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Vaagan A, Haaland-Øverby M, Eriksen AA, Fredriksen K, Stenov V, Varsi C, Ingadóttir B, Cleal BR, Alvheim AR, Westermann KF, Strømme H, Kristjansdottir OB. Group-based patient education via videoconference: A scoping review. PATIENT EDUCATION AND COUNSELING 2024; 118:108026. [PMID: 37939596 DOI: 10.1016/j.pec.2023.108026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To summarize recent evidence on the feasibility, acceptability, and effectiveness of videoconference (VC) group-based patient and caregiver education. METHODS Systematic searches of the literature were conducted. Data was extracted on the characteristics of the studies and interventions and on the feasibility, acceptability, and effectiveness of the interventions. RESULTS From 12,570 hits, 65 studies were eligible for inclusion. Their results confirmed previously identified tendencies of high feasibility and acceptability of VC group patient education, and improved health outcomes. However, evidence of effectiveness is limited, and the quality of studies is varied. Several patient and caregiver groups also remain under-researched. Only four studies stated that facilitators were trained in using VC-technology. CONCLUSION VC group-based patient and caregiver education is feasible and acceptable and may improve health outcomes for participant patients and caregivers. However future research should increase the number of high-quality randomized controlled trials to establish the effectiveness of VC group-based education for several groups of patients and caregivers. Studies of the training of facilitators is also warranted. PRACTICE IMPLICATIONS The results suggest that interventions should be more accessible. An overview of the recent evidence may also stimulate the development and evaluation of VC group-based patient and caregiver education.
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Affiliation(s)
- André Vaagan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Postbox 4959 Nydalen, 0424 Oslo, Norway.
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Kari Fredriksen
- Learning and Mastery Center, Stavanger University Hospital, Stavanger, Norway
| | - Vibeke Stenov
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Cecilie Varsi
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway,; Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Brynja Ingadóttir
- Faculty of Nursing and Midwifery, University of Iceland, Reykjavik, Iceland
| | - Bryan Richard Cleal
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Anita Røyneberg Alvheim
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Karl Fredrik Westermann
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Oslo, Norway
| | - Olöf Birna Kristjansdottir
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Mental health team West, Primary care of the capital area, Reykjavik, Iceland
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Park M, Kim S, Lee H, Shin YJ, Lyu CJ, Choi EK. Development and effects of an internet-based family resilience-promoting program for parents of children with cancer: A randomized controlled trial. Eur J Oncol Nurs 2023; 64:102332. [PMID: 37146351 DOI: 10.1016/j.ejon.2023.102332] [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: 11/16/2022] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE The diagnosis of cancer in children can negatively impact their parents, owing to the complex treatment processes. Families with high levels of resilience can overcome these difficulties and thus perform higher family functions. We aimed to develop an internet-based family resilience-promoting program for parents of children with cancer and evaluate its effect on the levels of family resilience, depression, and family function. METHODS This prospective, parallel-group, randomized-controlled study that was conducted at Yonsei Cancer Center from June to October 2021 included 41 parents of children with cancer. In total, four sessions of the internet-based family resilience-promoting program, led by a nurse, were conducted individually for parents. Levels of family resilience, depression, and family function were measured before, immediately after, and 4 weeks after the program. The data were analyzed using the linear mixed-effect model, and program satisfaction was evaluated through an internet-based questionnaire and interview. RESULTS The experimental group (the family resilience-promoting program participants) differed more significantly from the control group in the level of change in family resilience (β = 13.214, p = 0.003, effect size = 0.374) and family function (β = 1.256, p = 0.018, effect size = 0.394). However, there was no significant difference between the groups in the level of depression (β = 2.133, p = 0.187, effect size = 0.416). All the program participants showed a high program satisfaction score of 4.75 out of 5.00 points overall. CONCLUSIONS The applicability of the internet-based family resilience-promoting program as an appropriate nursing intervention was verified. Its application can help the families of children with cancer adapt to the stressful situation of their children's cancer diagnosis and treatment.
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Affiliation(s)
- Mina Park
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
| | - Sunah Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Hyejung Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Yoon Jung Shin
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - Chuhl Joo Lyu
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
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Thiblin E, Woodford J, Reuther C, Lundgren J, Lutvica N, von Essen L. Internet-administered, low-intensity cognitive behavioral therapy for parents of children treated for cancer: A feasibility trial (ENGAGE). Cancer Med 2023; 12:6225-6243. [PMID: 36404407 PMCID: PMC10028033 DOI: 10.1002/cam4.5377] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/05/2022] [Accepted: 10/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Parents of children treated for cancer may experience mental health difficulties, such as depression and anxiety. There is a lack of evidence-based psychological interventions for parents, with psychological support needs unmet. An internet-administered, guided, low-intensity cognitive behavioral therapy-based (LICBT) self-help intervention may provide a solution. METHODS The feasibility and acceptability of such an intervention was examined using a single-arm feasibility trial (ENGAGE). Primary objectives examined: (1) estimates of recruitment and retention rates; (2) feasibility and acceptability of data collection instruments and procedures; and (3) intervention feasibility and acceptability. Clinical outcomes were collected at baseline, post-treatment (12 weeks), and follow-up (6 months). RESULTS The following progression criteria were met: sample size was exceeded within 5 months, with 11.0% enrolled of total population invited, study dropout rate was 24.0%, intervention dropout was 23.6%, missing data remained at ≤10% per measure, and no substantial negative consequences related to participation were reported. Intervention adherence was slightly lower than progression criteria (47.9%). CONCLUSION Findings suggest an internet-administered, guided, LICBT self-help intervention may represent a feasible and acceptable solution for parents of children treated for cancer. With minor study protocol and intervention modifications, progression to a pilot randomized controlled trial (RCT) and subsequent superiority RCT is warranted.
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Affiliation(s)
- Ella Thiblin
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Johan Lundgren
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Nina Lutvica
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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4
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Drissi N, Ouhbi S, Serhani MA, Marques G, de la Torre Díez I. Connected Mental Health Solutions: Global Attitudes, Preferences, and Concerns. Telemed J E Health 2023; 29:315-330. [PMID: 35730979 DOI: 10.1089/tmj.2022.0036] [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: 11/12/2022] Open
Abstract
Background: Connected mental health (CMH) presents several technology-based solutions, which can help overcome many mental care delivery barriers. However, attitudes toward the use of CMH are diverse and differ from a cohort to another. Objective: The purpose of this study is to investigate the global attitudes toward CMH use and assess the use of technology for mental care. Methods: This study presents a synthesis of literature available in Scopus, Science Direct, and PubMed digital libraries, investigating attitudes toward CMH in different cohorts from different countries, based on a systematic review of relevant publications. This study also analyzes technology use patterns of the cohorts investigated, the reported preferred criteria that should be considered in CMH, and issues and concerns regarding CMH use. Results: One hundred and one publications were selected and analyzed. These publications were originated from different countries, with the majority (n = 23) being conducted in Australia. These studies reported positive attitudes of investigated cohorts toward CMH use and high technology use and ownership. Several preferred criteria were reported, mainly revolving around providing blended care functionalities, educational content, and mental health professionals (MHPs) support. Whereas concerns and issues related to CMH use addressed technical problems related to access to technology and to CMH solutions, the digital divide, lack of knowledge and use of CMH, and general reservations to use CMH. Concerns related to institutional and work barriers were also identified. Conclusions: Attitudes toward CMH show promising results from users and MHP views. However, factors such as providing blended care options and considering technical concerns should be taken into consideration for the successful adoption of CMH.
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Affiliation(s)
- Nidal Drissi
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sofia Ouhbi
- Department of Computer Science and Software Engineering, CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohamed Adel Serhani
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gonçalo Marques
- Polytechnic of Coimbra, School of Technology and Management of Oliveira do Hospital (ESTGOH), Coimbra, Portugal
| | - Isabel de la Torre Díez
- Department of Signal Theory and Communications and Telematics Engineering, University of Valladolid, Valladolid, Spain
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Grafft N, Aftosmes-Tobio A, Gago C, Lansburg K, Beckerman-Hsu J, Trefry B, Kumanyika S, Davison K. Adaptation and implementation outcomes of a parenting program for low-income, ethnically diverse families delivered virtually versus in-person. Transl Behav Med 2022; 12:1065-1075. [PMID: 36318233 PMCID: PMC9677462 DOI: 10.1093/tbm/ibac077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Driven by the COVID-19 pandemic, many in-person health behavior interventions were compelled to quickly pivot to a virtual format with little time or capacity to reflect on or examine possible equity-related implications of a format that required digital access and remote learning skills. Using a parenting program for low-income families as a case study, this paper (a) outlines the process of adapting the program from an in-person to a virtual format and (b) examines the equity-related implications of this adaptation. Parents Connect for Healthy Living (PConnect) is a 10-session empowerment-focused parenting intervention designed to promote family health for Head Start families. In 2020, PConnect was adapted over a 6-month period from an in-person to a virtual format due to the advent of the COVID-19 pandemic. Three core elements were retained in the adaptation; session content, provision of coaching support for facilitators, and the co-facilitation model. Key modifications include session length, group composition, and language of program delivery. Head Start and PConnect records provided data to compare reach, acceptability, and appropriateness of virtual and in-person PConnect. Seventy-eight parents enrolled in the in-person program and 58 in the virtual program. Participant demographics and satisfaction were similar across formats, and demographics similar to the general Head Start population. Participation was higher in the virtual format. Parents participated in the virtual program primarily via smart phones (68%). This case study supports the acceptability and appropriateness of virtual parenting programs in ethnically diverse, low-resource settings.
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Affiliation(s)
- Natalie Grafft
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | | | - Cristina Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kindra Lansburg
- Action for Boston Community Development (ABCD), Boston, MA, USA
| | | | - Brooke Trefry
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | | | - Kirsten Davison
- School of Social Work, Boston College, Chestnut Hill, MA, USA
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Sansom-Daly UM, McLoone JK, Touyz L, Signorelli C. New Frontiers in Child, Adolescent and Young Adult Psycho-Oncology Survivorship Care. Cancers (Basel) 2022; 14:4335. [PMID: 36139504 PMCID: PMC9496797 DOI: 10.3390/cancers14184335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 12/03/2022] Open
Abstract
The landscape of cancer survivorship has changed considerably from Fitzhugh Mullan's conceptualization of the three sequential phases or 'seasons of survival' that an individual might expect to pass through, from the acute (cancer diagnosis and treatment), extended (the period following treatment), and permanent (survivorship, aligned with cure) survivorship phases [...].
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Affiliation(s)
- Ursula M. Sansom-Daly
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Jordana K. McLoone
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
| | - Lauren Touyz
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
| | - Christina Signorelli
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Kensington, NSW 2052, Australia
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7
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Boele F, Hertler C, Dirven L, Piil K, Sherwood P. Family caregiver constructs and outcome measures in neuro-oncology: A systematic review. Neurooncol Pract 2022; 9:465-474. [DOI: 10.1093/nop/npac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
As a first step to reach consensus on the key constructs and outcomes in neuro-oncology caregiver research, we performed a systematic review to evaluate the constructs that are being evaluated in research studies and how these have been assessed.
