplace agreements appear important for parents of children with cancer. Our findings can assist organizations to understand that cancer-related disruptions are likely to continue after treatment completion, and therefore should offer benefits to parents where possible.
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Affiliation(s)
- Lauren Kelada
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Janine Vetsch
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia.,Institute for Applied Nursing Sciences IPW-FHS, University of Applied Sciences FHS St. Gallen, St. Gallen, Switzerland
| | - Deborah Schofield
- Centre for Economic Impacts of Genomic Medicine, Macquarie University, Sydney, New South Wales, Australia
| | - Ursula M Sansom-Daly
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Kate Hetherington
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Tracey O'Brien
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Richard J Cohn
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia
| | - Antoinette Anazodo
- School of Women's and Children's Health, UNSW Sydney, Kensington, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, High Street, Randwick, New South Wales, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, New South Wales, Australia
| | - Melanie J B Zeppel
- Centre for Economic Impacts of Genomic Medicine, Macquarie University, Sydney, New South Wales, Australia
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Zucchetti G, Ambrogio G, Bertolotti M, Besenzon L, Borghino F, Candela F, Galletto C, Fagioli F. Effects of a high-intensity psychosocial intervention among child-parent units in pediatric oncology. TUMORI JOURNAL 2020; 106:362-368. [PMID: 32539655 DOI: 10.1177/0300891620926226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To compare the efficacy of a high-intensity psychosocial intervention with standardized usual care in countering psychosocial complexity among child-parent units in a pediatric oncology setting. METHODS Two hundred pediatric oncology patients and their parents were recruited from Italian hospitals. A total of 81 child-parent units were assigned to the high-intensity psychosocial intervention and 119 child-parent units to standardized usual care. Psychosocial factors were assessed before and 1 year after intervention to measure efficacy. RESULTS More improvements over time were observed in the high-intensity intervention group of child-parent units compared to the standard intervention group. CONCLUSION An intensive, structured, and tailored high-intensity intervention positively affects the psychosocial factors of child-parent units. Patients and families should have access to intensive psychosocial support throughout the cancer trajectory.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy.,University of Turin, Turin, Italy
| | | | - Marina Bertolotti
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy
| | | | | | | | | | - Franca Fagioli
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy.,University of Turin, Turin, Italy
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Cai S, Guo Q, Luo Y, Zhou Y, Abbas A, Zhou X, Peng X. Spiritual needs and communicating about death in nonreligious theistic families in pediatric palliative care: A qualitative study. Palliat Med 2020; 34:533-540. [PMID: 31971068 DOI: 10.1177/0269216319896747] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Spiritual support should be offered to all patients and their families regardless of their affiliated status with an organized religion. AIM To understand nonreligious theistic parents' spirituality and to explore how parents discuss death with their terminally ill children in mainland China. DESIGN Qualitative study. SETTING/PARTICIPANTS This study was conducted in the hematology oncology center at Beijing Children's Hospital. Participants in this study included 16 bereaved parents. RESULTS Participants described themselves as nonreligious but showed a tendency toward a particular religion. Parents sought religious support in the face of the life-threatening conditions that affected their child and regarded the religious belief as an important way to get psychological and spiritual comfort after experiencing the death of their child. Religious support could partially address parents' spiritual needs. Parents' spiritual needs still require other supports such as bereavement services, death education, and family support groups. Some parents stated that it was difficult to find a way to discuss death with their children. For patients who come from nonreligious theistic families, their understanding of death was more complex and may be related to atheism. CONCLUSION Religious support could be an element of spiritual support for nonreligious theistic parents of terminally ill children. Multiple strategies including religious supports and nonreligious supports should be rationally integrated into spiritual support of nonreligious theistic family. Patient's personal belief in death should be assessed before discussing death with them.
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Affiliation(s)
- Siyu Cai
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Qiaohong Guo
- School of Nursing, Capital Medical University, Beijing, China
| | - Yanhui Luo
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yuchen Zhou
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ali Abbas
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xuan Zhou
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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What's past is prologue: Recalled parenting styles are associated with childhood cancer survivors' mental health outcomes more than 25 years after diagnosis. Soc Sci Med 2020; 252:112916. [PMID: 32200184 DOI: 10.1016/j.socscimed.2020.112916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/23/2019] [Accepted: 03/08/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND With the increased survival rates of childhood cancer, long-term survivors' well-being over the life span has come into focus. A better understanding of the determinants of childhood cancer survivors' (CCS) mental health outcomes contributes to the identification of vulnerable individuals as well as to the development of evidence-based prevention and intervention efforts. It has been noted that psychosocial factors such as parental rearing behavior shape individual differences in mental health. There is also evidence that parents show altered parenting behavior in the face of childhood cancer, e. g. that they express more emotional support, but also more worries. However, little is known about the relevance of different parenting styles for CCS' mental health decades after diagnosis and treatment. METHODS We examined the associations of recalled parenting styles and disease-related factors with lifetime diagnoses of depression and anxiety disorders in a German, registry-based sample of adult CCS (N = 948, 44.50% women) with survival times >25 years. We conducted logistic regression analyses of lifetime diagnoses of depression and anxiety disorders, respectively, on dimensions of recalled parental rearing behavior (measured with a validated German short version of the EMBU) controlling for relevant adjustment variables such as the presence of physical illnesses. RESULTS Recalled parenting styles of both parents had statistically relevant associations with CCS' lifetime depression and anxiety diagnoses. Maternal emotional warmth was related to fewer lifetime diagnoses of depression and fewer lifetime diagnoses of anxiety. Memories of paternal control and overprotection were positively associated with lifetime diagnoses of anxiety. CONCLUSION The results indicate that mental representations of one's caregivers are associated with psychological long-term outcomes. Thus, medical professionals should involve the parents and support them in accompanying their child through the difficult times of treatment and survivorship. Interventions aimed at fostering survivors' quality of life should consider the sustained relevance of early relationships.
