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Alexander ES, Halkett GKB, Lawrence BJ, O’Connor M. A Conceptual Model Depicting How Children Are Affected by Parental Cancer: A Constructivist Grounded Theory Approach. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1507. [PMID: 37761468 PMCID: PMC10530185 DOI: 10.3390/children10091507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 09/29/2023]
Abstract
Cancer patients' children are vulnerable to psychosocial and behavioural issues. The mechanisms underlying how children are affected by their parent's diagnosis are unknown, warranting further research. This study investigated how children are affected by their parent's cancer diagnosis and provides a theoretical model conceptualising this experience. Informed by methods of grounded theory, embedded within a social constructivist framework, 38 informants (15 health professionals (HPs); 11 parents; 12 children (5 to 17 years)) were interviewed using a semi-structured format. Three themes were identified: (i) children were worried and distressed because they felt alone, (ii) parents were unable to tend to children's needs because they were overwhelmed by practical factors, and (iii) HPs were not detecting children due to barriers that affected their visibility in clinical settings. The proposed Alexander's Children's Cancer Communication (ACCC) Model and clinical recommendations made can be used to guide the clinical practice and development of future intervention research.
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Affiliation(s)
- Elise S. Alexander
- Discipline of Psychology, School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia; (E.S.A.); (B.J.L.)
| | - Georgia K. B. Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Blake J. Lawrence
- Discipline of Psychology, School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia; (E.S.A.); (B.J.L.)
| | - Moira O’Connor
- Discipline of Psychology, School of Population Health/Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia;
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Alexander ES, O’Connor M, Halkett GKB. The Psychosocial Effect of Parental Cancer: Qualitative Interviews with Patients' Dependent Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010171. [PMID: 36670721 PMCID: PMC9857104 DOI: 10.3390/children10010171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/05/2022] [Accepted: 12/16/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent's diagnosis is still developing and patients' children are typically invisible in clinical practice. This study aimed to investigate how children are affected by their parent's cancer diagnosis, from children's perspectives. METHODS Informed by methods of grounded theory and embedded within a social constructivist framework, twelve children (ranging from 5 to 17 years) living with a parent with cancer were interviewed using a semi-structured format assisted by a novel approach derived from play- and art-based developmental literature. RESULTS Findings indicate that patients' children are constantly worried and distressed, and there are barriers that can be overcome to mitigate this. Four overarching themes were identified: (I) Feeling worried and distressed; (II) Comprehending their parent's cancer diagnosis; (III) Being disconnected from their supports; and (IV) Needing someone to talk to. CONCLUSIONS Children experience considerable levels of ongoing worry and distress when a parent is diagnosed with cancer and have difficulties comprehending and articulating this. They also feel a level of disconnection from their usual support systems (e.g., parents) and are limited regarding who they can seek out and talk to. Mitigating children's ongoing worries and distress by promoting the availability and accessibility of parents and other supports to children, and reducing communication barriers between children and adults, should be a primary focus of psycho-oncology research and practice.
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Affiliation(s)
- Elise S. Alexander
- Discipline of Psychology, School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Moira O’Connor
- Discipline of Psychology, School of Population Health/Curtin Health Innovation Research Institute (CHIRI), enABLE Institute, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Georgia K. B. Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
- Correspondence: ; Tel.: +61-8-9266-1762
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Stafford L, Sinclair M, Rauch P, Turner J, Mann GB, Newman L, Wakefield CE, Gilham L, Mason K, Cannell J, Little R, Schofield P. Feasibility of Enhancing Parenting in Cancer, a psychoeducational intervention for communicating with children about parental cancer. Psychooncology 2021; 30:1172-1177. [PMID: 33599354 DOI: 10.1002/pon.5655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle Sinclair
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Paula Rauch
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jane Turner
- Discipline of Psychiatry, Faculty of Medicine, University of Queensland, Herston, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - G Bruce Mann
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.,The Breast Service, The Royal Melbourne and Royal Women's Hospitals, Parkville, Victoria, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Louise Newman
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Leslie Gilham
- Consumer Representative, Breast Cancer Network Australia, Melbourne, Victoria, Australia
| | - Kylie Mason
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and the Royal Melbourne Hospital, Parkville, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julia Cannell
- Consumer Representative, Breast Cancer Network Australia, Melbourne, Victoria, Australia
| | - Ruth Little
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
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Inhestern L, Bultmann JC, Johannsen LM, Beierlein V, Möller B, Romer G, Koch U, Bergelt C. Estimates of Prevalence Rates of Cancer Patients With Children and Well-Being in Affected Children: A Systematic Review on Population-Based Findings. Front Psychiatry 2021; 12:765314. [PMID: 34899425 PMCID: PMC8656299 DOI: 10.3389/fpsyt.2021.765314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
This review assessed population-based estimate rates of cancer patients with minor and young adult children (≤ 25 years), children and young adults having a parent with cancer as well as the psychosocial situation and well-being of children and young adults affected by parental cancer. Eighteen publications on population-based studies were included. Studies varied in the age ranges of both cancer patients and children. The prevalence rates of cancer patients having children ranged from 14 to 24.7% depending on the sample structure (e.g., age, gender). Studies reported that between 1.6 and 8.4% of children resp. young adult children have a parent with a history of cancer. Seven publications reported on the psychosocial situation or well-being in children and young adults affected by parental cancer. Estimate rates of psychosocial problems, psychiatric diagnoses or distress ranged between 2.5 and 34% of children depending on the method of measurement and outcome. The differences in the sample structure between the studies impeded the comparison of prevalence rates. However, the findings help to determine the need for specific support services and health care planning. The results emphazise the importance to routinely include issues on the parental role of patients and questions on the well-being and coping of children into psychooncological care. If necessary, support should be provided to families living with a cancer diagnosis.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Lene Marie Johannsen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Möller
- Department of Social Work, Münster University of Applied Sciences, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Münster, Münster, Germany
| | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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Alexander E, O'Connor M, Halkett GKB. The perceived effect of parental cancer on children still living at home: According to oncology health professionals. Eur J Cancer Care (Engl) 2020; 29:e13321. [PMID: 32902057 DOI: 10.1111/ecc.13321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/26/2020] [Accepted: 08/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE How children are affected by their parent's diagnosis is limited in the literature, and children are typically not considered in current clinical practice. Despite suggestion that the patient's oncology team are well placed to support their children, this is yet to be sufficiently explored. This study aimed to explore how oncology healthcare professionals (HPs) perceive children are affected by a parent's diagnosis of cancer. METHODS This qualitative study was informed by principles of grounded theory and embedded within a social constructivist framework. 15 health professionals working in oncology were interviewed using a semi-structured format. Data were analysed using methods of constant comparison. RESULTS From the perspective of HPs, when a parent is diagnosed with cancer, their dependent children are rendered invisible. Factors within the (a) clinical healthcare system and (b) the families' psychosocial context were identified, which contribute to the invisibility of children. CONCLUSION HPs are well-placed to facilitate an entry point into the healthcare system for patients' children; however, this is not occurring due to children's lack of visibility. Clinical and psychosocial barriers need to be addressed to ensure HPs are visibly aware of all children and thus able to appropriately support, intervene or refer on.
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Affiliation(s)
- Elise Alexander
- Western Australian Cancer Prevention Research Unit (WACPRU), School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Moira O'Connor
- Western Australian Cancer Prevention Research Unit (WACPRU), School of Psychology, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Georgia K B Halkett
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Australia
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