Methods
All peer-reviewed publications with primary data reporting on outcomes of family caregivers of adult primary brain tumor patients were eligible. Electronic databases PubMed/Medline, Embase, Web of Science, Emcare, Cochrane Library, and PsycINFO were searched up to September 2021. Using Covidence, title and abstract screening, full-text review, and data extraction were done by two researchers independently, with a third guiding consensus. Constructs as reported in each study, and how these were assessed were the primary result.
Results
Searches yielded 1090 unique records, with 213 remaining after title/abstract screening. Of these, 157 publications met inclusion criteria, comprising 120 unique studies. These originated from 18 countries and were published between 1996 and 2022. Most were observational (75%) cross-sectional (61%) studies, reporting on quantitative methods (62%). Twenty-seven different constructs were assessed and mapped along the Caregiver Health Model (CGHM) categories, namely, caregiver health, needs, tasks, beliefs and attitudes, and environment. Seventeen questionnaires were used >2 times to measure the same construct, with the vast majority of questionnaires only used across one or two studies.
Conclusions
Neuro-oncology caregiving research is a field gaining traction, but lags behind in clear definition of key constructs, and consistency in assessment of these constructs. Developing consensus or guidance will improve comparability of studies, meta-analyses, and advance the science more quickly.
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Affiliation(s)
- Florien Boele
- Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds , Leeds , UK
- Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds , Leeds , UK
| | - Caroline Hertler
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich and University of Zurich , Zurich , Switzerland
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center , Leiden , The Netherlands
- Department of Neurology, Haaglanden Medical Center , The Hague , The Netherlands
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark
- Department of Public Health, Aarhus University , Aarhus , Denmark
| | - Paula Sherwood
- School of Nursing, University of Pittsburgh , Pittsburgh, Pennsylvania , USA
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Blessin M, Lehmann S, Kunzler AM, van Dick R, Lieb K. Resilience Interventions Conducted in Western and Eastern Countries-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6913. [PMID: 35682495 PMCID: PMC9180776 DOI: 10.3390/ijerph19116913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/26/2022]
Abstract
Previous research has demonstrated the efficacy of psychological interventions to foster resilience. However, little is known about whether the cultural context in which resilience interventions are implemented affects their efficacy on mental health. Studies performed in Western (k = 175) and Eastern countries (k = 46) regarding different aspects of interventions (setting, mode of delivery, target population, underlying theoretical approach, duration, control group design) and their efficacy on resilience, anxiety, depressive symptoms, quality of life, perceived stress, and social support were compared. Interventions in Eastern countries were longer in duration and tended to be more often conducted in group settings with a focus on family caregivers. We found evidence for larger effect sizes of resilience interventions in Eastern countries for improving resilience (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] 0.28 to 0.67; p < 0.0001; 43 studies; 6248 participants; I2 = 97.4%). Intercultural differences should receive more attention in resilience intervention research. Future studies could directly compare interventions in different cultural contexts to explain possible underlying causes for differences in their efficacy on mental health outcomes.
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Affiliation(s)
- Manpreet Blessin
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Sophie Lehmann
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Angela M. Kunzler
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
| | - Rolf van Dick
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, 55131 Mainz, Germany
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9
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Parental Sleep, Distress, and Quality of Life in Childhood Acute Lymphoblastic Leukemia: A Longitudinal Report from Diagnosis up to Three Years Later. Cancers (Basel) 2022; 14:cancers14112779. [PMID: 35681759 PMCID: PMC9179657 DOI: 10.3390/cancers14112779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/28/2022] [Accepted: 05/29/2022] [Indexed: 12/13/2022] Open
Abstract
This study assessed sleep, distress and quality of life (QoL) in parents of children with acute lymphoblastic leukemia (ALL) from diagnosis to three years after, and the impact of sleep and distress on QoL. Additionally, this study explored determinants of sleep and distress. Parents completed the MOS Sleep, Distress Thermometer for Parents and SF-12 at four-five months (T0), one year (T1), two years (T2), and three years (T3) after diagnosis. The course of outcomes and longitudinal impact of clinically relevant sleep problems (>1SD above reference’s mean) and clinical distress (score ≥ 4) on QoL Z-scores were assessed with linear mixed-models. Determinants of sleep and distress were assessed with multinomial mixed-models. Parents (81% mothers) of 139 patients (60% males; 76% medium-risk (MR)) participated. Distress and QoL gradually restored from T0 to T3. Sleep problems improved, but were still elevated at T3: 33% reported clinically relevant sleep problems, of which 48% in concurrence with distress. Over time, presence of sleep problems or distress led to lower mental QoL Z-scores (SD-score −0.2 and −0.5, respectively). Presence of both led to a cumulatively lower Z-score (SD-score −1.3). Parents in the latter group were more likely to report insufficient social support, parenting problems, a chronic illness, pain for their child, having a child with MR-ALL, and being closer to diagnosis. In conclusion, parental well-being improves over time, yet sleep problems persist. In combination with ongoing distress, they cumulatively affect QoL. Special attention should be given to parents who are vulnerable to worse outcomes.
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10
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Tonorezos ES, Cohn RJ, Glaser AW, Lewin J, Poon E, Wakefield CE, Oeffinger KC. Long-term care for people treated for cancer during childhood and adolescence. Lancet 2022; 399:1561-1572. [PMID: 35430023 PMCID: PMC9082556 DOI: 10.1016/s0140-6736(22)00460-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 01/31/2022] [Accepted: 03/03/2022] [Indexed: 12/25/2022]
Abstract
Worldwide advances in treatment and supportive care for children and adolescents with cancer have resulted in a increasing population of survivors growing into adulthood. Yet, this population is at very high risk of late occurring health problems, including significant morbidity and early mortality. Unique barriers to high-quality care for this group include knowledge gaps among both providers and survivors as well as fragmented health-care delivery during the transition from paediatric to adult care settings. Survivors of childhood and adolescent cancer are at risk for a range of late-occuring side-effects from treatment, including cardiac, endocrine, pulmonary, fertility, renal, psychological, cognitive, and socio-developmental impairments. Care coordination and transition to adult care are substantial challenges, but can be empowering for survivors and improve outcomes, and could be facilitated by clear, effective communication and support for self-management. Resources for adult clinical care teams and primary care providers include late-effects surveillance guidelines and web-based support services.
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Affiliation(s)
- Emily S Tonorezos
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, NSW, Australia
| | - Adam W Glaser
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Jeremy Lewin
- ONTrac at Peter Mac Victorian Adolscent and Young Adult Cancer Service, Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Eileen Poon
- Division of Medical Oncology, National Cancer Centre, Singapore
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, NSW, Australia
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Espinoza-Salgado FS, Robles García R, Wakefield CE, Kelada L, Sansom-Daly UM, McGill BC, Zentella Tusie A, Juárez García L, Cárdenas Cardos RDS, Zapata-Tarrés M. Adaptación cultural mexicana del programa de intervención CASCAdE para padres de supervivientes de cáncer infantil. PSICOONCOLOGIA 2022. [DOI: 10.5209/psic.80798] [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: Describir el proceso de adaptación cultural del programa CASCAdE en línea para padres de supervivientes de cáncer infantil mexicanos. Método: Se utilizó el Modelo Ecológico de Validación (MEV), en dos fases: la primera consistió en la traducción (inglés-español) y adaptación cultural de los contenidos del programa; la segunda fue la evaluación del contenido e integridad del tratamiento. Resultados: Se realizaron cambios en la redacción del texto, se modificó el uso de la segunda persona del singular por la tercera persona del singular “usted”. Del MEV se eligieron para adaptación de materiales: Lenguaje, Personas, Metáforas o dichos, Narrativa y Conceptos. Entre los cambios más relevantes se encuentran el uso de la tercera persona del singular (aceptabilidad) y la adaptación de metáforas que fueran entendibles en este contexto (relevancia). Para la intervención se adaptaron: Métodos, contexto y objetivos, dando como resultado la aplicación individual, cambios en el diseño gráfico e inclusión de iconografías llamativas y amigables para los padres (aceptabilidad). En la evaluación del contenido por jueces expertos se obtuvieron porcentajes del 50% de acuerdo en redacción de las sesiones de introducción del manual para el facilitador y 75% en redacción de la sesión cuatro del manual para padres. Conclusión: Este estudio muestra el proceso de adaptación cultural desde el MEV a fin de contar con los materiales necesarios para que la aplicación del programa CASCAdE en un contexto mexicano.
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12
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Akdeniz Kudubes A, Semerci R, Bektas M, Akgün Kostak M. The effects of administered interventions on quality of life of children with cancer in Turkey: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2022; 31:e13544. [PMID: 35088493 DOI: 10.1111/ecc.13544] [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: 10/21/2020] [Revised: 10/23/2021] [Accepted: 12/02/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The present systematic review and meta-analysis aimed to analyse the effects of administered interventions on the quality of life of children with cancer in Turkey. METHODS The quantitative studies conducted with paediatric oncology patients, analysing the quality of life of Turkish children, and published papers from 2009 to 2019 were searched. Joanna Briggs Institution MAStARI Experimental and Quasi-Experimental Research Control List and Quality Index were used for methodological assessment. Five studies comprising a total of 264 samples were included. Four studies were nonrandomised controlled trials, and one was a quasi-experimental study. RESULTS Tests for heterogeneity showed that the studies, which included interventions increasing the quality of life of children with cancer, were heterogeneous. The common effect size of all studies on quality of life was determined as having a strong positive effect. CONCLUSIONS This meta-analysis and systematic review contribute to the knowledge of Turkish health care professionals regarding these interventions by producing results with high levels of evidence on the improvement of the quality of life among children with cancer. The present study also significantly raises awareness and encourages health care professionals to implement interventions for the improvement of quality of life among children with cancer.