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Ay Kaatsız MA, Öz F. I'm Here, Too: Being an Adolescent Sibling of a Pediatric Cancer Patient in Turkey. J Pediatr Nurs 2020; 51:e77-e84. [PMID: 31653467 DOI: 10.1016/j.pedn.2019.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to determine experiences and needs of Turkish adolescent siblings of children with cancer (SCC) and to identify if there is a country/culture-specific risk factor for these siblings. DESIGN AND METHOD In this qualitative study hermeneutic phenomenological approach was used. Eighteen eligible siblings were selected purposively from two hospitals in Ankara, Turkey. Interviews were conducted with a semi-structured form. Content and thematic analyses were used to analyze the data. RESULTS The data revealed three levels of themes. The main theme was based on "I am here, too". From the first moment of diagnosis, siblings need to be visible and noticed by others. They seek ways to make sense of the disease as they experience dramatic changes in all aspects of their lives (high level themes - first encounter with the disease and changes in life). They expect their parents and relatives to support them (expectations) when they turn to various methods to cope with the changes (coping styles). CONCLUSIONS The lack of protective psychosocial care is a basic risk factor for adolescent SCC in Turkey. Despite its various limitations, the strongest aspect of this study is that it is the first publication that determines the experiences of Turkish SCC in their own words. In addition to supporting recent findings about siblings' experiences, obtaining some country-specific findings is a strength of the present study. PRACTICE IMPLICATIONS Providing psychosocial risk assessment of the siblings' immediately after diagnosis is necessary. It can be helpful to inform parents about the risks.
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Affiliation(s)
- Melike Ayça Ay Kaatsız
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey.
| | - Fatma Öz
- Faculty of Health Sciences, Nursing Department, Lokman Hekim University, Ankara, Turkey
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Howard Sharp KM, Fisher RS, Clark OE, Dunnells ZDO, Murphy LK, Prussien KV, Vannatta K, Compas BE, Gerhardt CA. Long-term trajectories of depression symptoms in mothers of children with cancer. Health Psychol 2019; 39:89-98. [PMID: 31789559 DOI: 10.1037/hea0000826] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To identify trajectories of depression symptoms in mothers of children with cancer from diagnosis/relapse through 5 years and examine maternal factors at diagnosis/relapse predicting membership in these trajectories. METHOD Mothers (n = 327; Mage = 37.6 years, SD = 7.7 years; 85.9% White) reported depression symptoms near the time of their child's diagnosis/relapse and then again at 1-, 3-, and 5-years postdiagnosis/relapse. Mothers also reported perceived stress, coping (primary control, secondary control, and disengagement coping), and spirituality near the time of diagnosis. Latent class growth analysis was used to identify latent trajectories of depression symptoms, and a 3-step multinomial logistic regression tested covariate predictors of membership in the trajectories. RESULTS Three trajectories were identified: "low depression symptoms" (63.3%), "moderate depression symptoms" (31.5%), and "high depression symptoms" (5.2%). Mothers who used more primary and secondary control coping were more likely to be in the low depression symptom trajectory as compared with the moderate (OR = 1.64, p = .024 and OR = 1.38, p = .013, respectively) or high trajectories (OR = 1.99, p = .008 and OR = 1.81, p = .001, respectively). CONCLUSIONS Although mothers of children with cancer generally displayed improved mental health further from diagnosis, mothers with more depression symptoms after diagnosis/relapse displayed substantial stability in depression symptoms over the 5 years. Mothers of children with cancer may benefit from early screening of mental health and coping strategies, as well as interventions to bolster effective coping for those with elevated depression symptoms. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Rachel S Fisher
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Olivia E Clark
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Zackery D O Dunnells
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Lexa K Murphy
- Department of Psychology and Human Development, Vanderbilt University
| | - Kemar V Prussien
- Department of Psychology and Human Development, Vanderbilt University
| | - Kathryn Vannatta
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital
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Pohlkamp L, Kreicbergs U, Sveen J. Factors During a Child's Illness Are Associated With Levels of Prolonged Grief Symptoms in Bereaved Mothers and Fathers. J Clin Oncol 2019; 38:137-144. [PMID: 31725342 DOI: 10.1200/jco.19.01493] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Previous research shows that bereaved parents are at an increased risk for intense and prolonged grief responses. To offer effective support to parents during a child's cancer treatment and after their child's death, more knowledge is needed about factors related to the child's illness trajectory that may contribute to prolonged grief in bereaved parents and about possible sex differences related to such factors. Therefore, we examined possible contributing factors associated with prolonged grief in cancer-bereaved mothers and fathers 1 to 5 years after their child died of cancer. METHODS We studied data from a population-based nationwide survey, including 133 mothers and 92 fathers who had lost a child to cancer 1 to 5 years earlier, using univariable and multiple regression analyses to assess the associations between prolonged grief and possible contributing variables. RESULTS The variables associated with lower levels of prolonged grief symptoms for mothers were being able to talk about feelings within the family (P = .00) and trusting that health care professionals made every possible effort to cure the child (P = .01). The statistically significantly associated variables for fathers were having said farewell to the deceased child in the way they wanted (P = .00) and feeling that they had received practical support from health care professionals during the child's illness trajectory (P = .01). CONCLUSION We found factors during the illness of children with cancer that contributed to prolonged grief for parents; these were different for mothers and fathers. The results may have implications for design of family bereavement support within pediatric oncology care, including addressing the differing needs of mothers and fathers more effectively.
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Affiliation(s)
| | - Ulrika Kreicbergs
- Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Karolinska Institutet, Stockholm, Sweden
| | - Josefin Sveen
- Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Uppsala University, Uppsala, Sweden
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Baran G, Arda Sürücü H, Hülya Üzel V. Resilience, life satisfaction, care burden and social support of mothers with a child with acute lymphoblastic leukaemia: a comparative study. Scand J Caring Sci 2019; 34:340-347. [PMID: 31250939 DOI: 10.1111/scs.12734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/06/2019] [Indexed: 01/05/2023]
Abstract
The study aimed to make comparison between the resilience, life satisfaction, care burden and social support of mothers with a child with acute lymphoblastic leukaemia (ALL) and those with a healthy child. The study was carried out using the comparative and descriptive methods, and the study group included mothers with ALL children hospitalised in the Paediatric Haematology Clinic of a university hospital (n = 51) and those with healthy children who applied to a family health centre (n = 53). While collecting the data, Personal Information Form, Resilience Scale for Adults, Life Satisfaction Scale, Zarit Care Burden Scale and Multidimensional Scale of Perceived Social Support Scale were used. The data were statistically analysed using the SPSS program, percentages, mean scores, standard deviations, Mann-Whitney U test and pearson correlation. For the comparison of the personal information about the mothers with ALL children and about those with healthy children, chi-square or student t test for independent groups depending on the data set was used. When the mothers with ALL children were compared with those with healthy children, it was found that the methods with ALL children had statistically lower mean scores for life satisfaction (13.92 ± 6.26, p < 0.001) and resilience (17.90 ± 7.09, p < 0.001) and statistically higher mean scores for care burden (42.23 ± 16.54, p < 0.05). In this study, when the mothers of ALL children were compared with those of healthy children, it was found that the former had lower levels of resilience and life satisfaction and higher levels of care burden.
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Affiliation(s)
- Gülbeyaz Baran
- Child Health and Pediatric Nursing, Atatürk School of Health, Dicle University, Diyarbakır, Turkey
| | - Hamdiye Arda Sürücü
- Internal Medicine Nursing, Atatürk School of Health, Dicle University, Diyarbakır, Turkey
| | - Veysiye Hülya Üzel
- Faculty of Medicine, The Pediatric Hematology Clinic, Dicle University, Diyarbakır, Turkey
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Ernst M, Brähler E, Klein EM, Jünger C, Wild PS, Faber J, Schneider A, Beutel ME. Parenting in the face of serious illness: Childhood cancer survivors remember different rearing behavior than the general population. Psychooncology 2019; 28:1663-1670. [PMID: 31145818 DOI: 10.1002/pon.5138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/23/2019] [Accepted: 05/27/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE A child's cancer diagnosis and treatment affect the whole family. While it has been recognized that parents are an important resource for their children, little is known about the specifics of parenting in the face of serious illness. METHODS We used the Recalled Parental Rearing Behavior Questionnaire in a register-based cohort of adult childhood cancer survivors (CCS) (N = 951) and a representative population sample of the same age range (N = 2042). The questionnaire assesses behavior of mothers and fathers with three scales (emotional warmth, rejection/punishment, and control/overprotection) by querying the (former) child. We compared the two groups using general linear models. With a hierarchical linear regression analysis, we tested associations of recalled rearing behavior with disease- and treatment-related factors. RESULTS Compared with the general population, CCS remembered both parents as emotionally warmer, more overprotective, and less punishing/rejecting and less ambitious. The regression analysis showed that having received radiotherapy (β = 0.092; P = .009) and chemotherapy (β = 0.077; P = .027) was positively related to memories of maternal emotional warmth. CONCLUSIONS CCS remembered parenting styles which are generally deemed more positive. The extent of recalled control and overprotection deviated from the population in different directions, suggesting that parenting in childhood cancer entails more complex adaptations than being affectionate and giving comfort. The results suggest an adaptation of parental behavior to particularly challenging treatments. They highlight potential vulnerability and resilience factors, some of which were sex-dependent.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Eva M Klein
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Claus Jünger
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Astrid Schneider
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Roser K, Erdmann F, Michel G, Winther JF, Mader L. The impact of childhood cancer on parents' socio‐economic situation—A systematic review. Psychooncology 2019; 28:1207-1226. [DOI: 10.1002/pon.5088] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/25/2019] [Accepted: 04/05/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Katharina Roser
- Department of Health Sciences and Health PolicyUniversity of Lucerne Lucerne Switzerland
| | - Friederike Erdmann
- Childhood Cancer Research GroupDanish Cancer Society Research Center Copenhagen Denmark
| | - Gisela Michel
- Department of Health Sciences and Health PolicyUniversity of Lucerne Lucerne Switzerland
| | - Jeanette Falck Winther
- Childhood Cancer Research GroupDanish Cancer Society Research Center Copenhagen Denmark
- Department of Clinical Medicine, Faculty of HealthAarhus University Aarhus Denmark