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Affiliation(s)
- Aslı Akdeniz Kudubes
- Department of Pediatric Nursing, Faculty of Health Sciences, Bilecik Şeyh Edebali University, Bilecik, Turkey
| | - Remziye Semerci
- Department of Pediatric Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Murat Bektas
- Department of Pediatric Nursing, Faculty of Health Sciences, Bilecik Şeyh Edebali University, Bilecik, Turkey
| | - Melahat Akgün Kostak
- Department of Pediatric Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey
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13
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Currie CL, Larouche R, Voss ML, Trottier M, Spiwak R, Higa E, Scott D, Tallow T. Effectiveness of live health professional-led group eHealth interventions for adult mental health: A systematic review of randomized controlled trials. J Med Internet Res 2021; 24:e27939. [PMID: 34878409 PMCID: PMC8790691 DOI: 10.2196/27939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 11/03/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background The COVID-19 pandemic has had adverse impacts on mental health and substance use worldwide. Systematic reviews suggest eHealth interventions can be effective at addressing these problems. However, strong positive eHealth outcomes are often tied to the intensity of web-based therapist guidance, which has time and cost implications that can make the population scale-up of more effective interventions difficult. A way to offset cost while maintaining the intensity of therapist guidance is to offer eHealth programs to groups rather than more standard one-on-one formats. Objective This systematic review aims to assess experimental evidence for the effectiveness of live health professional–led group eHealth interventions on mental health, substance use, or bereavement among community-dwelling adults. Within the articles selected for our primary aim, we also seek to examine the impact of interventions that encourage physical activity compared with those that do not. Methods Overall, 4 databases (MEDLINE, CINAHL, PsycINFO, and the Cochrane Library) were searched in July 2020. Eligible studies were randomized controlled trials (RCTs) of eHealth interventions led by health professionals and delivered entirely to adult groups by videoconference, teleconference, or webchat. Eligible studies reported mental health, substance use, or bereavement as primary outcomes. The results were examined by outcome, eHealth platform, and intervention length. Postintervention data were used to calculate effect size by study. The findings were summarized using the Synthesis Without Meta-Analysis guidelines. Risk of bias was assessed using the Cochrane Collaboration Tool. Results Of the 4099 identified studies, 21 (0.51%) RCTs representing 20 interventions met the inclusion criteria. These studies examined mental health outcomes among 2438 participants (sample size range: 47-361 participants per study) across 7 countries. When effect sizes were pooled, live health professional–led group eHealth interventions had a medium effect on reducing anxiety compared with inactive (Cohen d=0.57) or active control (Cohen d=0.48), a medium to small effect on reducing depression compared with inactive (Cohen d=0.61) or active control (Cohen d=0.21), and mixed effects on mental distress and coping. Interventions led by videoconference, and those that provided 8-12 hours of live health professional–led group contact had more robust effects on adult mental health. Risk of bias was high in 91% (19/21) of the studies. Heterogeneity across interventions was significant, resulting in low to very low quality of evidence. No eligible RCT was found that examined substance use, bereavement, or physical activity. Conclusions Live eHealth group interventions led by health professionals can foster moderate improvements in anxiety and moderate to small improvements in depression among community-based adults, particularly those delivered by videoconference and those providing 8-12 hours of synchronous engagement. Trial Registration PROSPERO CRD42020187551; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=187551 International Registered Report Identifier (IRRID) RR2-10.1186/s13643-020-01479-3
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Affiliation(s)
- Cheryl L Currie
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - M Lauren Voss
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - Maegan Trottier
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - Rae Spiwak
- Max Rady College of Medicine, University of Manitoba, Winnipeg, CA
| | - Erin Higa
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - David Scott
- Library Services, University of Lethbridge, Lethbridge, CA
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14
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Wakefield CE, Sansom-Daly UM, McGill BC, Hetherington K, Ellis SJ, Robertson EG, Donoghoe MW, McCarthy M, Kelada L, Girgis A, King M, Grootenhuis M, Anazodo A, Patterson P, Lowe C, Dalla-Pozza L, Miles G, Cohn RJ. Providing Psychological Support to Parents of Childhood Cancer Survivors: ' Cascade' Intervention Trial Results and Lessons for the Future. Cancers (Basel) 2021; 13:cancers13225597. [PMID: 34830752 PMCID: PMC8615912 DOI: 10.3390/cancers13225597] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary We assessed a new group-based cognitive behavior therapy videoconferencing program to support parents of childhood cancer survivors. The trial allocated parents to three groups: Cascade, peer-support, waitlist. Cascade achieved good parent engagement. We successfully delivered Cascade to participants who lived >3200 km apart. Any technical difficulties caused only minor disruptions. Most Cascade parents were satisfied and reported experiencing benefits from the program. However, Cascade did not improve our main outcomes, including parents’ quality of life, depression and anxiety. Cascade parents reported a short-term improvement in their confidence to use the skills they learnt, but this did not translate into actual use. After six months, Cascade parents felt their child survivor had lower psychological health than waitlisted parents. Our findings show that while some parents find Cascade helpful, it may not suit everyone. We used these findings to further improve Cascade and will trial the new version in future. Abstract We conducted a three-armed trial to assess Cascade, a four-module group videoconferencing cognitive behavior therapy (CBT) intervention for parents of childhood cancer survivors currently aged <18 years. We allocated parents to Cascade, an attention control (peer-support group), or a waitlist. The primary outcome was parents’ health-related quality of life (PedsQL-Family Impact/EQ-5D-5L) six months post-intervention. Parents also reported their anxiety/depression, parenting self-agency, fear of recurrence, health service and psychotropic medication use, engagement in productive activities, confidence to use, and actual use of, CBT skills, and their child’s quality of life. Seventy-six parents opted in; 56 commenced the trial. Cascade achieved good parent engagement and most Cascade parents were satisfied and reported benefits. Some parents expressed concerns about the time burden and the group format. Most outcomes did not differ across trial arms. Cascade parents felt more confident to use more CBT skills than peer-support and waitlisted parents, but this did not lead to more use of CBT. Cascade parents reported lower psychosocial health scores for their child than waitlisted parents. Cascade parents’ health service use, psychotropic medication use, and days engaged in productive activities did not improve, despite some improvements in waitlisted parents. Our trial was difficult to implement, but participants were largely satisfied. Cascade did not improve most outcomes, possibly because many parents were functioning well pre-enrolment. We used these findings to improve Cascade and will trial the new version in future.
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Affiliation(s)
- Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Correspondence: ; Tel.: +61-(2)-9382-3113; Fax: +61-(2)-9382-1789
| | - Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Kate Hetherington
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia;
| | - Eden G. Robertson
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Maria McCarthy
- Clinical Sciences, Brain and Mind, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia;
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 2052, Australia
| | - Lauren Kelada
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Afaf Girgis
- South West Sydney Clinical Campuses, UNSW Medicine and Health, Sydney, NSW 2052, Australia;
| | - Madeleine King
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia;
| | - Martha Grootenhuis
- Princess Máxima Center for Pediatric Oncology, 3584 CT Utrecht, The Netherlands;
| | - Antoinette Anazodo
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Pandora Patterson
- Research, Evaluation and Social Policy Unit, Canteen, Newtown, NSW 2042, Australia;
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Cherie Lowe
- Queensland Children’s Cancer Centre, Queensland Children’s Hospital, South Brisbane, QLD 4101, Australia;
| | - Luciano Dalla-Pozza
- Cancer Centre for Children, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia;
| | - Gordon Miles
- Child and Adolescent Mental Health Service, Perth Children’s Hospital, Perth, WA 6009, Australia;
| | - Richard J. Cohn
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; (U.M.S.-D.); (B.C.M.); (K.H.); (S.J.E.); (E.G.R.); (M.W.D.); (L.K.); (A.A.); (R.J.C.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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15
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McCarthy MC, Marks IR, Mulraney M, Downie P, Matson A, De Luca CR. Parental adjustment following their child's completion of acute lymphoblastic leukemia treatment. Pediatr Blood Cancer 2021; 68:e29302. [PMID: 34411413 DOI: 10.1002/pbc.29302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Few studies haveexamined parent and family adaptation in the early period following the end of childhood cancer treatment. We examined parent adjustment at the end of their child's treatment for acute lymphoblastic leukemia (ALL). METHODS Parents of childhood cancer survivors (CCS), who were 3 months post-ALL treatment, and parents of typically developing children completed measures of psychological and family functioning. Parents of CCS also completed distress and posttraumatic stress symptom (PTSS) questionnaires related to their child's cancer experience. RESULTS One hundred twenty-nine parents were recruited: 77 parents of CCS and 52 comparison parents. Overall mean psychological symptoms of depression, anxiety and stress, and family functioning were within normal limits for both groups. Parents of CCS endorsed higher scores for stress, depression, and family problems; however, mean scores for emotional distress were low for both groups, in particular the comparison group. Parents of CCS endorsed low rates of PTSS. Fifty-one percent of parents of CCS scored above the distress thermometer (DT-P) clinical cutoff (>4), with items elevated across all six DT-P domains. However, most parents did not indicate a wish to speak to a health professional about their symptoms. CONCLUSION Specialist psychosocial intervention may be indicated for only a subset of parents at the end of treatment. As per psychosocial standards of care, effective screening at this timepoint is warranted. Further examination of appropriate timing of psychosocial information and support services that are tailored to parents' circumstances is needed. eHealth approaches may be appropriate.
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Affiliation(s)
- Maria C McCarthy
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - India R Marks
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Melissa Mulraney
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Downie
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Children's Cancer Centre, Monash Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Alice Matson
- School of Psychological Science, University of Melbourne, Melbourne, Victoria, Australia
| | - Cinzia R De Luca
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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16
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Milbury K, Kroll J, Chen A, Antonoff MB, Snyder S, Higgins H, Yang CC, Li Y, Bruera E. Pilot Randomized Controlled Trial in Women With Non-Small Cell Lung Cancer to Assess the Feasibility of Delivering Group-Based Psychosocial Care via Videoconference. Integr Cancer Ther 2021; 20:15347354211052520. [PMID: 34663123 PMCID: PMC8529304 DOI: 10.1177/15347354211052520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The goal of this pilot randomized controlled trial was to examine the
feasibility and acceptability of delivering group-based psychosocial care
via videoconference (ie, Zoom) to women with lung cancer undergoing
treatment. Methods: At baseline, women indicated their typical computer and internet use and were
then randomized to a group-based intervention that either focused on
mindfulness training or psychoeducation. Participants completed 1 Zoom
“practice run” prior to starting the 5 group sessions (1 per week). After
the last session, they evaluated their experiences with the intervention and
its delivery. Results: With a consent rate of 68%, 54 women (mean age = 66 years; 69% non-Hispanic
White; 48% with stage IV disease) were equally randomized. Attendance was
high in both arms (session mean, mindfulness = 4.38; education = 4.75; 85%
attended all sessions). Across arms, all women rated the program as useful;
most preferred group-based delivery (67%) and remote delivery (50%) or had
no preference. Although the sample’s typical computer use was relatively low
(eg, 19% said that they rarely or never use a computer), most women (76%)
indicated that Zoom was “very easy” or “easy” to use. After only 0 to 1
attempts, 56% felt comfortable but 26% stated that they never felt
comfortable with the technology. Conclusions: It seems to be feasible to deliver group-based psychosocial interventions via
videoconference in women with lung cancer undergoing treatment. Challenges
regarding scheduling the group sessions and familiarizing older rather than
infrequent computer users with the technology were encountered but resolved
over the course of the trial.
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Affiliation(s)
- Kathrin Milbury
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
| | - Juliet Kroll
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
| | - Aileen Chen
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
| | - Mara B Antonoff
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
| | - Stella Snyder
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
| | - Hannah Higgins
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
| | | | - Yisheng Li
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
| | - Eduardo Bruera
- The University of Texas, MD Anderson Cancer Center, Houston TX, USA
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17
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Morris BB, Rossi B, Fuemmeler B. The role of digital health technology in rural cancer care delivery: A systematic review. J Rural Health 2021; 38:493-511. [PMID: 34480506 DOI: 10.1111/jrh.12619] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Rural residents face higher cancer incidence rates and mortality rates, disparities that could be mitigated with health technology interventions, yet a digital divide is also apparent. This paper systematically and critically examines existing literature to understand how digital technologies have been used to support rural oncology care. METHODS PubMed, CINAHL Complete, PsycINFO, and Embase were searched using Medical Subject Headings terms and keywords. Studies were eligible if they presented empirical data investigating the use of technology in rural oncology and were published in English in a peer-reviewed journal within the last decade. The Mixed Methods Appraisal Tool was used to assess methodological quality. FINDINGS Digital health has been less extensively utilized in rural oncology compared with the general cancer population and other chronic diseases. We identified 54 studies that used technology in rural cancer care delivery, a comparatively small number, representing a significant gap in the literature. Studies were classified into 4 categories: Telemedicine (n = 32), phone calls (n = 11), Internet (n = 9), and mobile phone (n = 2). Of the 54 articles, 12 were RCTs, 17 were quasi-experimental, 3 were descriptive, 12 were mixed methods, and 10 were qualitative. Most of the studies involved patients only (n = 31) and were not specific to a cancer type (n = 41). CONCLUSIONS Further implementation and expansion of telemedicine and phone-based strategies in rural cancer care delivery are warranted. Rural cancer survivors value digital approaches to their care. However, social and behavioral determinants of health and access to technology must be considered.
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Affiliation(s)
- Bonny B Morris
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Brianna Rossi
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Bernard Fuemmeler
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
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18
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Perski O, Short CE. Acceptability of digital health interventions: embracing the complexity. Transl Behav Med 2021; 11:1473-1480. [PMID: 33963864 PMCID: PMC8320880 DOI: 10.1093/tbm/ibab048] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Acceptability is a core concept in digital health. Available frameworks have not clearly articulated why and how researchers, practitioners and policy makers may wish to study the concept of acceptability. Here, we aim to discuss (i) the ways in which acceptability might differ from closely related concepts, including user engagement; (ii) the utility of the concept of acceptability in digital health research and practice; (iii) social and cultural norms that influence acceptability; and (iv) pragmatic means of measuring acceptability, within and beyond the research process. Our intention is not to offer solutions to these open questions but to initiate a debate within the digital health community. We conducted a narrative review of theoretical and empirical examples from the literature. First, we argue that acceptability may usefully be considered an emergent property of a complex, adaptive system of interacting components (e.g., affective attitude, beliefs), which in turn influences (and is influenced by) user engagement. Second, acceptability is important due to its ability to predict and explain key outcomes of interest, including user engagement and intervention effectiveness. Third, precisely what people find acceptable is deeply contextualized and interlinked with prevailing social and cultural norms. Understanding and designing for such norms (e.g., through drawing on principles of user centered design) is therefore key. Finally, there is a lack of standard acceptability measures and thresholds. Star ratings coupled with free-text responses may provide a pragmatic means of capturing acceptability. Acceptability is a multifaceted concept, which may usefully be studied with a complexity science lens.
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Affiliation(s)
- Olga Perski
- Department of Behavioural Science and Health, University College London, London, UK
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
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19
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Woodford J, Farrand P, Hagström J, Hedenmalm L, von Essen L. Internet-Administered Cognitive Behavioral Therapy for Common Mental Health Difficulties in Parents of Children Treated for Cancer: Intervention Development and Description Study. JMIR Form Res 2021; 5:e22709. [PMID: 34142662 PMCID: PMC8367173 DOI: 10.2196/22709] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/08/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Following the end of a child's treatment for cancer, parents may report psychological distress. However, there is a lack of evidence-based interventions that are tailored to the population, and psychological support needs are commonly unmet. An internet-administered low-intensity cognitive behavioral therapy (LICBT)-based intervention (EJDeR [internetbaserad självhjälp för föräldrar till barn som avslutat en behandling mot cancer]) may provide a solution. OBJECTIVE The first objective is to provide an overview of a multimethod approach that was used to inform the development of the EJDeR intervention. The second objective is to provide a detailed description of the EJDeR intervention in accordance with the Template for Intervention Description and Replication (TIDieR) checklist. METHODS EJDeR was developed through a multimethod approach, which included the use of existing evidence, the conceptualization of distress, participatory action research, a cross-sectional survey, and professional and public involvement. Depending on the main presenting difficulty identified during assessment, LICBT behavioral activation or worry management treatment protocols are adopted for the treatment of depression or generalized anxiety disorder when experienced individually or when comorbid. EJDeR is delivered via the Uppsala University Psychosocial Care Programme (U-CARE) portal, a web-based platform that is designed to deliver internet-administered LICBT interventions and includes secure videoconferencing. To guide parents in the use of EJDeR, weekly written messages via the portal are provided by e-therapists comprising final year psychology program students with training in cognitive behavioral therapy. RESULTS An overview of the development process and a description of EJDeR, which was informed by the TIDieR checklist, are presented. Adaptations that were made in response to public involvement are highlighted. CONCLUSIONS EJDeR represents a novel, guided, internet-administered LICBT intervention for supporting parents of children treated for cancer. Adopting the TIDieR checklist offers the potential to enhance fidelity to the intervention protocol and facilitate later implementation. The intervention is currently being tested in a feasibility study (the ENGAGE study). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2018-023708.
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Affiliation(s)
- Joanne Woodford
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
| | - Paul Farrand
- Clinical Education, Development, and Research (CEDAR), Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Josefin Hagström
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
| | - Li Hedenmalm
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
| | - Louise von Essen
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
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20
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Ogez D, Péloquin K, Bertout L, Bourque CJ, Curnier D, Drouin S, Laverdière C, Marcil V, Aramideh J, Ribeiro R, Rondeau É, Sinnett D, Sultan S. “Taking back control together”: Definition of a new intervention designed to support parents confronted with childhood cancer. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.1944476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- David Ogez
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Psychology, Université De Montréal, Québec, Canada
- Department of Anesthesiology and Pain Medicine, Université De Montréal, Québec
| | | | - Laurence Bertout
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Claude-Julie Bourque
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
| | - Daniel Curnier
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Kinesiology, Université De Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
| | - Valérie Marcil
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Nutrition, Université De Montréal, Québec, Canada
| | | | - Rebeca Ribeiro
- Department of Psychology, Université De Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Psychology, Université De Montréal, Québec, Canada
- Department of Pediatrics, Université De Montréal, Québec, Canada
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21
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Harrison R, Raman M, Walpola RL, Chauhan A, Sansom-Daly UM. Preparing for partnerships in cancer care: an explorative analysis of the role of family-based caregivers. BMC Health Serv Res 2021; 21:620. [PMID: 34187469 PMCID: PMC8240189 DOI: 10.1186/s12913-021-06611-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/07/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Family-based 'informal' caregivers are critical to enable sustainable cancer care that produces optimal health outcomes but also gives rise to psychological burdens on caregivers. Evidence of psychosocial support for caregivers does not currently address the impacts of their role in providing clinical and health-related care for their loved ones. The present study sought to address this gap including with those from priority populations. METHODS Qualitative data was collected using focus group and interview methods. We purposively sampled caregivers identified as having a high burden of responsibility for providing clinical care including those from ethnic minority backgrounds, parental caregivers and those living rurally. Transcripts were subject to thematic analysis utilising a team-based approach. RESULTS Family-based caregivers included spouses (11), parents (7), children (1), siblings (1). Ten participants were from ethnic minority backgrounds and five participants were from regional or rural locations. Four resulting inter-related themes were; 1) Dual burden of providing clinical care and managing personal emotional distress; 2) Navigating healthcare partnership dynamics; 3) Developing a caregiving skillset, and 4) Unique supportive needs and barriers to access. These data provide evidence of the unique challenge of providing clinical care as part of family-based caregiving for a loved one with cancer, and the absence of support for caregivers to take up this role. CONCLUSION Our findings highlight the substantial contribution of family-based caregivers to the provision of cancer care in contemporary health systems. Inadequate support for caregivers is apparent with regard to their role in providing clinical aspects of care such as medication administration and management. Support programs to prepare caregivers to provide clinical care while building capacity to manage their stressors and emotions through this challenging period may be valuable towards sustainable, person-centred care.
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Affiliation(s)
- Reema Harrison
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
- School of Population Health, UNSW Sydney, Sydney, Australia.
| | - Madhav Raman
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Ramesh Lahiru Walpola
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Ashfaq Chauhan
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Ursula M Sansom-Daly
- School of Women's and Children's Health, UNSW Sydney, Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
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22
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Kamaladasa DS, Sansom-Daly UM, Hetherington K, McGill BC, Ellis SJ, Kelada L, Donoghoe MW, Evans H, Anazodo A, Patterson P, Cohn RJ, Wakefield CE. How Are Families Faring? Perceived Family Functioning Among Adolescent and Young Adult Cancer Survivors in Comparison to Their Peers. J Adolesc Young Adult Oncol 2021; 10:711-719. [PMID: 33960837 DOI: 10.1089/jayao.2020.0215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescent and young adult (AYA) cancer survivors' families can face ongoing challenges into survivorship. Families' adjustment and functioning as a unit can subsequently impact AYAs' mental health and quality of life. This study examined AYA cancer survivors' perceived family functioning, compared with their peers, and investigated factors associated with family functioning. Methods: Eligible participants were aged between 15 and 40 years, fluent in English, and cancer survivors who had completed treatment. AYA cancer survivors were recruited from hospital clinics, and the comparison group from an affiliated university campus. Participants completed the McMaster Family Assessment Device, Kidcope, and the Depression, Anxiety and Stress Scale-Short Form. We analyzed between-group differences in family functioning using multivariate analysis of covariance and used partial correlations to investigate associations between demographic cancer-related psychological coping variables and family functioning. Results: Ninety-three AYA cancer survivors and 141 comparison peers participated (ages: 15-32 years). AYA cancer survivors reported significantly better family functioning (p = 0.029), lower depression (p = 0.016), and anxiety symptoms (p = 0.008) compared with the comparison group. Approximately one-third of AYA survivors (34.4%) reported clinically significant maladaptive family functioning; however, this was more prevalent in the comparison group (50.4%). After adjusting for covariates, poorer family functioning was associated with AYA survivors using more avoidant escape-oriented coping strategies (p = 0.010). Conclusions: Our cancer survivor cohort reported better family functioning and psychological outcomes compared with their peers. Interventions targeting avoidant coping behaviors may support improved family functioning in some survivors. Further research disentangling the relationship between coping mechanisms and family functioning among AYA cancer survivors is needed.
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Affiliation(s)
- Dinuli S Kamaladasa
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Ursula M Sansom-Daly
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
| | - Kate Hetherington
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Brittany C McGill
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Sarah J Ellis
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Lauren Kelada
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Mark W Donoghoe
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, Australia
| | - Holly Evans
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,School of Psychology, UNSW Sydney, Kensington, Australia
| | - Antoinette Anazodo
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Pandora Patterson
- Canteen Australia, Newtown, Australia.,Cancer Nursing Research Unit, Sydney Nursing School, The University of Sydney, Sydney, Australia
| | - Richard J Cohn
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
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23
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Psychological Outcomes, Health-Related Quality of Life, and Neurocognitive Functioning in Survivors of Childhood Cancer and Their Parents. Pediatr Clin North Am 2020; 67:1103-1134. [PMID: 33131537 DOI: 10.1016/j.pcl.2020.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood cancer disrupts the lives of patients and their families and affects acute and long-term psychological health. This article summarizes (1) psychological challenges, including depression, anxiety, worries, and posttraumatic stress, as well as positive outcomes such as benefit finding and posttraumatic growth in young survivors and parents; (2) health-related quality of life; (3) interventions to support survivors and parents with psychological difficulties; and (4) neurocognitive problems and interventions to help alleviate them. Although many survivors and parents fare well in the long term, many survivors may benefit from interventions. Interventions should be further evaluated and integrated into routine clinical care.