| | - Luzius Mader
- Childhood Cancer Research GroupDanish Cancer Society Research Center Copenhagen Denmark
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Mader L, Roser K, Baenziger J, Vetsch J, Winther JF, Scheinemann K, Michel G. Relationship status and quality of the partner relationship in parents of long-term childhood cancer survivors: The Swiss Childhood Cancer Survivor Study-Parents. Psychooncology 2018; 28:309-316. [PMID: 30421855 DOI: 10.1002/pon.4941] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/08/2018] [Accepted: 11/08/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The intensive and long-lasting experience of childhood cancer is a tremendous stressor for the parental relationship. We aimed to (1) compare civil status and partner relationship of parents of long-term childhood cancer survivors with population-based comparisons, (2) identify cancer-related characteristics associated with not being married, and (3) evaluate the quality of the partner relationship. METHODS We sent questionnaires to parents of survivors aged ≤16 years at diagnosis and ≥20 years at study. Population-based comparisons were derived from a random sample of the general population (≥1 child aged ≥20 years) and standardized by sociodemographic characteristics of survivor parents. We used logistic regression to identify cancer-related characteristics associated with not being married. The quality of the partner relationship was evaluated using the relationship-specific attachment scale for adults assessing the dimensions security (secure-fearful) and dependency (dependent-independent). RESULTS A total of 784 parents (58.9% mothers) of 512 survivors (response rate: 44.0%) and 471 comparison parents completed the questionnaire. Parents of survivors were less often divorced/separated (9.0% vs 17.5%, P < 0.001) and more often in a partner relationship (89.9% vs 85.0%, P = 0.010) than comparisons. Not being married was not associated with cancer-related characteristics. Parents of survivors reported similar security (P = 0.444) but higher dependency (P = 0.032) within the partner relationship than comparisons. In both populations, fathers indicated higher security and dependency than mothers. CONCLUSIONS Long after the diagnosis of cancer in their child, parents' relationship appears similar as in parents of the general population. The increased dependency reported by parents of survivors suggests that they managed their child's disease as a team.
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Affiliation(s)
- Luzius Mader
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Katharina Roser
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Julia Baenziger
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Janine Vetsch
- School of Women's and Children's Health, UNSW, Sydney, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Katrin Scheinemann
- Division of Hematology/Oncology, University Children's Hospital Basel, University of Basel, Basel, Switzerland.,Department of Pediatrics, McMaster Children's Hospital & McMaster University, Hamilton, Canada.,Division of Hematology/Oncology, Hospital for Children and Adolescents, Kantonsspital Aarau, Aarau, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
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Burns W, Péloquin K, Rondeau É, Drouin S, Bertout L, Lacoste-Julien A, Krajinovic M, Laverdière C, Sinnett D, Sultan S. Cancer-related effects on relationships, long-term psychological status and relationship satisfaction in couples whose child was treated for leukemia: A PETALE study. PLoS One 2018; 13:e0203435. [PMID: 30192798 PMCID: PMC6128557 DOI: 10.1371/journal.pone.0203435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/21/2018] [Indexed: 01/21/2023] Open
Abstract
Objectives Follow-up studies suggest that the psychosocial impact of pediatric cancer on parents often extends beyond the end of their child’s cancer treatments, and parents can continue to experience both individual and relationship effects. In a long-term study of parents of children who were treated for acute lymphoblastic leukemia (ALL), we aimed to: 1) describe parents’ adjustment (psychological distress, relationship satisfaction; 2) describe the perceived impact of cancer on couples’ relationship, and; 3) identify to what extent the perceived impact of cancer on the couple is related to both parents’ long-term adjustment. Methods Parents of childhood ALL survivors (n = 103 couples) were surveyed as part of a cohort recall (PETALE cohort). Both parents completed questionnaires exploring adjustment (Brief Symptom Inventory-18, Dyadic Adjustment Scale) and perceived impact of cancer on the relationship (Impact of Cancer on the Couple). Mothers’ and fathers’ scores were compared using MANOVAs. We also examined the degree to which a parent’s perceived changes in relationship dynamics following their child’s cancer were associated with their own current adjustment (actor effects), and their partner’s current adjustment (partner effects) using the Actor-Partner Interdependence Model (APIM). Results Frequencies of current distress were normative in parents (mothers/fathers): general distress (6.8/7.8%), anxiety (5.8/6.8%), depression (2.9/6.8%), somatization (13.6/9.7%), and relationship distress (21.4/20.4%). Mothers and fathers typically agreed on their reported relationship satisfaction, and the perceived nature of relationship changes following the illness. Dyadic analyses indicated that whereas mothers’ adjustment was related to their own perceived relationship changes, fathers’ adjustment was primarily related to their partner’s perceptions. Conclusion In long-term stable couples, mothers may act as an influential bridge connecting the illness experiences of survivors and fathers. This could explain why mothers’ perceptions of relationship changes were related to their partners’ long-term adjustment, which was not the case for fathers.