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24
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McLoone J, Wakefield CE, Taylor N, Johnston K, Sansom-Daly UM, Cohen J, O'Brien TA, Cohn RJ, Signorelli C. The COVID-19 pandemic: Distance-delivered care for childhood cancer survivors. Pediatr Blood Cancer 2020; 67:e28715. [PMID: 32970366 DOI: 10.1002/pbc.28715] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Jordana McLoone
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Natalie Taylor
- Cancer Research Division, Cancer Council New South Wales, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Karen Johnston
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Ursula M Sansom-Daly
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.,Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Jennifer Cohen
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.,CanTeen, Sydney, New South Wales, Australia
| | - Tracey A O'Brien
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
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25
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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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26
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Delemere E, Maguire R. The role of Connected Health technologies in supporting families affected by paediatric cancer: A systematic review. Psychooncology 2020; 30:3-15. [PMID: 32893415 DOI: 10.1002/pon.5542] [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] [Received: 05/02/2020] [Revised: 08/06/2020] [Accepted: 08/31/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Families impacted by paediatric cancer are met with logistical, financial and psychological impacts, with severe acute respiratory syndrome coronavirus two creating additional barriers and stressors for these families. Connected Health (CH) may facilitate cancer care. The objective of the present study was to systematically review CH for families/informal caregivers affected by paediatric cancer. METHODS Using search terms relating to: (1) paediatric cancer, (2) family/caregivers and (3) CH, the databases of PsycINFO, Pubmed, EMBASE and Web of Science were searched. Inclusion criteria included an evaluation of CH technologies for supportive care for families/caregivers affected by paediatric cancer at any stage of treatment or survivorship. RESULTS Sixteen studies met inclusion criteria. CH was primarily web-based (n = 6), however smartphone applications (n = 5), telehealth (n = 2) and online groups (n = 3) were utilised. Intervention areas included psycho-social (n = 6), health and information provision (n = 8) and palliative care (n = 2). CONCLUSIONS While limited studies have evaluated the impact of CH on families living with paediatric cancer, emerging evidence suggests potential benefits. More evidenced-based interventions are required.
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Affiliation(s)
- Emma Delemere
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
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27
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Muscara F, McCarthy MC, Rayner M, Nicholson JM, Dimovski A, McMillan L, Hearps SJC, Yamada J, Burke K, Walser R, Anderson VA. Effect of a Videoconference-Based Online Group Intervention for Traumatic Stress in Parents of Children With Life-threatening Illness: A Randomized Clinical Trial. JAMA Netw Open 2020; 3:e208507. [PMID: 32735335 PMCID: PMC7395233 DOI: 10.1001/jamanetworkopen.2020.8507] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE A substantial proportion of parents whose child is diagnosed with a life-threatening illness experience high levels of distress that can lead to long-term mental health difficulties. This can affect the child's recovery. OBJECTIVE To evaluate the efficacy of an acceptance and commitment therapy-based group intervention, delivered using videoconferencing, in reducing posttraumatic stress symptoms (PTSS) in these parents. DESIGN, SETTING, AND PARTICIPANTS This study was a randomized clinical trial of an intervention for parents with elevated acute stress symptoms. It was a single-site study conducted in a tertiary pediatric hospital in Australia. Parents of children aged 0 to 18 years admitted for a life-threatening illness or injury to the oncology, cardiology, or pediatric intensive care departments were eligible. Participants were screened for eligibility within the first month after diagnosis or admission and then were randomized to the intervention group or the waiting list control group 4 to 10 months after diagnosis or admission. Recruitment commenced January 2014, and final postintervention follow-up was completed in February 2018. Data analysis was performed from July to September 2018. INTERVENTIONS Treatment was a psychological acceptance and commitment therapy-based group therapy program called Take a Breath, which consisted of a 6-session parent-mediated psychological intervention delivered via online videoconferences over the course of 8 weeks. Waiting list control participants received treatment as usual and were offered the intervention 3 months after randomization. MAIN OUTCOMES AND MEASURES The primary outcome was PTSS, as measured by the Posttraumatic Stress Disorder Checklist-Version 5 (total score range, 0-80, with higher scores indicating greater symptom severity). The PTSS was measured both before and immediately after the intervention. Changes in psychological skills taught within the intervention were also evaluated, including acceptance, mindfulness, values-based living, and psychological flexibility. RESULTS Of 1232 parents who were assessed for eligibility, 313 were randomized; 161 were allocated to the waiting list control group, and 152 were allocated to the intervention group. Of those allocated, 44 parents in the waiting list group and 37 in the intervention group completed the postintervention questionnaire and were analyzed (81 participants total; mean [SD] age, 37.17 [6.43] years). Sixty-five participants (80.2%) were women, 48 participants (59.3%) were married, and 40 participants (49.4%) lived in rural or regional areas, or in a different state. In addition, 24 parents (29.6%) were in the cardiology illness group, 32 parents (39.5%) were in the oncology group, and 25 parents (30.9%) were in the pediatric intensive care unit group. The intervention group demonstrated significantly greater improvements in PTSS compared with the waiting list group (Cohen d = 1.10; 95% CI, 0.61-1.59; P = .03). The mean Posttraumatic Stress Disorder Checklist-Version 5 scores decreased from 31.7 (95% CI, 27.0-36.4) to 26.2 (95% CI, 21.8-30.7) in the waiting list control group and from 23.3 (95% CI, 18.6-28.1) to 17.8 (95% CI, 13.8-21.8) in the intervention group. CONCLUSIONS AND RELEVANCE The findings of this study support the use of acceptance and commitment therapy to reduce PTSS in parents of very ill children, regardless of diagnosis. These findings also suggest that a brief, group format using a videoconferencing platform can be used effectively to access hard-to-reach populations, particularly fathers and caregivers living in nonmetropolitan areas. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry Identifier: ACTRN12611000090910.
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Affiliation(s)
- Frank Muscara
- Clinical Sciences, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Maria C. McCarthy
- Children’s Cancer Centre, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Meredith Rayner
- Clinical Sciences, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Jan M. Nicholson
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Anica Dimovski
- Clinical Sciences, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Laura McMillan
- Clinical Sciences, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Stephen J. C. Hearps
- Clinical Sciences, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Jackie Yamada
- Clinical Sciences, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Kylie Burke
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Robyn Walser
- Department of Psychology, University of California, Berkeley
- TL Consultation Services, Menlo Park, California
| | - Vicki A. Anderson
- Clinical Sciences, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
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28
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Conway Keller M, King C, Hart L, Engelke K, Needham A, Holden E, Foy K, Lucas R. The end of cancer treatment experience for children, adolescents, and their parents: A systematic review of the literature. J Psychosoc Oncol 2020; 38:573-591. [DOI: 10.1080/07347332.2020.1769795] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Mary Conway Keller
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Courtney King
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Leigh Hart
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Karina Engelke
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Andrew Needham
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Elizabeth Holden
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Kelly Foy
- Division of Hematology-Oncology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
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29
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West CH, Dusome DL, Winsor J, Rallison LB. Falling Down the Rabbit Hole: Child and Family Experiences of Pediatric Hematopoietic Stem Cell Transplant. QUALITATIVE HEALTH RESEARCH 2020; 30:1125-1138. [PMID: 32249699 PMCID: PMC7252601 DOI: 10.1177/1049732320912410] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pediatric hematopoietic stem cell transplant (HSCT) is an intensive treatment that can be life-threatening. All family members experience distress. We conducted a grounded theory study using a family systems-expressive arts framework to develop a theoretical understanding of the family experience of HSCT. Six families (15 family members) participated in two interviews, drew an image, and were guided through a "dialoguing with images" process. Participants did not always perceive HSCT as an experience they had lived as a family and were surprised to hear other family members' experiences. While one mother drew, she suddenly understood it was not only her ill child, but the entire family who had "fallen down the rabbit hole." The family experience of HSCT is described across (a) the pre-HSCT trajectory, (b) family fragmentation (hospitalization), and (c) family reintegration. We identified a critical need for targeted family intervention during the transition into HSCT, throughout and following hospitalization.
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Affiliation(s)
| | - Debra L. Dusome
- Brandon University (Winnipeg site), Winnipeg,
Manitoba, Canada
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30
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Kermani F, Orooji A, Sheikhtaheri A. Teleoncology for children with cancer: A scoping review on applications and outcomes. Int J Med Inform 2020; 139:104118. [PMID: 32353751 DOI: 10.1016/j.ijmedinf.2020.104118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/26/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Teleoncology can be used to reduce the limitations due to the lack of access to specialists, inadequate resources and training, and reducing unnecessary travels and arising of the costs. The purpose of this study was to review the literatures to identify and classify the areas of application and outcomes of using teleoncology in diagnosis, management, and treatment of children with cancer. METHODS This scoping review of the published literatures was conducted by searching the Web of Science, PubMed/Medline, Scopus, and Cochrane Library databases in October 2019. Studies investigated telemedicine in diagnosis, management, and treatment of cancer in children were also included. We identified and classified different applications and the reported outcomes of this technology. RESULTS In this study, 1834 articles were retrieved, and after removing the unrelated and duplicated articles, 20 articles were reviewed ultimately. We found that, teleoncology services were provided to the patients with cancer, their parents, and nurses in various clinical fields such as telepathology, telemental care (telepsychology), teleneurology, teledermatology, telehematology, and teleophthalmology. The findings also showed that, the outcomes of using telemedicine in children with cancer can be classified into six general categories (five primary and 14 secondary outcomes). Primary outcomes including diagnosis accuracy, reduced costs as well as mortality and secondary outcomes consist of improved relationship and training, better care management, satisfaction, and workload. CONCLUSION The use of telemedicine for children with cancer is growing, and there is a tendency for using this technology for families and clinical staff. Providing teleoncology services to children with cancer may improve diagnosis accuracy and reduce the cost and mortality rate. Also, better care management, appropriate relationships and training, increased satisfaction, and decreased workload may be achieved.
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Affiliation(s)
- Farzaneh Kermani
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Azam Orooji
- School of Medicine, North Khorasan University of Medical Science (NKUMS), North Khorasan, Iran
| | - Abbas Sheikhtaheri
- Health Management and Economics Research Center, Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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A Multi-Modal Family Peer Support-Based Program to Improve Quality of Life among Pediatric Brain Tumor Patients: A Mixed-Methods Pilot Study. CHILDREN-BASEL 2020; 7:children7040035. [PMID: 32326026 PMCID: PMC7231280 DOI: 10.3390/children7040035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/11/2020] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
Background: Pediatric brain tumor (PBT) survivors and their families are at risk for diminished psychosocial and quality of life outcomes. Community-based programs that leverage peer support in the context of integrative modalities such as traditional Chinese medicine (TCM) represent a promising avenue for meeting the multidimensional needs of survivors and their families. Methods: Parents and children were enrolled in a 12-week program that included weekly group TCM, a moderated private Facebook support group designed through social support and modeling theory, and weekly parent-only health behavior education and yoga. Process measures and quantitative and qualitative survey data was collected to gauge participant adherence, acceptability, and satisfaction, as well as exploratory outcomes. Results: Eleven parents completed surveys at all time points. Six of nine families attended at least 80% of the group TCM sessions, and eight of nine families interacted in the Facebook support group at least five days a week. Parents reported high levels of satisfaction and perceived benefits for the program. Baseline emotional distress, health behaviors, and QoL measurements improved during the three-month intervention. Qualitative data indicated parents perceived both in-person and the Facebook group peer support contributed to the benefits of the program. Conclusion: This feasibility study demonstrated that a multimodal peer support-based intervention that included in-person and online group interaction is feasible and acceptable to parents of pediatric brain tumor patients. Further research on interventions for caregivers that include in-person and online group-based peer support is warranted, with the goal of exploring similar outcomes in other childhood cancer diagnoses.