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Affiliation(s)
- Willow Burns
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Katherine Péloquin
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | | | - Maja Krajinovic
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada
- * E-mail:
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de Arruda-Colli MNF, Bedoya SZ, Muriel A, Pelletier W, Wiener L. In good times and in bad: what strengthens or challenges a parental relationship during a child's cancer trajectory? J Psychosoc Oncol 2018; 36:635-648. [PMID: 30862312 PMCID: PMC6645386 DOI: 10.1080/07347332.2018.1485813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/07/2018] [Accepted: 06/04/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To identify events during a child's cancer trajectory when parents perceived their marriage/partnership to be most strengthened and/or challenged. RESEARCH APPROACH Using a cross-sectional qualitative design, participants completed a self-administered questionnaire addressing changes in their relationship during their child's cancer trajectory, including events perceived to strengthen/challenge their relationship, and recommendations for other parents. PARTICIPANTS 192 parents of pediatric oncology patients across three institutions. Data were analyzed using qualitative content analysis. FINDINGS Themes included relationship-specific, illness experience-related, and external supports/stressors that impacted the relationship. Dyadic strategies, empathic communication, and supportive behaviors strengthened the couple's relationship, whereas physical and emotional distance most commonly challenged the relationship. Recommendations to other parents included open communication, couple's connectedness, and use of external supports. INTERPRETATION Offering psychosocial support and helping parents anticipate when their relationship can be strengthened/challenged can be an important part of ongoing care. Implications for psychosocial providers: Teaching communication and dyadic coping strategies can help parents manage stress and build cohesion.
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Affiliation(s)
- Marina Noronha Ferraz de Arruda-Colli
- Department of Psychosocial Oncology and Palliative Care, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sima Zadeh Bedoya
- Department of Psychosocial Oncology and Palliative Care, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Anna Muriel
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Wendy Pelletier
- Hematology/Oncology/Blood & Marrow Transplant Program, Alberta Children’s Hospital, Alberta, Canada
| | - Lori Wiener
- Department of Psychosocial Oncology and Palliative Care, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Conijn T, Nijmeijer SCM, van Oers HA, Wijburg FA, Haverman L. Psychosocial Functioning in Parents of MPS III Patients. JIMD Rep 2018; 44:33-41. [PMID: 29980992 DOI: 10.1007/8904_2018_119] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/30/2018] [Accepted: 06/04/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mucopolysaccharidosis type III (MPS III or Sanfilippo syndrome) is a lysosomal storage disease resulting in progressive neurocognitive decline during childhood and early demise. Its diagnosis may have a great impact on parents, potentially leading to psychosocial problems such as anxiety, depression, parental distress, and posttraumatic stress. METHODS Twenty-six mothers and 19 fathers of 34 Dutch MPS III patients completed the "Hospital Anxiety and Depression Scale" (HADS), the "Distress Thermometer for Parents" (DT-P), and the "Self-Rating Scale for Posttraumatic Stress Disorders" (SRS-PTSD). Independent-sample T-tests and chi-square tests were used to assess differences between parents of MPS III patients and reference groups regarding anxiety and depression (HADS), distress (DT-P), and posttraumatic stress (SRS-PTSD). RESULTS Mothers met the criteria for clinically relevant anxiety (50%) and depression (34.6%) more frequently compared to reference mothers (p = 0.001). Fathers more often met the criteria for clinically relevant depression (36.8%) compared to reference fathers (p = 0.022). Clinically relevant distress was highly prevalent in mothers (84.6%) and fathers (68.4%) of MPS III patients compared to reference parents (p < 0.01). Finally, the prevalence of PTSD was strikingly higher in both mothers (26.9%) and fathers (15%) than reported in the general Dutch population (respectively, p < 0.001 and p < 0.05). CONCLUSIONS We report a clinically relevant impact of parenting an MPS III patient on psychosocial functioning, which is demonstrated by high levels of anxiety, depression, distress, and a remarkably high prevalence of PTSD. Structural monitoring of the psychosocial functioning of MPS III parents is therefore essential and may be beneficial for the whole family.
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Affiliation(s)
- Thirsa Conijn
- Department of Pediatric Metabolic Diseases, Emma Children's Hospital and Lysosome Center 'Sphinx', Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephanie C M Nijmeijer
- Department of Pediatric Metabolic Diseases, Emma Children's Hospital and Lysosome Center 'Sphinx', Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Frits A Wijburg
- Department of Pediatric Metabolic Diseases, Emma Children's Hospital and Lysosome Center 'Sphinx', Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
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Supporting Parent Caregivers of Children with Life-Limiting Illness. CHILDREN-BASEL 2018; 5:children5070085. [PMID: 29949926 PMCID: PMC6069074 DOI: 10.3390/children5070085] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 06/20/2018] [Indexed: 11/17/2022]
Abstract
The well-being of parents is essential to the well-being of children with life-limiting illness. Parents are vulnerable to a range of negative financial, physical, and psychosocial issues due to caregiving tasks and other stressors related to the illness of their child. Pediatric palliative care practitioners provide good care to children by supporting their parents in decision-making and difficult conversations, by managing pain and other symptoms in the ill child, and by addressing parent and family needs for care coordination, respite, bereavement, and social and emotional support. No matter the design or setting of a pediatric palliative care team, practitioners can seek to provide for parent needs by referral or intervention by the care team.