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Hovén E, Hagström J, Pöder U, Grönqvist H, von Essen L. Parents' needs of support following the loss of a child to cancer: a Swedish, prospective, longitudinal, multi-centre study. Acta Oncol 2020; 59:351-357. [PMID: 31702406 DOI: 10.1080/0284186x.2019.1686535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Parents' needs of support following the loss of a child to cancer and whether these needs are met are not fully known. This study aimed to describe parents' needs, opportunity, and benefit of support from healthcare professionals and significant others from shortly after, up to five years after bereavement.Material and methods: Data were collected at nine months (T5, n = 20), eighteen months (T6, n = 37), and five years after the child's death (T7, n = 38). Parents answered questions via telephone about need, opportunity, and benefit of talking to psychologists, social workers, partners, and friends. Needs were examined in relation to parent and child characteristics, including sex, age, and parent posttraumatic stress symptoms (PTSS).Results: The proportion reporting a need of support from psychologists varied from 56% and 46% at T5 to 20% and 6% at T7 (mothers and fathers, respectively). All mothers and 90% of fathers reported a need of support from social workers at T5. At T7, the corresponding percentages were 30% and 6%. More mothers than fathers reported a need of support from friends at T7 (p = .001). The proportion reporting a need of support from psychologists, social workers, and friends decreased over time (all p ≤ .050). Parents reporting a higher level of PTSS were more likely to report a need of support from social workers at T6 (p = .040) and from psychologists (p = .011) and social workers (p = .012) at T7. Opportunities for support from healthcare professionals varied, most reported need of and opportunity for support from significant others. Almost all reported benefit from received support.Conclusion: Bereaved parents need and benefit of support from healthcare professionals and significant others. Results show a need for improved access to psychosocial services, even at five years post bereavement. Large-scale studies are needed to better understand the associations between parent and child characteristics and support needs.
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Affiliation(s)
- Emma Hovén
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Josefin Hagström
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Ulrika Pöder
- Caring Sciences, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Baenziger J, Hetherington K, Wakefield CE, Carlson L, McGill BC, Cohn RJ, Michel G, Sansom-Daly UM. Understanding parents’ communication experiences in childhood cancer: a qualitative exploration and model for future research. Support Care Cancer 2020; 28:4467-4476. [DOI: 10.1007/s00520-019-05270-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
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Rensen N, Steur LMH, Schepers SA, Merks JHM, Moll AC, Grootenhuis MA, Kaspers GJL, van Litsenburg RRL. Concurrence of sleep problems and distress: prevalence and determinants in parents of children with cancer. Eur J Psychotraumatol 2019; 10:1639312. [PMID: 31448065 PMCID: PMC6691919 DOI: 10.1080/20008198.2019.1639312] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/23/2019] [Accepted: 06/18/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Parents of children with cancer are at risk for sleep problems. If these problems persist, an important perpetuating factor might be ongoing parental distress. Objective: The aim of this study is to assess the prevalence of sleep problems and the concurrence with distress in parents of children treated for cancer, and to identify predictors of this symptom clustering. Method: Parents completed the Medical Outcomes Study (MOS) Sleep Scale and Distress Thermometer for Parents (DT-P). Clinically relevant sleep problems were defined as a score >1SD above the norm and clinical distress as a thermometer score above the established cut-off of 4. Four parent categories were constructed: neither sleep problems nor distress; no distress but sleep problems; no sleep problems but distress; both sleep problems and distress. Predictive determinants (sociodemographic, medical, psychosocial) for each category were assessed with multilevel multinomial logistic regression. Results: Parents (202 mothers and 150 fathers) of 231 children with different cancers participated. Mean time since diagnosis was 3.3 ± 1.4 years (90% off-treatment). The prevalence of sleep problems was 37%. Fifty percent of parents reported neither sleep problems nor distress, 9% had only sleep problems, 13% only distress, and 28% reported both. Compared to parents without sleep problems or distress, parents who reported both were more likely to report parenting problems (OR 4.4, [2.2-9.1]), chronic illness (OR 2.8, [1.2-6.5]), insufficient social support (OR 3.7, [1.5-9.1]), pre-existent sleep problems (OR 6.2, [2.0-18.6]) and be female (OR 1.8, [1.1-4.2]). Conclusions: Sleep problems are common in parents of children treated for cancer, and occur mostly in the presence of clinical distress. Future research must show which interventions are most effective in this group: mainly targeted at sleep improvement or with prominent roles for stress management or trauma processing.
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Affiliation(s)
- Niki Rensen
- Pediatric Oncology-Hematology, Cancer Center Amsterdam, Amsterdam UMC, Emma Children’s Hospital, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Lindsay M. H. Steur
- Pediatric Oncology-Hematology, Cancer Center Amsterdam, Amsterdam UMC, Emma Children’s Hospital, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sasja A. Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Psychosocial Department, Amsterdam UMC, Emma Children’s Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Johannes H. M. Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Pediatric Oncology-Hematology, Amsterdam UMC, Emma Children’s Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Annette C. Moll
- Ophthalmology, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Martha A. Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Psychosocial Department, Amsterdam UMC, Emma Children’s Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Gertjan J. L. Kaspers
- Pediatric Oncology-Hematology, Cancer Center Amsterdam, Amsterdam UMC, Emma Children’s Hospital, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Raphaële R. L. van Litsenburg
- Pediatric Oncology-Hematology, Cancer Center Amsterdam, Amsterdam UMC, Emma Children’s Hospital, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
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Boele FW, Rooney AG, Bulbeck H, Sherwood P. Interventions to help support caregivers of people with a brain or spinal cord tumour. Cochrane Database Syst Rev 2019; 7:CD012582. [PMID: 31264707 PMCID: PMC6604115 DOI: 10.1002/14651858.cd012582.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The diagnosis and treatment of a brain or spinal cord tumour can have a huge impact on the lives of patients and their families with family caregiving often resulting in considerable burden and distress. Meeting the support needs of family caregivers is critical to maintain their emotional and physical health. Although support for caregivers is becoming more widely available, large-scale implementation is hindered by a lack of high-quality evidence for its effectiveness in the neuro-oncology caregiver population. OBJECTIVES To assess the effectiveness of supportive interventions at improving the well-being of caregivers of people with a brain or spinal cord tumour. To assess the effects of supportive interventions for caregivers in improving the physical and emotional well-being of people with a brain or spinal cord tumour and to evaluate the health economic benefits of supportive interventions for caregivers. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 7), MEDLINE via Ovid, and Embase via Ovid. We also handsearched relevant published conference abstracts (previous five years), publications in the two main journals in the field (previous year), searched for ongoing trials via ClinicalTrials.gov, and contacted research groups in the field. The initial search was in March 2017 with an update in August 2018 (handsearches completed in January 2019). SELECTION CRITERIA We included all randomised controlled trials (RCTs) where caregivers of neuro-oncology patients constituted more than 20% of the sample and which evaluated changes in caregiver well-being following any supportive intervention. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies and carried out risk of bias assessments. We aimed to extract data on the outcomes of psychological distress, burden, mastery, quality of patient-caregiver relationship, quality of life, and physical functioning. MAIN RESULTS In total, the search identified 2102 records, of which we reviewed 144 in full text. We included eight studies. Four interventions focused on patient-caregiver dyads and four were aimed specifically at the caregiver. Heterogeneity of populations and methodologies precluded meta-analysis. Risk of bias varied, and all studies included only small numbers of neuro-oncology caregivers (13 to 56 participants). There was some evidence for positive effects of caregiver support on psychological distress, mastery, and quality of life (low to very low certainty of evidence). No studies reported significant effects on caregiver burden or quality of patient-caregiver relationship (low to very low certainty of evidence). None of the studies assessed caregiver physical functioning. For secondary outcomes (patient emotional or physical well-being; health economic effects), we found very little to no evidence for the effectiveness of caregiver support. We identified five ongoing trials. AUTHORS' CONCLUSIONS The eight small-scale studies included employed different methodologies across different populations, with low certainty of evidence overall. It is not currently possible to draw reliable conclusions regarding the effectiveness of supportive interventions aimed at improving neuro-oncology caregiver well-being. More high-quality research is needed on support for family caregivers of people diagnosed, and living, with a brain or spinal cord tumour.
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Affiliation(s)
- Florien W Boele
- University of Leeds and Leeds Cancer CentreLeeds Institute of Health Sciences and Leeds Institute of Cancer and PathologyPOG, Level 3, Bexley WingSt James's Institute of OncologyLeedsUKLS9 7TF
| | - Alasdair G Rooney
- Edinburgh Centre for Neuro‐Oncology (ECNO)Department of Psychological MedicineWestern General HospitalCrewe Road SouthEdinburghScotlandUKEH4 2XU
| | - Helen Bulbeck
- brainstrustDirector of Services4 Yvery CourtCastle RoadCowesIsle of WightUKPO31 7QG
| | - Paula Sherwood
- University of PittsburghDepartment of Acute and Tertiary Care336 Victoria Building3500 Victoria StreetPittsburghMAUSA15261
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Rensen N, Steur LM, Schepers SA, Merks JH, Moll AC, Kaspers GJ, Grootenhuis MA, van Litsenburg RR. Gender-specific differences in parental health-related quality of life in childhood cancer. Pediatr Blood Cancer 2019; 66:e27728. [PMID: 30916456 DOI: 10.1002/pbc.27728] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parents of children with cancer are at risk for impaired health-related quality of life (HRQoL). Most prior research has focused on the HRQoL of mothers. The aim of this study is to describe HRQoL in mothers and fathers, and determine the influence of sociodemographic, medical, and psychosocial factors. PROCEDURE In a cross-sectional study, both parents completed questionnaires on sociodemographics, distress, and HRQoL. Parental HRQoL was compared to healthy population values. Differences between mothers and fathers were evaluated with multilevel analysis. Gender-specific HRQoL determinants were assessed via multiple linear regression analysis. RESULTS Parents (202 mothers, 150 fathers; comprising 121 couples) of 231 children with different cancer diagnoses (mean time since diagnosis 3.3 ± 1.4 years, 90% posttreatment) participated. Compared to healthy women and men, mothers and fathers reported significantly impaired HRQoL on the following domains: cognitive functioning, sleep, daily activities, and vitality (Cohen's d = 0.3-0.9). Additionally, maternal HRQoL was reduced on the domains gross motor functioning, pain, social functioning, sexuality, and depressive emotions. Mothers scored worse than fathers on six of 12 domains. Risk factors for adverse outcomes in both parents were higher distress, emotional and parenting problems, little social support, medication use, and active treatment of the child. Other determinants in mothers were non-Dutch background and unemployment, while lower HRQoL in fathers was predicted by their child's diagnosis type, shorter time since diagnosis, and treatment intensity. CONCLUSION These outcomes illustrate the need for family-centered care. Future interventions aimed at improving parental functioning should take into account gender-specific differences in HRQoL to reach optimal efficacy.