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Kukkola L, Hovén E, Cernvall M, von Essen L, Grönqvist H. Perceptions of support among Swedish parents of children after end of successful cancer treatment: a prospective, longitudinal study. Acta Oncol 2017; 56:1705-1711. [PMID: 28971717 DOI: 10.1080/0284186x.2017.1374554] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Most children survive childhood cancer, however parenting a child diagnosed with cancer is a major challenge. The main aim of the current study was to describe Swedish parents' need, opportunity and benefit of support from healthcare professionals and significant others after end of a child's successful cancer treatment. MATERIAL AND METHODS Data was collected from approximately one week after end of successful treatment/six months after transplantation (T4, n = 212) up to five years thereafter (T7, n = 137). Parents answered questions via telephone about need, opportunity and benefit of talking to psychologists, social workers, partners and friends. RESULTS The proportion reporting need of support from healthcare professionals varied between 73% (mothers' need of support from social workers, T4) and 7% (fathers' need of support from psychologists/social workers, T7). Need of support from significant others varied between 99% (mothers' and fathers' need of support from partners, T4) and 27% (fathers' need of support from friends, T7). The proportion reporting need of support decreased over time (p < .001), no decrease occurred from three months after end of treatment/nine months after transplantation (T5) to one year after end of treatment/18 months after transplantation (T6). More mothers than fathers reported need of support from friends at T5 (p < .001) and T7 (p < .05) and from psychologists at T7 (p < .05). Opportunities for support from healthcare professionals varied, most reported opportunity for support from significant others. Almost all reported benefit from received support. CONCLUSION A declining number reports a need of support over time, however subgroups report an unmet need and almost every parent perceive support from healthcare professionals as beneficial. More parents should get access to psychosocial support services after end of a child's cancer treatment/transplantation.
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Affiliation(s)
- Laura Kukkola
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Emma Hovén
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Martin Cernvall
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Uppsala University, Uppsala, Sweden
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Hjelmstedt S, Lindahl Norberg A, Montgomery S, Hed Myrberg I, Hovén E. Sick leave among parents of children with cancer - a national cohort study. Acta Oncol 2017; 56:692-697. [PMID: 28084892 DOI: 10.1080/0284186x.2016.1275780] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Due to psychological distress and an increased care burden, parents of children diagnosed with cancer may face a higher risk of sickness absence from work. The objective of this study was to examine the association of childhood cancer with parents' sick leave. MATERIAL AND METHODS The sample comprised 3626 parents of 1899 children diagnosed with cancer in Sweden during 2004-2009, and a matched control group of parents (n = 34 874). Sick leave was measured as number of days with sickness benefit, retrieved from national registries. Logistic and negative binomial regression models were used to compare outcomes with parents from the control cohort. RESULTS The risk of sick leave was statistically significantly higher up to six years following a child's cancer diagnosis. The increase in number of days with sickness benefit was most pronounced the year after diagnosis. Although mothers' sick leave prevalence was higher, the increase in risk relative to control parents was similar for mothers and fathers. Bereavement was associated with a heightened risk of sick leave, especially on the year of the child's death. CONCLUSIONS Findings confirm that mothers and fathers of children diagnosed with cancer are at higher risk of sickness absence from work, with particularly pronounced risk among bereaved parents. Acquisition of further knowledge is warranted regarding possibilities and constraints of parents trying to combine their work life with caring for both their child and themselves.
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Affiliation(s)
- Sofia Hjelmstedt
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Annika Lindahl Norberg
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Scott Montgomery
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Epidemiology and Biostatistics, Örebro University, Örebro, Sweden
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Ida Hed Myrberg
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Emma Hovén
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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Hoehn JL, Dahlquist LM, Hahn AL, Bollinger ME. Parents of Children With Food Allergy: Gender Differences in Perceived Impact and Perceived Food Allergy Severity. J Pediatr Psychol 2017; 42:186-197. [PMID: 27424484 PMCID: PMC5896635 DOI: 10.1093/jpepsy/jsw059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 05/04/2016] [Accepted: 05/31/2016] [Indexed: 11/12/2022] Open
Abstract
Objective To compare fathers' and mothers' perceptions of the impact and severity of their child's food allergy and their levels of involvement in allergy-related care. Methods One hundred parents of children with food allergy (50 mother-father pairs) rated the severity of their child's food allergies and completed the Food Allergy Impact Scale. A subset of 52 parents reported how often they engaged in food allergy-related care. Results Mothers reported more impact than fathers for meal preparation, family social activities, and stress and free time, and significantly greater involvement in allergy-related care. Fathers who reported more frequent medical appointment attendance perceived meal preparation as being significantly more impacted by food allergy than fathers who were less involved. Conclusions Fathers who are less involved may be buffered from experiencing the impact of their child's health condition. Differences in involvement rather than other gender differences may explain discrepancies in mothers' and fathers' illness perceptions.