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Affiliation(s)
- Niki Rensen
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lindsay M Steur
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gertjan J Kaspers
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Raphaële R van Litsenburg
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Darling SJ, Hearps SJC, Muscara F, McCarthy M, Nicholson JM, Burke K, Dimovski A, Anderson V. Psychological trajectories of mothers and fathers following their child's diagnosis of a life-threatening illness or injury: A longitudinal investigation. J Clin Psychol 2019; 75:1930-1942. [PMID: 31254362 DOI: 10.1002/jclp.22829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Explore the mental health trajectories of parents following their child's life-threatening illness/injury. METHODS Participants were 217 parents (mean age: 34.9-40.0; 66 fathers) of 165 children who presented to a tertiary hospital with a life-threatening illness/injury. Parents completed questionnaires about their mental health and psychosocial stressors within 4 weeks of the child's illness/injury (T1), and 4 months (T2), 7 months (T3), and 19 months (T4) postdiagnosis. RESULTS For both mothers and fathers, mental health symptoms were elevated at diagnosis declining to normal levels by T3, with a pattern of increase at T4. Fathers demonstrated a faster decline in symptoms between T1 and T2, and fathers, but not mothers, experienced a relapse in depressive symptoms at T4. Fathers reported higher rates of work changes. CONCLUSIONS These findings have important implications for the design and timing of parental interventions to support families of children with life-threatening disease/injury.
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Affiliation(s)
- Simone J Darling
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Stephen J C Hearps
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Frank Muscara
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Maria McCarthy
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Kylie Burke
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, St. Lucia, Queensland, Australia
| | - Anica Dimovski
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Psychology Department, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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Psychosocial Intervention Programs for Parents of Children with Cancer: A Systematic Review and Critical Comparison of Programs’ Models and Development. J Clin Psychol Med Settings 2019; 26:550-574. [DOI: 10.1007/s10880-019-09612-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ogez D, Bourque CJ, Péloquin K, Ribeiro R, Bertout L, Curnier D, Drouin S, Laverdière C, Marcil V, Rondeau É, Sinnett D, Sultan S. Definition and improvement of the concept and tools of a psychosocial intervention program for parents in pediatric oncology: a mixed-methods feasibility study conducted with parents and healthcare professionals. Pilot Feasibility Stud 2019; 5:20. [PMID: 30774970 PMCID: PMC6366012 DOI: 10.1186/s40814-019-0407-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background Studies have shown that supporting parents in pediatric oncology reduces family distress following a cancer diagnosis. Manualized programs for parents have therefore been developed to reduce family distress. However, these programs have limitations that need to be improved, such as better defining programs’ procedures, developing interventions focusing on parents’ conjugal relationship, conducting rigorous evaluations of implementation, and proposing adaptations to various cultural dimensions. According to the Obesity-Related Behavioral Intervention Trials (ORBIT) model for the development of behavioral intervention, we improved these limitations and developed TAKING BACK CONTROL TOGETHER, a six in-person intervention sessions to support parents of children with cancer by taking the active components of two programs: Bright IDEAS and SCCIP. Referring to the redesign phase of the ORBIT model, this study aims to refine the definition of this program’s design by interviewing parents and healthcare professionals. Methods In order to refine the program, we used a sequential mixed-methods study. Parents and healthcare professionals first completed questionnaires assessing the program, and then discussed its limitations, benefits, and areas for improvement in group and/or individual interviews. We performed a descriptive thematic content analysis of the qualitative data from the open-ended questions (questionnaires and interviews) with NVivo 11 to categorize recommendations for the program refinement. Results The results showed that components seemed pertinent to final users. The main areas needing improvement were the level of complexity and understandability of the parent manual, the possibility to choose the place and time of the intervention, and the lack of ethnic/cultural diversity. Changes to the program were made accordingly. Conclusions It is necessary to include end-users when developing complex intervention programs designed for vulnerable populations and sensitive clinical contexts. Following the present refinement, we now have a treatment package, which is safe and acceptable for the target population and has a better chance of yielding a clinically significant benefit for users in a future pilot study.
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Affiliation(s)
- David Ogez
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,2Department of Psychology, Université de Montréal, Québec, Canada
| | - Claude-Julie Bourque
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
| | | | - Rebeca Ribeiro
- 2Department of Psychology, Université de Montréal, Québec, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada
| | - Daniel Curnier
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,4Department of Kinesiology, Université de Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
| | - Valérie Marcil
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,5Department of Nutrition, Université de Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Center, Chaussée de la Côte-Sainte-Catherine, 3175, Montréal, Québec H3T 1C5 Canada.,2Department of Psychology, Université de Montréal, Québec, Canada.,3Department of Pediatrics, Université de Montréal, Québec, Canada
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Vetsch J, McGill BC, Sansom-Daly UM, Hetherington K, Ellis SJ, Marshall KH, Wakefield CE. Comorbidity of distress experienced by parents of childhood cancer survivors points to the importance of understanding transdiagnostic cognitive-affective mechanisms. Acta Oncol 2019; 58:189-190. [PMID: 30264637 DOI: 10.1080/0284186x.2018.1512157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Janine Vetsch
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, Australia
- Sydney Children’s Hospital, Kids Cancer Centre, Randwick, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, Australia
- Sydney Children’s Hospital, Kids Cancer Centre, Randwick, Australia
| | - Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, Australia
- Sydney Children’s Hospital, Kids Cancer Centre, Randwick, Australia
| | - Kate Hetherington
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, Australia
- Sydney Children’s Hospital, Kids Cancer Centre, Randwick, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, Australia
- Sydney Children’s Hospital, Kids Cancer Centre, Randwick, Australia
| | - Kate H. Marshall
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, Australia
| | - Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, Australia
- Sydney Children’s Hospital, Kids Cancer Centre, Randwick, Australia
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Tonorezos ES, Barnea D, Cohn RJ, Cypriano MS, Fresneau BC, Haupt R, Hjorth L, Ishida Y, Kruseova J, Kuehni CE, Kurkure PA, Langer T, Nathan PC, Skeen JE, Skinner R, Tacyildiz N, van den Heuvel-Eibrink MM, Winther JF, Hudson MM, Oeffinger KC. Models of Care for Survivors of Childhood Cancer From Across the Globe: Advancing Survivorship Care in the Next Decade. J Clin Oncol 2018; 36:2223-2230. [PMID: 29874138 DOI: 10.1200/jco.2017.76.5180] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
With improvements in cancer treatment and supportive care, a growing population of survivors of childhood cancer at risk for significant and potentially life-threatening late effects has been identified. To provide a current snapshot of the models of care from countries with varying levels of resources and health care systems, stakeholders in childhood cancer survivorship clinical care and research were identified from 18 countries across five continents. Stakeholders responded to a survey and provided a brief narrative regarding the current state of survivorship care. Findings indicate that among pediatric-age survivors of childhood cancer (allowing for differences in age cutoffs across countries), resources are generally available, and a large proportion of survivors are seen by a physician familiar with late effects in most countries. After survivors transition to adulthood, only a minority are seen by a physician familiar with late effects. Despite the need to improve communication between pediatric oncology and primary care, only a few countries have existing national efforts to educate primary care physicians, although many more reported that educational programs are in development. These data highlight common challenges and potential solutions for the lifelong care of survivors of childhood cancer. Combining risk-based and patient-oriented solutions for this population is likely to benefit both providers and patients.
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Affiliation(s)
- Emily S Tonorezos
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Dana Barnea
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Richard J Cohn
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Monica S Cypriano
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Brice C Fresneau
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Riccardo Haupt
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Lars Hjorth
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Yasushi Ishida
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Jarmila Kruseova
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Claudia E Kuehni
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Purna A Kurkure
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Thorsten Langer
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Paul C Nathan
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Jane E Skeen
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Roderick Skinner
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Nurdan Tacyildiz
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Marry M van den Heuvel-Eibrink
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Jeanette F Winther
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Melissa M Hudson
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
| | - Kevin C Oeffinger
- Emily S. Tonorezos, Memorial Sloan Kettering Cancer Center, New York, NY; Dana Barnea, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Richard J. Cohn, Sydney Children's Hospital, and University of New South Wales Medicine, Sydney, New South Wales, Australia; Monica S. Cypriano, Grupo de Apoio ao Adolescente e Criança com Câncer (GRAACC)/Universidade Federal de São Paulo, São Paulo, Brazil; Brice C. Fresneau, Gustave Roussy, Université Paris-Saclay, Paris-Sud University, Centre for Research in Epidemiology and Population Health (CESP), and L'Institut National de la Santé et de la Recherche Médicale, Villejuif, France; Riccardo Haupt, Istituto Giannina Gaslini, Genoa, Italy; Lars Hjorth, Lund University, Skane University Hospital, Lund, Sweden; Yasushi Ishida, Ehime Prefectural Central Hospital, Matsuyama, Japan; Jarmila Kruseova, Charles University, Prague, Czech Republic; Claudia E. Kuehni, University of Bern, Bern, Switzerland; Purna A. Kurkure, Society for Rehabilitation of Crippled Children (SRCC) Children's Hospital, Indian Cancer Society, and Tata Memorial Hospital, Mumbai, India; Thorsten Langer, University Hospital, Luebeck, Germany; Paul C. Nathan, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada; Jane E. Skeen, Starship Children's Hospital, Auckland, New Zealand; Roderick Skinner, Great North Children's Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, and Newcastle University, Newcastle upon Tyne, United Kingdom; Nurdan Tacyildiz, Ankara University School of Medicine, Ankara, Turkey; Marry M. van den Heuvel-Eibrink, Princess Máxima Center, Utrecht, and Dutch Childhood Oncology Group Long-Term Effects After Childhood Cancer (LATER) Group, The Hague, the Netherlands; Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, and Aarhus University, Aarhus, Denmark; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; and Kevin C. Oeffinger, Duke University, Durham, NC
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Canter KS, Christofferson J, Scialla MA, Kazak AE. Technology-Focused Family Interventions in Pediatric Chronic Illness: A Systematic Review. J Clin Psychol Med Settings 2018; 26:68-87. [DOI: 10.1007/s10880-018-9565-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Peikert ML, Inhestern L, Bergelt C. Psychosocial interventions for rehabilitation and reintegration into daily life of pediatric cancer survivors and their families: A systematic review. PLoS One 2018; 13:e0196151. [PMID: 29672608 PMCID: PMC5908186 DOI: 10.1371/journal.pone.0196151] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/07/2018] [Indexed: 11/18/2022] Open
Abstract
Background The survival rate of childhood cancer patients increased over the past decades. However, even after successful treatment the transition back to normalcy is often a major challenge for the whole family. Therefore, this study aims to provide an overview of psychosocial interventions for childhood cancer survivors and their families in the first years after the end of cancer treatment. Methods We conducted a systematic review following the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO registration number: CRD42017059782). In November 2016 and September 2017, we searched the databases CINAHL, MEDLINE, PSYNDEX, and Web of Science. We included studies investigating psychosocial interventions for childhood cancer survivors diagnosed under the age of 21, their family members or the family as a whole. Further, we summarized the study characteristics and conducted a narrative synthesis of the results. Finally, we assessed the study quality with the Effective Public Health Practice Project Quality Assessment Tool. Results We identified a total of 8215 records based on our database searches and 17 additional records through hand searches. We included 33 articles in the qualitative synthesis. Most of the studies described interventions for the cancer survivor (n = 15). Nine studies investigated interventions for the whole family, and two studies interventions for siblings. The interventions mainly take place in an outpatient group setting (n = 15). Overall, most of the studies reported a significant psychosocial benefit of the interventions. However, the quality of the included studies was limited. Conclusion In summary, we identified a broad range of different interventions and thus could give a comprehensive overview of existing interventions for childhood cancer survivors and their families. However, there is a necessity for high quality studies. The results may help to optimize health care services that support families with the re-entry into daily life.
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Affiliation(s)
- Mona Leandra Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wikman A, Kukkola L, Börjesson H, Cernvall M, Woodford J, Grönqvist H, von Essen L. Development of an Internet-Administered Cognitive Behavior Therapy Program (ENGAGE) for Parents of Children Previously Treated for Cancer: Participatory Action Research Approach. J Med Internet Res 2018; 20:e133. [PMID: 29669710 PMCID: PMC5932329 DOI: 10.2196/jmir.9457] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/05/2018] [Indexed: 12/28/2022] Open
Abstract
Background Parenting a child through cancer is a distressing experience, and a subgroup of parents report negative long-term psychological consequences years after treatment completion. However, there is a lack of evidence-based psychological interventions for parents who experience distress in relation to a child’s cancer disease after end of treatment. Objective One aim of this study was to develop an internet-administered, cognitive behavior therapy–based, psychological, guided, self-help intervention (ENGAGE) for parents of children previously treated for cancer. Another aim was to identify acceptable procedures for future feasibility and efficacy studies testing and evaluating the intervention. Methods Participatory action research methodology was used. The study included face-to-face workshops and related Web-based exercises. A total of 6 parents (4 mothers, 2 fathers) of children previously treated for cancer were involved as parent research partners. Moreover, 2 clinical psychologists were involved as expert research partners. Research partners and research group members worked collaboratively throughout the study. Data were analyzed iteratively using written summaries of the workshops and Web-based exercises parallel to data collection. Results A 10-week, internet-administered, cognitive behavior therapy–based, psychological, guided, self-help intervention (ENGAGE) was developed in collaboration with parent research partners and expert research partners. The content of the intervention, mode and frequency of e-therapist support, and the individualized approach for feedback were modified based on the research partner input. Shared solutions were reached regarding the type and timing of support from an e-therapist (eg, initial video or telephone call, multiple methods of e-therapist contact), duration and timing of intervention (eg, 10 weeks, 30-min assessments), and the removal of unnecessary support functions (eg, removal of chat and forum functions). Preferences for study procedures in future studies testing and evaluating the intervention were discussed; consensus was not reached for all aspects. Conclusions To the best of our knowledge, this study is the first use of a participatory action research approach to develop a psychological intervention for parents of children previously treated for cancer and to identify acceptable study procedures. Involvement of parents with lived experience was vital in the development of a potentially relevant and acceptable intervention for this population.
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Affiliation(s)
- Anna Wikman
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Laura Kukkola
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helene Börjesson
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Martin Cernvall
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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McCullough A, Ruehrdanz A, Jenkins MA, Gilmer MJ, Olson J, Pawar A, Holley L, Sierra-Rivera S, Linder DE, Pichette D, Grossman NJ, Hellman C, Guérin NA, O’Haire ME. Measuring the Effects of an Animal-Assisted Intervention for Pediatric Oncology Patients and Their Parents: A Multisite Randomized Controlled Trial. J Pediatr Oncol Nurs 2017; 35:159-177. [PMID: 29268667 DOI: 10.1177/1043454217748586] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: This multicenter, parallel-group, randomized trial examined the effects of an animal-assisted intervention on the stress, anxiety, and health-related quality of life for children diagnosed with cancer and their parents. Method: Newly diagnosed patients, aged 3 to 17 years (n = 106), were randomized to receive either standard care plus regular visits from a therapy dog (intervention group), or standard care only (control group). Data were collected at set points over 4 months of the child’s treatment. Measures included the State-Trait Anxiety Inventory™, Pediatric Quality of Life Inventory, Pediatric Inventory for Parents, and child blood pressure and heart rate. All instruments were completed by the child and/or his/her parent(s). Results: Children in both groups experienced a significant reduction in state anxiety ( P < .001). Parents in the intervention group showed significantly decreased parenting stress ( P = .008), with no changes in stress among parents in the control group. However, no significant differences between groups over time on any measures were observed. Conclusions: Animal-assisted interventions may provide certain benefits for parents and families during the initial stages of pediatric cancer treatment.
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Affiliation(s)
| | | | | | - Mary Jo Gilmer
- Vanderbilt University School of Nursing, Nashville, TN, USA
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, USA
- Pediatric Palliative Care Research Team, Nashville, TN, USA
| | - Janice Olson
- Randall Children’s Hospital at Legacy Emanuel, Portland, OR, USA
| | - Anjali Pawar
- UC Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | | | | | - Deborah E. Linder
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
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Slater H, Campbell JM, Stinson JN, Burley MM, Briggs AM. End User and Implementer Experiences of mHealth Technologies for Noncommunicable Chronic Disease Management in Young Adults: Systematic Review. J Med Internet Res 2017; 19:e406. [PMID: 29233804 PMCID: PMC5743925 DOI: 10.2196/jmir.8888] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/02/2017] [Accepted: 11/02/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chronic noncommunicable diseases (NCDs) such as asthma, diabetes, cancer, and persistent musculoskeletal pain impose an escalating and unsustainable burden on young people, their families, and society. Exploring how mobile health (mHealth) technologies can support management for young people with NCDs is imperative. OBJECTIVE The aim of this study was to identify, appraise, and synthesize available qualitative evidence on users' experiences of mHealth technologies for NCD management in young people. We explored the perspectives of both end users (young people) and implementers (health policy makers, clinicians, and researchers). METHODS A systematic review and meta-synthesis of qualitative studies. Eligibility criteria included full reports published in peer-reviewed journals from January 2007 to December 2016, searched across databases including EMBASE, MEDLINE (PubMed), Scopus, and PsycINFO. All qualitative studies that evaluated the use of mHealth technologies to support young people (in the age range of 15-24 years) in managing their chronic NCDs were considered. Two independent reviewers identified eligible reports and conducted critical appraisal (based on the Joanna Briggs Institute Qualitative Assessment and Review Instrument: JBI-QARI). Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive emergent themes across the included data. External validity checking was undertaken by an expert clinical researcher and for relevant content, a health policy expert. Themes were subsequently subjected to a meta-synthesis, with findings compared and contrasted between user groups and policy and practice recommendations derived. RESULTS Twelve studies met our inclusion criteria. Among studies of end users (N=7), mHealth technologies supported the management of young people with diabetes, cancer, and asthma. Implementer studies (N=5) covered the management of cognitive and communicative disabilities, asthma, chronic self-harm, and attention deficit hyperactivity disorder. Quality ratings were higher for implementer compared with end user studies. Both complementary and unique user themes emerged. Themes derived for end users of mHealth included (1) Experiences of functionality that supported self-management, (2) Acceptance (technical usability and feasibility), (3) Importance of codesign, and (4) Perceptions of benefit (self-efficacy and empowerment). For implementers, derived themes included (1) Characteristics that supported self-management (functional, technical, and behavior change); (2) Implementation challenges (systems level, service delivery level, and clinical level); (3) Adoption considerations for specific populations (training end users; specific design requirements); and (4) Codesign and tailoring to facilitate uptake and person-centered care. CONCLUSIONS Synthesizing available data revealed both complementary and unique user perspectives on enablers and barriers to designing, developing, and implementing mHealth technologies to support young people's management of their chronic NCDs. TRIAL REGISTRATION PROSPERO CRD42017056317; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD 42017056317 (Archived by WebCite at http://www.webcitation.org/6vZ5UkKLp).
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Affiliation(s)
- Helen Slater
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Jared M Campbell
- Joanna Briggs Institute, Faculty of Health Science, University of Adelaide, Adelaide, Australia
| | - Jennifer N Stinson
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Megan M Burley
- Health Networks, Department of Health, Government of Western Australia, Perth, Australia
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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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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Salem H, Johansen C, Schmiegelow K, Winther JF, Wehner PS, Hasle H, Rosthøj S, Kazak AE, E. Bidstrup P. FAMily-Oriented Support (FAMOS): development and feasibility of a psychosocial intervention for families of childhood cancer survivors. Acta Oncol 2017; 56:367-374. [PMID: 28080169 DOI: 10.1080/0284186x.2016.1269194] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND We developed and tested the feasibility of a manualized psychosocial intervention, FAMily-Oriented Support (FAMOS), a home-based psychosocial intervention for families of childhood cancer survivors. The aim of the intervention is to support families in adopting healthy strategies to cope with the psychological consequences of childhood cancer. The intervention is now being evaluated in a nationwide randomized controlled trial (RCT). METHODS AND DESIGN FAMOS is based on principles of family systems therapy and cognitive behavioral therapy, and is delivered in six sessions at home. Families were recruited from all four pediatric oncology departments in Denmark after the end of intensive cancer treatment. We evaluated the feasibility of the intervention and of a RCT design for comparing the intervention with usual care. The evaluation was conducted among families enrolled in the study by tracking procedures and parents' evaluations. RESULTS A total of 68 families (68 mothers, 60 fathers, 68 children with cancer and 73 siblings) were enrolled, with a participation rate of 62% of families. Fathers were highly represented (88% of families); also families with single parents (12%) and parents with basic education (7-12 years of primary, secondary, and grammar school education) were represented (12%). The dropout rate was 12% of families (all in the control group), and two families did not complete the intervention because of relapse. Evaluation by parents in the intervention group showed overall satisfaction with the format, timing, and content of the intervention. CONCLUSION The results indicate that the FAMOS intervention is feasible in terms of recruitment, retention, and acceptability. The effects of the intervention on post-traumatic stress, depression, anxiety, family functioning, and quality of life will be reported after the nationwide RCT has been completed.
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Affiliation(s)
- Hanin Salem
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christoffer Johansen
- Department of Oncology, Finsen Centre, Rigshospitalet, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- University Hospital Rigshospitalet, Institute of Clinical Medicine, Medical Faculty, University of Copenhagen, Copenhagen, Denmark
| | | | - Peder Skov Wehner
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children’s Hospital, Odense University Hospital, Denmark
| | - Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Steen Rosthøj
- Department of Pediatrics, Aalborg Hospital, Aalborg, Denmark
| | - Anne E. Kazak
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA
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