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Affiliation(s)
- Jessica L. Hoehn
- Department of Psychology, University of Maryland, Baltimore County
| | | | - Amy L. Hahn
- Department of Psychology, University of Maryland, Baltimore County
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Post Traumatic Stress Disorder in Parents of Children With Cancer in Jordan. Arch Psychiatr Nurs 2017; 31:8-12. [PMID: 28104064 DOI: 10.1016/j.apnu.2016.07.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 11/23/2022]
Abstract
AIM To investigate levels of post traumatic stress disorder (PTSD) of those parenting children with cancer and make a comparison between mothers and fathers. BACKGROUND Parenting a child with cancer is traumatic. Maternal and paternal roles and responsibilities change after the cancer diagnosis of their child, adding more stress to the lives of all concerned. The gender of the parent may have an effect on their PTSD. However, there is a lack of studies in Arabic countries on the differences between parents in their PTSD levels. METHODS A sample of 416 biological parents (comprising 207 mothers and 209 fathers) of children with cancer in Jordan completed a demographic checklist and the PTSD Checklist Civilian (PCLC). RESULTS There was a significant difference in PTSD levels between mothers and fathers, with mothers having significantly higher PTSD levels than fathers. The mean PTSD levels for mothers was (M=59.68, SD=4.86) compared to (M=52.76, SD=5.81) for fathers. The magnitude of the differences in the means was very large (eta squared=0.29). Additionally, results indicated that there was a significant negative correlation between parental PTSD levels with their age and the time since their child was diagnosed with cancer (r=-0.68, r=-0.62 respectively and p<0.001). An increase in parental PTSD levels was associated with a decrease in parental age and short time duration since the cancer diagnosis of the child. CONCLUSION The study concluded that parenting children with cancer is traumatic and mothers were at higher risk of PTSD than fathers. Risk of PTSD was found to decrease with time. IMPLICATIONS FOR NURSING EBP Investigating differences in PTSD between mothers and fathers in Jordan may be helpful when designing interventions to reduce the risk of PTSD. An individual parental support program is important, taking into consideration that mothers are at higher risk of PTSD, and both parents need thorough attention and care.
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Lamb AE, Biesecker BB, Umstead KL, Muratori M, Biesecker LG, Erby LH. Family functioning mediates adaptation in caregivers of individuals with Rett syndrome. PATIENT EDUCATION AND COUNSELING 2016; 99:1873-1879. [PMID: 27373960 PMCID: PMC5097876 DOI: 10.1016/j.pec.2016.06.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/21/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The objective of this study was to investigate factors related to family functioning and adaptation in caregivers of individuals with Rett syndrome (RS). METHODS A cross-sectional quantitative survey explored the relationships between demographics, parental self-efficacy, coping methods, family functioning and adaptation. A forward-backward, step-wise model selection procedure was used to evaluate variables associated with both family functioning and adaptation. Analyses also explored family functioning as a mediator of the relationship between other variables and adaptation. RESULTS Bivariate analyses (N=400) revealed that greater parental self-efficacy, a greater proportion of problem-focused coping, and a lesser proportion of emotion-focused coping were associated with more effective family functioning. In addition, these key variables were significantly associated with greater adaptation, as was family functioning, while controlling for confounders. Finally, regression analyses suggest family functioning as a mediator of the relationships between three variables (parental self-efficacy, problem-focused coping, and emotion-focused coping) with adaptation. CONCLUSION This study demonstrates the potentially predictive roles of expectations and coping methods and the mediator role of family functioning in adaptation among caregivers of individuals with RS, a chronic developmental disorder. PRACTICE IMPLICATIONS A potential target for intervention is strengthening of caregiver competence in the parenting role to enhance caregiver adaptation.
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Affiliation(s)
- Amanda E Lamb
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 31 Center Dr. Rm. B1B36, Bethesda, MD, 20814, USA; Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Barbara B Biesecker
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 31 Center Dr. Rm. B1B36, Bethesda, MD, 20814, USA; Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, USA; Johns Hopkins Center for Talented Youth, Baltimore, USA.
| | - Kendall L Umstead
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 31 Center Dr. Rm. B1B36, Bethesda, MD, 20814, USA
| | - Michelle Muratori
- Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Johns Hopkins Center for Talented Youth, Baltimore, USA
| | - Leslie G Biesecker
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, USA
| | - Lori H Erby
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 31 Center Dr. Rm. B1B36, Bethesda, MD, 20814, USA; Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Wikman A, Hovén E, Cernvall M, Ljungman G, Ljungman L, von Essen L. Parents of children diagnosed with cancer: work situation and sick leave, a five-year post end-of-treatment or a child's death follow-up study. Acta Oncol 2016; 55:1152-1157. [PMID: 27159219 DOI: 10.3109/0284186x.2016.1167956] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cancer in a child is associated with a significant impact on parental employment. We assessed the proportions of parents of survivors and bereaved parents working and reporting sick leave five years after end of successful treatment (ST)/child's death (T7) compared with one year after end of ST/child's death (T6) and the association between partial post-traumatic stress disorder (PTSD) and work situation and sick leave at T7. Participants and procedure: The sample included 152 parents of survivors (77 mothers, 75 fathers) and 42 bereaved parents (22 mothers, 20 fathers) of children diagnosed with cancer in Sweden. RESULTS The proportions of parents working or reporting sick leave did not differ among mothers and fathers of survivors (92% vs. 96% working, 20% vs. 18% on sick leave) or among bereaved mothers and fathers (91% vs. 90% working, 14% vs. 20% on sick leave) at T7. There was no change from T6 to T7 in the proportion of fathers working (fathers of survivors 91% vs. 96%, bereaved fathers 95% vs. 90%). Although more mothers of survivors (92% vs. 82%) and bereaved mothers (91% vs. 77%) worked at T7 than at T6, this increase was not significant. Fewer bereaved mothers reported sick leave at T7 than at T6 (14% vs. 59%, p < 0.05). Although more fathers reported sick leave at T7 than at T6 (fathers of survivors 18% vs. 8%, bereaved fathers 20% vs. 15%), this was not significant. Partial PTSD was not associated with parents' work situation or sick leave at T7. CONCLUSION Results suggest little adverse effect on work situation and sick leave among parents of survivors and bereaved parents five years after end of ST/child's death from cancer. However, the pattern of change observed differed between parents, which could potentially indicate possible delayed consequences for fathers not captured in the present paper.
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Affiliation(s)
- Anna Wikman
- Clinical Psychology in Healthcare, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Emma Hovén
- Clinical Psychology in Healthcare, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Martin Cernvall
- Clinical Psychology in Healthcare, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Gustaf Ljungman
- Pediatric Oncology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lisa Ljungman
- Clinical Psychology in Healthcare, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Pergert P, Ekblad S, Björk O, Enskär K, Andrews T. Resourcing: An approach used by foreign-born parents struggling on in childhood cancer care. Eur J Oncol Nurs 2016; 23:1-7. [DOI: 10.1016/j.ejon.2016.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 02/23/2016] [Accepted: 03/06/2016] [Indexed: 11/17/2022]
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Jordan A, Crabtree A, Eccleston C. 'You have to be a jack of all trades': Fathers parenting their adolescent with chronic pain. J Health Psychol 2016; 21:2466-2476. [PMID: 25897044 DOI: 10.1177/1359105315580461] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Adolescent chronic pain has an extensive impact on parents, with research typically focused on exploring maternal experiences. This exploratory study sought to identify the specific experiences of six UK fathers who parent an adolescent with chronic pain. Data from semi-structured interviews were analysed using interpretative phenomenological analysis. Paternal experiences were characterised by four themes: 'helplessness', 'containment', 'balance' and 're-evaluation'. Findings highlighted paternal efforts to manage the impact of adolescent chronic pain by focusing inwardly on the family and adopting multiple roles. Fathers identified ways in which they could renegotiate their relationship with their adolescent to manage pain-related disruption.
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Affiliation(s)
- Abbie Jordan
- 1 Department of Psychology, University of Bath, UK.,2 Shrublands Day Hospital, High Wycombe, UK
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Eilertsen ME, Hjemdal O, Le TT, Diseth TH, Reinfjell T. Resilience factors play an important role in the mental health of parents when children survive acute lymphoblastic leukaemia. Acta Paediatr 2016; 105:e30-4. [PMID: 26426347 DOI: 10.1111/apa.13232] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/26/2015] [Accepted: 09/25/2015] [Indexed: 11/28/2022]
Abstract
AIM Childhood cancer is a tremendous stressor that requires parents to adapt to new challenges, and research has mainly focused on psychopathology and rarely on a resource-oriented perspective, such as resilience. This study assessed resilience factors among parents of children surviving acute lymphoblastic leukaemia and parents of healthy children. We also explored the association between parental resilience and mental health. METHODS The study compared 57 parents of 40 children from eight to 15 years of age in remission from acute lymphoblastic leukaemia and 63 parents of 42 healthy children. The Resilience Scale for Adults and the General Health Questionnaire were used to assess parental resilience and mental health. RESULTS Parents of children surviving acute lymphoblastic leukaemia showed significantly lower levels of resilience than parents of healthy children, but no significant difference was found for mental health. Certain resilience factors were positively associated with mental health, especially for mothers, such as family cohesion, good perception of self and being able to plan their future. CONCLUSION Resilience factors may help to protect parents' mental health, especially mothers, when their child has survived acute lymphoblastic leukaemia and should be considered in a clinical setting. Further research on resilience factors for fathers is needed.
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Affiliation(s)
- Mary-Elizabeth Eilertsen
- Faculty of Nursing; The Research Centre for Health Promotion and Resources HiST/NTNU; Sør-Trondelag University College (HiST); Trondheim Norway
| | - Odin Hjemdal
- Department of Psychology; Norwegian University of Science and Technology; Trondheim Norway
| | - Thien Thanh Le
- Faculty of Social Science and Technology Management; Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - Trond H. Diseth
- Section for Psychosomatics and CL-child Psychiatry; Women and Children's Division; Department of Clinical Neurosciences for Children; Oslo University Hospital; Oslo Norway
| | - Trude Reinfjell
- Department of Psychology; Norwegian University of Science and Technology; Trondheim Norway
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50
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Kearney JA, Salley CG, Muriel AC. Standards of Psychosocial Care for Parents of Children With Cancer. Pediatr Blood Cancer 2015; 62 Suppl 5:S632-83. [PMID: 26700921 PMCID: PMC5066591 DOI: 10.1002/pbc.25761] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/24/2015] [Indexed: 11/12/2022]
Abstract
Parents and caregivers of children with cancer are both resilient and deeply affected by the child's cancer. A systematic review of published research since 1995 identified 138 studies of moderate quality indicating that parent distress increases around diagnosis, then returns to normal levels. Post-traumatic symptoms are common. Distress may be impairing for vulnerable parents and may impact a child's coping and adjustment. Moderate quality evidence and expert consensus informed a strong recommendation for parents and caregivers to receive early and ongoing assessment of their mental health needs with access to appropriate interventions facilitated to optimize parent, child, and family well being.
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Affiliation(s)
- Julia A Kearney
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Christina G Salley
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Anna C Muriel
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, Massachusetts
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